DI 13095: Exhibits for FO CDR Processing
BASIC (10-04)
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
We recently reviewed the evidence in your Social Security disability claim and find that your disability is continuing. Any special situation involving your claim will be indicated by one of more of the blocks checked below. We have also enclosed information about working that explains some of the terms we use.
| 1. | The doctors and other trained staff who decided that you are disabled expect your health to improve. Therefore, we will review your case in. We will send you a letter before we start the review. | |
| 2. | You have worked in some months of the trial work period, but you were unable to continue working. We counted as your trial work months. | |
| 3. | The way we count your trial work months has changed because the law has changed. Under the new law, effective in 1992, only trial work months in a period of 60 months in a row count. You have worked at least month(s) of the 9-month trial work period. We counted as trial work months. | |
| 4. | We have scheduled your claim for review in since it appears your 9th month of trial work will end at that time, according to the information reported to us. | |
| 5. | You have completed your trial work period. We counted as your trial work months. Although you are now working (or have recently worked and stopped), we find that the work you have been doing does not show that you can do substantial work. | |
| 6. | Your claim will be reviewed from time to time to see if you are still eligible for benefits based on disability or blindness. When your claim is reviewed, you will be contacted if there is any question as to whether your eligibility continues. |
If you are receiving Supplemental Security Income payments, any decision about that claim will be sent to you in a separate notice.
Promptly Report Events Which May Affect Your Benefits
You must promptly report any changes that may affect your benefits. Failure to do so could mean you may have to repay any benefits not due. Let us know if:
You returned to work since your last report or you return to work in the future (no matter how little you earn); or
You already reported your work, but your duties or pay changed. (Remember to keep records of your work and earnings such as pay statements from your employer.); or
Your doctor says your condition has improved (even if you do not work now); or
You apply for, start getting, or there is a change in the amount of workers' compensation or another public benefit; or
You start paying for work expenses related to your disability (for example, you may need special transportation) or the amount you pay for these work expenses changes or you no longer pay for such expenses. (Remember to keep records and proof of payment for any work expenses.)
We will use this information to decide if your health problems still meet our rules or if we must change your payment amount.
If You Disagree With The Decision
If you disagree with the decision, you have the right to appeal. We will review your case again and consider 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 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 must have a good reason if you wait more than 60 days to ask for an appeal.
You have to ask for an appeal in writing. We will ask you to sign a form SSA-561-U2, called "Request for Reconsideration." Contact one of our offices if you want help.
Please read the enclosed pamphlet, "Your Right to Question the Decision Made on Your Social Security Claim." It contains more information about the appeal.
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 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.
If You Have Any Questions
We invite you to visit our web site at www.socialsecurity.gov on the Internet to find general information about Social Security. If you have any specific questions, you may call us toll-free at 1-800-772-1213, or call your local office at <<F1>>. 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 any Social Security office. The office that serves your area is located at:
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.
Do you want to work but worry about losing your payments or Medicare before you can support yourself?
If so the following information highlights how going back to work may be easier.
Explanation of Trial Work Period
In most cases, you can work and earn any amount of money for up to 9 months. (The months do not have to be in a row.) During this time, called a trial work period, you can still get your disability payments. The following information shows how we count the 9 months of the trial work period.
If you are an employee, we only count months you:
earn over $(TWP amount) beginning January 20XX(current year), or
earn over $(TWP amount) beginning January 20XX(last year).
If you are self-employed, we only count months you:
earn over $(TWP amount) or work more than 80 hours beginning January 20XX(current year), or
earn over $(TWP amount) or work more than 80 hours beginning January 20XX(last year).
Beginning in January 1992, the trial work period is not over until 9 trial work months are completed in a period of 60 months in a row.
Before 1992, you could only have a trial work period the first time you qualified for disability payments. If you qualified for disability payments a second time, usually you could not have a trial work period. Effective January 1992, you can now have a trial work period each time you qualify for disability payments.
After Your Trial Work Period
After we count your 9 trial work months, your right to monthly payments will still continue if you are disabled and your average earnings are not over:
$(SGA amount) a month beginning January 20XX(current year), or
$(SGA amount) a month beginning January 20XX(last year).
If your average earnings are more than these amounts, we call your work "substantial" and we will stop your monthly payments. (The monthly amounts are higher for Social Security disability benefits due to blindness.)
Extended Period of Eligibility
If we must stop your monthly payments after 9 months of trial work, we may still be able to help you. For 36 months after your trial work period ends, we can pay you for any month that you are disabled and your work is not substantial. To get these benefits, you do not have to apply again. Just let us know how much you are earning.
Continuation of Medicare
You can keep your Medicare for at least 93 months after your trial work period ends. Your hospital insurance will be free, but you will still pay for your medical insurance. Beginning in July 1990, you can keep your Medicare after your free hospital insurance coverage ends. But, you must pay a premium for both parts.