TN 1 (06-10)

Dear                 :

We have examined your Social Security earnings record and considered the facts you provided to us. Your record shows that you have not worked long enough under Social Security to be eligible for disability insurance benefits.

The record shows you have at least 120 months of railroad service under the Railroad Retirement Act, or at least 60 months of railroad service after December 31, 1995 under the Railroad Retirements and Survivors' Improvement Act of 2001. You may be eligible for benefits under these programs. You should contact the Railroad Retirement Board (RRB) at  [1]  to determine if you qualify for benefits. If it is not convenient for you to call or write your local RRB office, you may write to the Railroad Retirement Board, Office of Programs - Disability Benefits Division, 844 N Rush Street, Chicago, Illinois 60611. Additional information about Railroad Retirement Board benefits is available on the Internet at
http://www.rrb.gov/default.asp .

If you file a claim for a disability annuity with the Railroad Retirement Board, it will also be considered an application to establish a period of disability under the Social Security Act. When a person meets the minimum creditable railroad service requirements, his/her railroad and Social Security earnings can be combined to establish a period of disability freeze under the Social Security Act. They cannot, however, be combined for the purpose of receiving Social Security disability benefits.

If a period of disability freeze is established, it may help you qualify for retirement insurance benefits under Social Security after age 62. If you are already eligible for retirement benefits, this period of disability freeze may increase the amount of your benefit payments. If you wish to receive a formal determination of your status under the Social Security Act, you should contact our office and file an application for benefits.

SSA also provides benefits under the Supplemental Security Income program to individuals who are disabled, blind or visually impaired, or age 65 or older and have limited income and resources. Please contact our office if you have any questions about SSI and wish to file an application.

We invite you to visit our website at www.socialsecurity.gov on the Internet to find general information about Social Security. However, if you have any specific questions, you can call us at 1-800-772-1213. We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. You can also write or visit your local Social Security office. Our office is located at:

[ 2 ]

If you call or visit our office, please have this letter with you. It will help us answer your questions.

Sincerely yours,
District Manager

Fill-ins:

[1] Local address of servicing RRB FO

[2] Field office address

(This is a modification of the UTI REF001   REFERRAL, DOMESTIC ADDRESS. Field offices could modify it further by adding the local telephone number, etc.)