Effective Dates: 05/09/2023 - Present Previous | Next

TN 97 (05-23)

NL 00703.215 Notice Affirming Selection of Representative Payee on Reconsideration

Document Identifier for Word Processor: E3215

A. Exhibit Letter

You asked us to review our decision to pay your (1) checks to a representative payee. We have finished this review which we call a reconsideration. We find that our decision to pay your checks to a payee is correct and that having a payee will help you. The rest of this letter will explain what this means to you.  

Our Decision About How We Will Pay You

 

 
3215A We made our decision based on medical records we have gotten in the last year. These records show that because of your health problems, it is best if someone else manages your benefits for you.
3215B We made our decision based on facts which show that it is best if someone else manages your benefits for you.

Someone who did not make the first decision reviewed the facts in your file and made this new decision.

 

 

(Optional)

3215CF

If You Disagree With the Decision

If you disagree with the decision, you have the right to appeal. A person who has not seen your case before will look at it. That person will be an Administrative Law Judge (ALJ). The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing.

  • •

    You have 60 days to ask for a hearing.

  • •

    The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it, unless you show us that you did not get it within the 5-day period.

  • •

    You will have to have a good reason for waiting more than 60 days to ask for a hearing.

  • •

    You have to ask for a hearing in writing. We will ask you to sign a Form HA-501-U5, called “Request for Hearing.” Contact one of our offices if you want help.

Please read the enclosed pamphlet, “Your Right to an Administrative Law Judge Hearing and Appeals Council Review of Your Social Security Case.” It contains more information about the hearing.

(Optional)

3215CF

If You Disagree With the Decision

If you disagree with the decision, you have the right to appeal. A person who has not seen your case before will look at it. That person will be an Administrative Law Judge (ALJ). The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing.

  • •

    You have 60 days to ask for a hearing.

  • •

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

  • •

    You will have to have a good reason for waiting more than 60 days to ask for a hearing.

  • •

    You can only have a hearing in the United States. You would have to pay any costs for traveling to the United States for the hearing. If you cannot come to the hearing, the judge will review your case plus any new information you send us. We will send you a letter about the judge's decision.

  • •

    You have to ask for a hearing in writing. Contact us if you want help.

Please read the enclosed pamphlet, “Your Right to an Administrative Law Judge Hearing and Appeals Council Review of Your Social Security Case.” It contains more information about the hearing.

(Optional)

If You Want Help With Your Appeal

3100E

 ​

(Optional)

3215D

If You Disagree With the Decision

If you disagree with the decision, you have the right to appeal. A person who has not seen your case before will look at it. That person will be an Administrative Law Judge. In the rest of our letter we will call this person an ALJ. The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing.

 
  • •

    You have 60 days to ask for a hearing.

  • •

    The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it, unless you show us that you did not get it within the 5-day period.

  • •

    You will have to have a good reason for waiting more than 60 days to ask for a hearing.

  • •

    You have to ask for a hearing in writing. We will ask you to sign a Form HA-501-U5, called “Request for Hearing.” Contact one of our offices if you want help.

 

How a Hearing Works

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    The ALJ will tell you the time and place for the hearing.

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    The ALJ will explain the law in your case. The ALJ will state the known facts and tell you what has to be decided.

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    You can tell the ALJ why you think we are wrong. You can give the ALJ more facts. And you can bring people to say why you are right.

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    The ALJ can make people come to your hearing and bring important papers. You can question these people at the hearing.

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    We will ask if you want to go to the hearing in person. If you say you want to go, you should attend if at all possible. If you change your mind or if you can not get to the hearing you should tell us. You should know that your being there may help the ALJ decide your case.

(Optional)

3215E

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before they can collect it.

If You Have Any Questions

3901C - Domestic

3901D - Foreign

(2)

B. Requesting Instructions

NOTE: Use only when there is no other issue present.

The reconsideration reviewer is responsible for requesting this notice in SSA and BL cases. The notice should be used in situations where the reconsideration determination affirms a decision to pay benefits to a representative payee rather than to a beneficiary age 18 or over who has not been adjudged legally incompetent. In title XVI cases, the field office requests the letter.

Fill-in:

  1. (1) 

    Social Security, Supplemental Security Income, Black Lung

  2. (2) 

    “Enclosure: Pub. No. 70-10281 (OHA)-1”/NULL if this is a foreign case.

    • •

      Select paragraph 3215A when there is a medical statement indicating inability to manage benefit payments

    • •

      Select paragraph 3215B when the decision was based on other than a medical statement.

    • •

      Select paragraph 3215C and 3100E for all title II domestic cases.

    • •

      Select paragraph 3215D and 3215E for title XVI and concurrent cases.

See NL 00703.005E. for 3901C and 3901D text and fill-in. See NL 00703.100 for 3100E text.

C. Typing Instructions

For SSA or BL cases, use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573. Pay close attention to the optional paragraphs requested. For SSI cases use Form SSA-L8455-U2.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703215
NL 00703.215 - Notice Affirming Selection of Representative Payee on Reconsideration - 05/09/2023
Batch run: 05/09/2023
Rev:05/09/2023