GN 03960: Administrative Review of Determinations Under the Fee Agreement Process
TN 3 (03-95)
A. Policy
1. Servicing Office and 800 Number Referral Paragraph
SSA must include the address and local telephone number of the servicing FO as well as 800 number information in all administrative review notices and determinations.
2. Signature Requirement
When a PC has jurisdiction for review, one of the following officials signs the notice of determination:
the Assistant Regional Commissioner for Management and Budget;
the Director of the Office of Central Operations; or
a designee, acting on his/her behalf.
3. Copies Sent to Other Parties
Because of Privacy Act considerations, SSA must not reveal:
the claimant's mailing address when sending a copy of a letter addressed to the claimant, or the claimant's request for administrative review, to a party other than a representative or a decision maker; or
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the auxiliary beneficiary's mailing address when sending a copy of a letter addressed to the beneficiary, or the beneficiary's request for administrative review, to a party other than a representative or a decision maker.
NOTE: Representatives are bound by the regulations not to disclose any information we furnish or disclose about the claim or prospective claim of another person (see 20 CFR 404.1740(d) and 416.1520(d)).
This means the address must be covered before photocopying or completely blocked out before mailing.
B. Procedure
1. Requesting the Letter(s)
Prepare requests for letter(s) as follows:
Make requests on Form SSA-573 (Special Typing Instructions) or SSA-559 (Transmittal Slip for Claims Folders).
Prepare dictated letters patterned after the model letters contained in GN 03960.075 (acknowledgment), GN 03960.080 (interim), and GN 03960.085 (final).
2. Typing the Letter(s)
Prepare letter(s) as follows:
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Paper
Use the Form SSA-L2000-C2 (Universal Notice) or SSA letterhead, showing the return address.
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Enclosure Paragraphs
Place “Enclosure” or “Enclosures” at the left margin on the first page.
If the letter is:
a single page, place “Enclosure(s)” two lines below the title of the signatory; or
more than one page, place “Enclosure(s)” two lines below the text.
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Copies
Handle copies as follows:
Produce an extra copy or copies to send notice to the other party or parties and the FO (in concurrent titles II and XVI or title XVI only claims).
Return a file box copy for review by the employee who requested the letter before placing it in the claim(s) file.
Place a copy of each letter sent in the claim(s) file.
C. References
Instructions on preparing title II exhibit or dictated letters, NL 00703.005, and NL 00601.040 ff.
Instructions on manually preparing title XVI notices when the claimant has an appointed representative, NL 00801.015.