DI 28075: Special CDR Issues
TN 7 (10-15)
Paragraph1 |
1619(a) |
1619(b) |
1619(a) 301 Status |
1619(b) 301 Status |
1619(b) Blind or Visually Impaired |
|---|---|---|---|---|---|
|
Lead In |
4207 |
4207 |
4207 |
4207 |
4207 |
|
Attachment 2 |
4041 |
4041 |
4041 |
4041 |
4041 |
|
Payments End |
4213 |
---- |
4213 |
---- |
---- |
|
Medicaid Ends |
---- |
4229 |
---- |
4229 |
4229 |
|
Information About Medicaid |
4050 |
4217 |
4050 |
4217 |
4217 |
|
Vocational Rehabilitation |
---- |
---- |
4053 |
4227 |
---- |
|
Appeals |
4056 |
4056 |
4057 |
4057 |
4056 |
|
Benefit Continuation |
4061 |
4231 |
4061 |
4231 |
4231 |
|
Disability Hearing |
4066 |
4066 |
4066 |
4066 |
4067 |
|
If You Need Help |
4069 |
4069 |
4069 |
4069 |
4069 |
|
Things to Remember |
4073 |
4073 |
4073 |
4073 |
4077 |
|
DO Referral |
4078 |
4078 |
4078 |
4078 |
4078 |
|
Enclosure |
3 |
3 |
3 |
3 |
3 |
Footnotes:
1 For paragraph language, see NL 00708.100.
2 Delete if personalized explanation is included in the body of the notice.
3 Enclosures:
Explanation of Determination
SSA Pub. No. 05-11008
(NOTE: Delete “Explanation of Determination” if the personalized information is included in the body of the notice.)