NL: Notices, Letters and Paragraphs
TN 30 (03-96)
Document Identifier for Word Processor: E3215
A. Exhibit Letter
You asked us to review our decision to pay your (1) checks to a representative payee. We have finished this review which we call a reconsideration. We find that our decision to pay your checks to a payee is correct and that having a payee will help you. The rest of this letter will explain what this means to you.
Our Decision About How We Will Pay You
| 3215A | We made our decision based on medical records we have gotten in the last year. These records show that because of your health problems, it is best if someone else manages your benefits for you. |
| 3215B | We made our decision based on facts which show that it is best if someone else manages your benefits for you. |
Someone who did not make the first decision reviewed the facts in your file and made this new decision.
(Optional) |
If You Disagree With the Decision If you disagree with the decision, you have the right to appeal. A person who has not seen your case before will look at it. That person will be an Administrative Law Judge (ALJ). The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing.
Please read the enclosed pamphlet, “Your Right to an Administrative Law Judge Hearing and Appeals Council Review of Your Social Security Case.” It contains more information about the hearing. |
(Optional) |
If You Disagree With the Decision If you disagree with the decision, you have the right to appeal. A person who has not seen your case before will look at it. That person will be an Administrative Law Judge (ALJ). The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing.
Please read the enclosed pamphlet, “Your Right to an Administrative Law Judge Hearing and Appeals Council Review of Your Social Security Case.” It contains more information about the hearing. |
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(Optional) If You Want Help With Your Appeal | |
3100E |
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(Optional) |
If You Disagree With the Decision If you disagree with the decision, you have the right to appeal. A person who has not seen your case before will look at it. That person will be an Administrative Law Judge. In the rest of our letter we will call this person an ALJ. The ALJ will correct mistakes and look at any new facts you have before deciding your case. We call this a hearing. |
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How a Hearing Works
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(Optional) |
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. |
If You Have Any Questions
3901C - Domestic
3901D - Foreign
(2)
B. Requesting Instructions
NOTE: Use only when there is no other issue present.
The reconsideration reviewer is responsible for requesting this notice in SSA and BL cases. The notice should be used in situations where the reconsideration determination affirms a decision to pay benefits to a representative payee rather than to a beneficiary age 18 or over who has not been adjudged legally incompetent. In title XVI cases, the field office requests the letter.
Fill-in:
Social Security, Supplemental Security Income, Black Lung
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“Enclosure: Pub. No. 70-10281 (OHA)-1”/NULL if this is a foreign case.
Select paragraph 3215A when there is a medical statement indicating inability to manage benefit payments
Select paragraph 3215B when the decision was based on other than a medical statement.
Select paragraph 3215C and 3100E for all title II domestic cases.
Select paragraph 3215D and 3215E for title XVI and concurrent cases.
See NL 00703.005E. for 3901C and 3901D text and fill-in. See NL 00703.100 for 3100E text.
C. Typing Instructions
For SSA or BL cases, use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573. Pay close attention to the optional paragraphs requested. For SSI cases use Form SSA-L8455-U2.