NL 00701.267 Form SSA-L800-U2 — Reconsideration — Affirmation of DIB Denial

A. Sample form

B. Purpose/Use

This form notice is used to advise a claimant that the denial of his or her DIB claim was affirmed upon reconsideration.

This notice does not require any fill-ins. Prepare two form notices - one for the claimant and one for the claimant's folder.

NOTE: Personalized disability notice procedures implemented July 1, 1981, require that Forms SSA-4268-U6/C6 be attached to unfavorable disability form notices. In addition to preparing this form notice according to instructions, the typist must:

  1. 1. 

    Type the personalized and technical rationales on the Form SSA-4268-U6 or SSA-4268-C6.

  2. 2. 

    Prepare appropriate rider (or include paragraphs on form notice if there is room).

  3. 3. 

    Assemble form notice, personalized rationale and the rider stapled together in that order, with envelope for mailing.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701267
NL 00701.267 - Form SSA-L800-U2 — Reconsideration — Affirmation of DIB Denial - 03/18/1995
Batch run: 04/14/2014
Rev:03/18/1995