Section |
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Latest Transmittal |
NL 00701.001 |
Usage Chart for RSDI Authorization and General Use Form Notices |
TN 18 02-21 |
NL 00701.003 |
Usage Chart for Form Notices Relating Specifically to Disability Issues |
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NL 00701.007 |
Usage Chart for Benefit Adjustment Form Notices |
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NL 00701.024 |
Form SSA-L51 — Determination of One-Half Support (At Time N/H's Disability Began —
Disapproved)
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TN BASIC 11-81 |
NL 00701.036 |
Form SSA-L223 — Auxiliary Disapproval — N/H Not Entitled |
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NL 00701.060 |
Form SSA-L236 — CDB Disapproval — Not Disabled Before Age 22 |
TN BASIC 11-81 |
NL 00701.063 |
Form SSA-L236A — CDB Disapproval — Not Disabled Through Point of Decision (Not Yet
Age 22)
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TN BASIC 11-81 |
NL 00701.066 |
Form SSA-L237 — DIB Denial — Miscellaneous (Fill-In Letter) |
TN BASIC 11-81 |
NL 00701.069 |
Form SSA-L237B — DIB Denial — Death Before End of 5-Month Waiting Period |
TN BASIC 11-81 |
NL 00701.093 |
Form SSA-L250 — Approval of Withdrawal |
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NL 00701.114 |
Form SSA-L412 — Reconsideration — Initial Interim Notice — Additional Evidence is
Being Obtained
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TN BASIC 11-81 |
NL 00701.116 |
Form SSA-L445-U2 — Notice to Spouse in Separate Household |
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NL 00701.126 |
Form SSA-L467 — Disability Benefit Suspension Notice (Miscellaneous) |
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NL 00701.135 |
SSA-L501 Home Visit Letter |
TN 15 06-10 |
NL 00701.136 |
SSA-L502 Telephone Interview Letter |
TN 15 06-10 |
NL 00701.137 |
SSA-L503 Centenarian Project -- Representative Payee Notice of Interview |
TN 15 06-10 |
NL 00701.138 |
SSA-L504 Centenarian Project -- Nursing Home Notice of Interview |
TN 15 06-10 |
NL 00701.139 |
SSA-L505 Residence Address Request Letter |
TN 15 06-10 |
NL 00701.205 |
SSA-L725, Employer Verification of Monthly Wages |
TN 13 09-06 |
NL 00701.237 |
Form SSA-L761 — Miscellaneous Adjustment Notice |
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NL 00701.255 |
Form SSA-L795-U2 — Reconsideration — Affirmation of DIB or CDB Cessation |
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NL 00701.267 |
Form SSA-L800-U2 — Reconsideration — Affirmation of DIB Denial |
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NL 00701.270 |
Form SSA-L801-U2 — Reconsideration — Affirmation of DWB Cessation |
TN BASIC 11-81 |
NL 00701.354 |
Form SSA-L823 — Auxiliary Denial — N/H Not Entitled |
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NL 00701.360 |
Form SSA-L829-U2-Disapproval -- Miscellaneous Fill-In Letter |
TN BASIC 11-81 |
NL 00701.387 |
Form SSA-L850 — Approval of Request for Withdrawal (Disability) |
TN BASIC 11-81 |
NL 00701.390 |
Form SSA-L917 — Reconsideration — DIB Earnings Requirement Not Met |
TN BASIC 11-81 |
NL 00701.391 |
Form SSA-L928 – Reconsideration -- Affirmation of DIB, DWB, or CDB Denial |
TN 14 09-07 |
NL 00701.425 |
Form SSA-L1013 — DIB Continuance — Title II |
TN 19 09-22 |
NL 00701.430 |
Form SSA-L1014 — DIB Continuance — Title XVI |
TN 20 09-22 |
NL 00701.435 |
Form SSA-L1016 (Formerly SSA-L368) — DIB Cessation (T21) No OPA/UPA — No HI/SMI |
TN BASIC 11-81 |
NL 00701.440 |
Form SSA-L1017 (Formerly SSA-L368A) — DIB Cessation (T21) — No DIB OPA/UPA HI/SMI
Arrearage
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TN BASIC 11-81 |
NL 00701.445 |
Form SSA-L1018 (Formerly SSA-L368B) — DIB Cessation (T21) — No DIB OPA/UPA — SMI Refund |
TN BASIC 11-81 |
NL 00701.450 |
Form SSA-L1019 (Formerly SSA-L368C) — DIB Cessation (T21) — DIB Underpayment — SMI
Premium Arrearage
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TN BASIC 11-81 |
NL 00701.455 |
Form SSA-L1020 (Formerly SSA-L368D) — DIB Cessation (T21) — No DIB OPA/UPA HI/SMI
With No Overage or Arrearage
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TN BASIC 11-81 |
NL 00701.460 |
Form SSA-L1021 (Formerly SSA-L369) — DIB Cessation (T20 and T28) — No DIB OPA/UPA
— No HI/SMI
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TN BASIC 11-81 |
NL 00701.465 |
Form SSA-L1022 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — HI/SMI Premium Arrearage |
TN BASIC 11-81 |
NL 00701.470 |
Form SSA-L1023 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — SMI Premium Refund |
TN BASIC 11-81 |
NL 00701.475 |
Form SSA-L1024 — DIB Cessation (T20 and T28) — DIB Underpayment — SMI Premium Arrearage |
TN BASIC 11-81 |
NL 00701.480 |
Form SSA-L1025 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — HI/SMI With No Premium
Overage or Arrearage
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TN BASIC 11-81 |
NL 00701.485 |
Form SSA-L1026 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — No HI/SMI Auxiliaries
in NH's Household
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TN BASIC 11-81 |
NL 00701.490 |
Form SSA-L1027 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — HI/SMI Premium Arrearage
— Auxiliaries in NH's Household
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TN BASIC 11-81 |
NL 00701.495 |
Form SSA-L1028 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — SMI Refund — Auxiliaries
in NH's Household
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TN BASIC 11-81 |
NL 00701.500 |
Form SSA-L1029 — DIB Cessation (T20 and T28) DIB U/P Premium Arrearage — Auxiliaries
in NH's Household
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TN BASIC 11-81 |
NL 00701.505 |
Form SSA-L1030 — DIB Cessation (T20 and T28) — No DIB OPA/UPA — HI/SMI With No Overage
or Arrearage — Auxiliaries in NH's Household
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TN BASIC 11-81 |
NL 00701.515 |
Form SSA-L1032 — Disability Cessation (T22) — No DIB OPA/UPA — HI/SMI Premium Arrearage |
TN BASIC 11-81 |
NL 00701.520 |
Form SSA-L1033 — Disability Cessation (T22) — No DIB OPA/UPA — SMI Refund |
TN BASIC 11-81 |
NL 00701.525 |
Form SSA-L1034 — Disability Cessation (T22) — DIB Underpayment SMI Arrearage |
TN BASIC 11-81 |
NL 00701.530 |
Form SSA-L1035 — Disability Cessation (T22) — No DIB OPA/UPA — HI/SMI With No Premium
Arrearage or Overage
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TN BASIC 11-81 |
NL 00701.535 |
Form SSA-L1036 — Disability Cessation (T22) — No DIB OPA/UPA — No HI/ SMI — Auxiliaries
in NH's Household
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TN BASIC 11-81 |
NL 00701.540 |
Form SSA-L1037 — Disability Cessation (T22) — No DIB OPA/UPA — HI/SMI Premium Arrearage
— Auxiliaries in NH's Household
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TN BASIC 11-81 |
NL 00701.545 |
Form SSA-L1038 — Disability Cessation (T22) — No DIB OPA/UPA — SMI, Refund — Auxiliaries
in NH's Household
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TN BASIC 11-81 |
NL 00701.550 |
Form SSA-L1039 — Disability Cessation (T22) — DIB Underpayment — SMI Arrearage — Auxiliaries
in NH's Household
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TN BASIC 11-81 |
NL 00701.555 |
Form SSA-L1040 — Disability Cessation (T22) — No DIB OPA/UPA — HI/SMI With No Premium
Overage or Arrearage — Auxiliaries In NH's Household
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TN BASIC 11-81 |
NL 00701.600 |
Form SSA-L1064-C1 — Lump Sum Approval |
TN BASIC 11-81 |
NL 00701.612 |
Form SSA-L1157-U2 — DI Medical Requirements Met — Non Medical Requirements To Be Determined |
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NL 00701.615 |
Form SSA-L1221 — RIB Disapproval — Lack of Insured Status |
TN BASIC 11-81 |
NL 00701.620 |
Form SSA-L1222 — RIB Disapproval — Lack of Insured Status — Date of Birth Not Established |
TN BASIC 11-81 |
NL 00701.625 |
Form SSA-L1223 — RIB Disapproval — Not Retirement Age |
TN BASIC 11-81 |
NL 00701.630 |
Form SSA-L1224 — RIB Disapproval — Not Yet Age 62 |
TN BASIC 11-81 |
NL 00701.740 |
Form SSA-L4967-U2 — Reconsideration — Affirmation of Cessation |
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NL 00701.750 |
Form SSA-L5620 — One Check Only Adjustment — Reconsideration Paragraph Required —
Beneficiary In Conditional Pay or Suspense Status After Action
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