TN 37 (12-21)

NL 00725.008 Notice of Disapproved Claim

 

EXAMPLE 1: NOTICE OF DISAPPROVAL

Social Security Administration

Retirement, Survivors, and Disability Insurance

Notice of Disapproved Claim

                                                                                           Miscellaneous Program Service Center

                                                                                          225 E. Oak Street

                                                                                          Central City, ST 00000

                                                                                          Date:

                                                                                         BNC: 21MS123J45678-A

 

JOHN G. BENEFICIARY

101 MAIN STREET

ANYTOWN, ST 00001

 

We have considered your application and find that you are not entitled to any Social Security benefits.

Why We Cannot Pay You

You do not qualify for retirement benefits now because, based on your correct date of birth was, January 17, 1927, you are not yet age 62.

 

Your Date of Birth

Based on the evidence we have, we have decided that your correct date of birth was January 17, 1927.

 

Do You Think We Are Wrong?

If you think we are wrong, you have the right to appeal. We will correct any mistakes and will look at any new facts you have. A person who did not make the first decision will decide your case.

 

  • You have 60 days to ask for an appeal.

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

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

 

Other Social Security Benefits

 

You are not entitled to any other Social Security benefits based on the application you filed. In the future, if you think you may be entitled to benefits, you will need to apply again.

 

If You have Any Questions

 

If you have any questions, you may call us at 1-800-2345-SSA. We can answer most questions over the phone. You can also write any Social Security office. The office that serves your area is located at:

 

                                                         Street address

                                                         City, State Zip

 

If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment at the office. This will help us serve you more quickly when you arrive at the office.

 

                                                                                            Social Security Administration

 

EXAMPLE 2: NOTICE OF DISALLOWANCE

Social Security Administration

Retirement, Survivors, and Disability Insurance

Notice of Disapproved Claim

 

                                                                                           Mid-Atlantic Program Service Center

                                                                                          300 Spring Garden Street

                                                                                          Philadelphia, Pennsylvania 19123-2992

                                                                                          Date:

                                                                                         BNC: 21MS123J45678-A

JOHN G. BENEFICIARY

101 MAIN STREET

ANYTOWN, ST 00001

We are writing to tell you that you do not qualify for retirement benefits.

 

Why We Cannot Pay You

You did not work long enough under Social Security to receive benefits.

 

Work under Social Security if figured in credits. Please read the enclosed pamphlet, "How You Earn Social Security Credits," which explains how the credits are earned and how many a person needs to receive benefits.

 

To qualify for benefits, you need a total of 40 work credits. You have earned 36 credits, and still need 4 credits more. These figures are based on your date of birth, September 13, 1932.

 

Other Social Security Benefits

You are not entitled to any other Social Security benefits based on the application you filed. In the future, if you think you may be entitled to benefits, you will need to apply again.

 

Enclosure(s):

Pub-05-10058

Pub-05-10072

 

Do You Disagree With The Decision?

If you think we are wrong, you have the right to appeal. We will correct any mistakes and we will look at any new facts you have. A person who did not make the first decision will decide your case.

 

• You have 60 days to ask for an appeal.

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

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

 

Please read the enclosed pamphlet, "Your Right to Question the Decision Made on Your Social Security Claim". It contains more information about the appeal.

 

New Application

You have the right to file a new application at any time, but filing a new application is not the same as appealing this decision. If you disagree with this decision and you file a new application instead of appealing:

• you might lose some benefits, or not qualify for any benefits, and

• we could deny the new application using this decision, if the facts and issues are the same.

• So, if you disagree with this decision, you should file an appeal within 60 days.

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 he or she can collect it. And if you hire a lawyer, we will withhold up to 25 percent of any past due benefits to pay toward the fee.

 

If You Have Any Questions

If you have any questions, you may call us toll-free at 1-800-772-1213, or call your local Social Security office at 1-234-567-8900. We can answer most questions over the phone. You can also write or visit any Social Security office. The office that serves your area is located at:

                                                          DISTRICT OFFICE

3689 OFFUTT ROAD

                                            RANDALLSTOWN, MARYLAND 21133

 

If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly when you arrive at the office.

 

Social Security Administration


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900725008
NL 00725.008 - Notice of Disapproved Claim - 12/14/2021
Batch run: 12/14/2021
Rev:12/14/2021