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  Obtain a signed form SSA-795 from the claimant that states the claimant understands the effect of cancelling their WD request (i.e. they will receive benefits as originally awarded);

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  Send WD cancellation request and SSA-795 (if separate documents) to the servicing Processing Center (PC) using the Paperless Barcode application under document type: WITHDRAW CLM if it is Title II; and,

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  Fax all documents into the electronic folder via the Non-Disability Repository for Evidentiary Documents (NDRed). Once the documents are stored and viewed in the Claims File User Interface (CFUI) (i.e. making sure all forms and documents are clear and legible), destroy the paper copies.

If the request meets the requirements for cancellation:

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  Process the cancellation request and forward the action to the benefit authorizer (BA) or Benefits Technical Examiner (BTE) to reestablish payment for each applicable beneficiary on the record via the Manual Adjustment Credit and Award Data Entry (MACADE);

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  Reissue any repaid benefits to the requester and to all beneficiaries whose prior entitlement was nullified by the WD;

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  If an underpayment exists after WD cancellation, notify the claimant of the amount we are returning because of the WD cancellation. Include the appropriate paragraph in the notice of cancellation (e.g., paragraph WDW017 found in NL 00720.405), and

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  Send all appropriate notices per GN 00206.145.

NOTE: If the claimant cancels the WD, it will not count toward the once per lifetime limit.