TN 20 (09-90)

DI 28055.045 Model Language: Impairment Severity Continuance Notice - Exhibit

We are writing to you about your benefits under the Social Security Disability program.

“You previously received a notice that you completed 9 trial work period service months. You were told of special provisions of the law available to you if you continued to have a disabling impairment. The medical evidence in your case shows that your condition continues to be disabling within the meaning of the law. Therefore, your status as a Social Security beneficiary is unchanged.

You must, however, report promptly any changes which may affect your benefit or payment status. Let us know if:

1. a. 

   You start working or you are currently working and your work activity stops.

2. b. 

   You previously reported your work but your duties or pay have changed.

3. c. 

   Your doctor says your condition has improved.

4. d. 

   You start receiving workers' compensation or the amount you currently receive changes.

5. e. 

   You start to pay for work expenses related to your disability or the amount you pay for work expenses related to your disability changes.

This information will be used to decide if you still meet the requirements for continued eligibility under the special provisions of the Social Security Act.

Contact any Social Security office if you have a question, want more information about your claim,or need to report a change. Most matters can be handled by phone.”