We are writing to tell you that we plan to reduce ___(1)___

Special Veterans Benefits (SVB) to $___(2)___ beginning ___(3)___ . Our records show ___(4)___ due this reduced rate effective ___(5)___ because ___(6)___ receiving other benefit income in the amount(s) of $___(7)___ in ___(8)___ .

 

[Optional Paragraph-Delayed Reduction]

This determination replaces all previous determinations for the above periods.

We will send you another letter explaining more about the payment(s) you already received for ___(1)___.

If You Disagree With The Decision

If you disagree with our decision, you have the right to appeal. A person who did not make the first decision will decide your case. We will review those parts of the decision with which you disagree and will look at any new facts you have. We may also review those parts with which you agree and may make them unfavorable or less favorable to you.

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  You have 60 days to ask for an appeal.

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  You must put the request for an appeal in writing.

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  The 60 days start the day after you receive this letter.

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  You must have a good reason if you wait more than 60 days to ask for an appeal.

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  You may make your request through any U.S. Social Security office, United States Embassy or consulate, or the U.S. Veterans Affairs Regional Office in Manila. Or, you may write to us at the address shown at the top of this letter.

Please read the enclosed leaflet, “Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about an appeal.

Appeal In 10 Days to Keep Getting the Benefit Amount

If you appeal within 10 days, you will continue to get the same benefit amount until we decide your case.

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  The 10 days start the day after you get this letter.

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  If you lose your appeal, you may have to pay back some or all of this money.

However, even if you appeal in 10 days, we may reduce the payment amount as shown on page 1 if both of the following are true:

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  our new decision is the same as the one appealed, and

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  we send or give you a letter with our new decision in time to reduce your payments.

How To Appeal

There are three ways to appeal. You can choose the one you want. However, conferences (choices two and three below) are only held in the United States, District of Columbia, and the Northern Mariana Islands. We will not pay for travel to these places from outside the United States.

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  Case Review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

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  Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

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  Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Have Questions or Need Help

If you have questions, you should contact one of the offices shown below. You may also write to us at the address shown at the top of this letter. However, if you call or visit an office, please have this letter with you.

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  If you live in Canada, contact any U.S. Social Security office.

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  If you live in Guam, Puerto Rico, American Samoa or the U.S. Virgin Islands, you should contact the nearest U.S. Social Security office.

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  If you live in Mexico, contact any U.S. Social Security office or the nearest United States Embassy or consulate.

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  If you live in the Philippines, please call 523-1001 extension 2516 or 2645 from 8:00am to 2:00p.m. or write/visit SSA Division, U.S. Department of Veteran's Affairs, American Embassy, 1131 Roxas Boulevard, 0930 Manila.

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  If you live in any other country, you should contact the nearest United States Embassy or consulate.

Fill-ins:

1. (1) 

   (your) or ([Veteran's Name]), possessive

2. (2) 

   ([$$$.¢¢])--reduced monthly payment amount

3. (3) 

   ([MM/YY])—month and year payment reduction begins

4. (4) 

   (you are) or ([Veteran's Name] is)

5. (5) 

   ([MM/YY])—effective date of reduced payment amount

6. (6) 

   (you are) or ([Veteran's Name] is)

7. (7) 

   ([$$$.¢¢])--amount of other benefit income, e.g., SSA benefits

8. (8) 

   ([source of other benefit income])

Optional Paragraph—Delayed Reduction Fill-In:

1. (1) 

   ([MM/YY]) or ([MM/YY through MM/YY])—month(s) and year(s) for which unreduced payment(s) sent

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  The CPS is responsible for sending this notice.

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  If the monthly SVB benefit reduction has been delayed, request the optional Delayed Reduction paragraph.

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  Enclose SSA Pub. 05-10058, “Your Right to Question the Decision Made on Your Social Security Claim.”

  NOTE: If veteran has more than one source of other benefit income, use fill-ins (7) and (8) to expand sentence to include additional benefit income amount and source. For example: Your SVB of $384 has been reduced to $84 because you are receiving other benefit income in the amount of $250 in Social Security benefits, and $50 in Veterans benefits from the Philippines Government.