NL 00708.005: Usage Chart for Numbered Paragraphs

changes
←	*	→

~~Effective Dates: 10/30/2014 - Present~~
Effective Dates: 11/22/2017 - Present
NL 00708.005 Usage Chart for Numbered Paragraphs
A. Claims Paragraphs
* AGE
* DEPENDENCY REQUIREMENTS
* RELATIONSHIP
* WAGES, SELF-EMPLOYMENT, MILITARY SERVICE AND RAILROAD EMPLOYMENT
* DIB APPLICATION FILED AFTER DEATH OF NUMBER HOLDER
* CHILDHOOD DISABILITY
* DIB NOT DISABLED
* RIB/DIB (RIB or DIB)
* DWB WIDOW(ER)
* LUMP-SUM DISALLOWANCES
B. Failure to Meet Earnings (or Prescribed Period) Requirement
Paragraph
Fill-ins
~~Special Age 72 Payments—N/H Not Insured~~
~~277B~~
3
DIB-NH Deceased and Not Insured at Alleged Onset or Later
318
2
General Description of Earnings Requirement
320.1
None
Description of 6/12 Test—Disability Before Age 24
320.2
None
Description of Earnings Requirement—Disability Between the Ages 24-31
320.3
None
Description of Earnings Requirement—Disability at Age 31 or Later—Not Due to Statutory Blindness
320.4
None
Description of Fully Insured Test—Disability Due to Statutory Blindness
320.5
None
DWB—Explanation of the Disability Requirement and the Prescribed Period
320.6
None
DIB Denial—Earnings Requirement Not Met—No QC at Any Time
322.2
None
DIB Denial—AOD Before Age 24—6/12 Test Not Met in AQD or Later
322.3
2
DIB Denial—AOD Between Ages 24-31—Earnings Requirement Not Met in AOD or Later
322.4
2
DIB Denial—AOD at Early Age—Earnings Requirement Not Met
322.6
None
DIB Denial—Earnings Requirement Not Met in AOD (AOD 1973 or Later) Disability Due to Statutory Blindness
322.7
2
DWB Denial—Disabled When Alleged or Onset Established Later Than Alleged—Prescribed Period Requirement Not Met
323.1
2
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disabled Before Age 24—6/12 Test Not Met
323.2
3
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disabled Between Ages 24-31—Earnings Requirement Not Met
323.3
2
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disabled Age 31 or Later—Earnings Requirement Not Met—Disability Not Due to Statutory Blindness
323.4
4
DIB Denial—Disabled in Quarter Alleged or Onset Established Later Than Alleged—Disability Due to Statutory Blindness—Earnings Requirement Not Met—EOD 1/73 or Later
323.5
3
DIB—Not Disabled Before Insured Status Expired
324(A)
1
C. Work and Earnings Deduction
Paragraph
Fill-ins
Suspension of Payment to Child(ren)—W/E Employed
600
None
Auxiliary Beneficiary Suspended Because “A” Worked
608 R
2
Work Deduction for the Month Immediately Preceding the Current Month
609
1
Overpayment-Credit Months Involved
633
9
Penalty Determination—Good Cause Not Found—Current Payment Status—Explanation of Late Filing Not Furnished
635(A) R
1
Penalty Determination—Good Cause Not Found—Current Payment Status—Explanation of Late Filing Furnished
635(B) R
1
Penalty Determination—Good Cause Not Found—Conditional Benefit Status—Explanation of Late Filing Not Furnished
636(A) R
1
Penalty Determination—Good Cause Not Found—Conditional Benefit Status—Explanation of Late Filing Furnished
636(B) R
1
Late Filing of Report—Beneficiary Not Previously Notified of Good Cause and Penalty—Foreign Work Deduction
660 R
2
To Working Beneficiary—Temporary Deductions—Deferred Resumption Based on Age 70
683
3
“A” Receiving “B” or “B1” Benefit in Combined Check—“B” or “B1” Benefits Suspended Because Spouse is Working
686
1
To Working Beneficiary—Yearly Earnings Assumed
721 R
2
To Working Beneficiary—Work Month Assumed
722 R
3
Reminded to File an Annual Report
778 R
1
Payment Based on Age 70 Attainment
779 R
None
D. Awards
Paragraph
Fill-ins
Proceeds of Check for Month of Death or Later and Overpayment Accrued Prior to Death Withheld From Lump Sum
59(B)
4
To Applicant—Part of Lump Sum Authorized to be Paid to Funeral Home, Part Paid to Applicant
67
1
Primary Benefits Based on Transitionally Insured Status
73
1
Underpayment Award in Addition to Other Award (Benefit to Wife Included With Payment)
407(A)
None
Increase in Rate—Benefits Payable at Both Rates
430
2
Decrease in Rate—Benefits Payable at Both Rates
432
2
Check to Deceased Beneficiary Outstanding—Amount Withheld From Lump Sum and /or Underpayment Award (Modify Where More Than One Check)
685 R
5
Lump Sum Payment Widow—Lump Sum Death Payment Being Made as a PMA Check While the Initial “D” Award Will be Made as a CMA Payment
687
1
Combined “AB” Check for Month of Death Negotiated by Surviving Spouse Under “Superendorsement” Process
691
None
Lead-In Paragraph for Award Notices
950
1
Former Representative Payee Notified Student Benefits Will be Paid Directly to Student
958 R
None
E. Suspension/Offset
Paragraph
Fill-ins
To Former Wife—No Child in Her Care—Payment Suspended
18(a)
None
Currently Suspended With Some Benefits Payable
44
1
Wife Under 62 and Widow Under 60 With Payee—Child No Longer Entitled
52(C)
2
SSI Offset overpayment—Offset Period is Same as Retroactive (PMS) Period
80
4
SSI Offset Overpayment—Offset Period Less Than Retroactive (PMA) Period
81
5
Additional Information Regarding the Student's Benefits
733 R
None
F. Reinstatement
Paragraph
Fill-ins
Completion of Form SSA-21 (or SSA-22-F4) by Beneficiary (or Payee of Beneficiary) Who Has Moved to Foreign Country
684
None
G. Adjustment
Paragraph
Fill-ins
E or D Conversion Affecting Other Survivors
10
None
Benefits Now Payable With Some Months Suspended
44(A)
3
Previous Action Revised Upon Reconsideration (For Residents Other Than U.S., Guam, American Samoa, Philippines, Canada, Mexico, Western Samoa and British Virgin Islands)
136(D) F
None
Previous Action Revised Upon Reconsideration After Implied Request (For Residents Other Than U.S., Guam, American Samoa, Philippines, Canada, Mexico, Western Samoa and British Virgin Islands)
136(E) F
None
Program Service Center Reconsiders Case Remanded Prior to a Hearing
137
None
Hearing Paragraph for Reconsidered Disability Cases Hearing Paragraph Used in Reconsideration Notice
140
None
Where Claim is Denied on the Basis of Res Judicata
140(A)
None
Increase in Rate—Benefits Payable at Both Rates
430
2
Decrease in Rate—Benefits Payable at Both Rates
432
2
Change in Benefit Rate
439
None
Change in Benefit Rate—Increase or Decrease in Benefits for Retroactive Period
439(A) R
None
Beneficiary's Benefit Rate Adjusted Due to Termination of Benefits to Another Beneficiary
440
3
Change in One Beneficiary's Rate—Wage Earner's and Spouse's Benefits Combined
441 R
None
Form SSA-L562 Change in Rate Reasons
462(A-M)
1
Waiver of Deduction Overpayment—Auxiliary Beneficiaries
624
1
Overpayment—30 Day Adjustment Paragraph
651 R
None
Student Entitled—Family Maximum Case—No Adjustment Required
652
1
Late Filing of Report—Beneficiary Not Previously Notified of Good Cause and Penalty—No Child-in-Care Deduction
656A R
2
Auxiliary Beneficiary Living With W/E Also Overpaid—Request for Refund (to be added to W/E's Notice)
662
3
Auxiliary Beneficiary Living With W/E Also Overpaid—Adjustment Possible (to be added to W/E's Notice)
663
7
Combined Check—Check for Month Subsequent to Month of Death Adjusted Against Current Benefits
676
2
H. Terminations
Paragraph
Fill-ins
To Former Wife—Child No Longer Entitled
16(A)
None
Wife Under 62 and Widow Under 60 (50 if Disabled)With Payee—Child No Longer Entitled
52(C)
2
Child Receiving Direct Payment—Age 18—Terminated
61(A)
1
Child Paid By Employer While Attending School
209(A)
None
School Does Not Qualify as an Educational Institution
209(B)
1
Disability Ceases—Payments Terminate
412
Varies
Title II—VR Continued Payments—Termination Paragraph
413
2
Title XVI—VR Continued Payments—Termination Paragraph
414
2
Title II—VR Cessation-Auxiliaries in Separate Households—VR Payments Terminate
415
1
Title II—VR Cessation—Auxiliaries in the Same Household—VR Payments Terminate
417
3
Spouse (B1) (B2), Age 62 When Last Child Terminated
671
None
I. Appellate Process and Attorney Fees
Paragraph
Fill-ins
Court Order Provides for Payment of Attorney Fees
145
2
Notice to Auxiliary Living Apart that Court Order Does Not Provide for Payment of Attorney Fee
146.2
4
Direct Payment of Attorney's Fee at the Time Award is Made to Claimant
147
1
Combined Notice Where Direct Payment of Attorney Fee is Made at the Time Award is Made to Claimant
147.1
1
Separate Notice to Auxiliary Where Attorney Fee Has Not Yet Been Authorized
148.2
1
Title II Offset Cases When a Fee for Representation is Involved (Offset Adjustment Notice)
970
4
Authorized Check Equals Amount of Past-Due Benefits Withheld
980
None
Authorized Check is Less Than Amount of Past-Due Benefits Withheld
980.1
1
Authorized OHA Fee Equals Amount of Past-Due Benefits Withheld
980.4
1
Authorized OHA Fee is Less Than Amount of Past-Due Benefits Withheld
980.5
2
Authorized OHA Fee Exceeds Amount of Past-Due Benefits Withheld
980.6
2
Fee Waiver or Statement That No Fee Will be Charged
981.1
None
Waiver of Right to Direct Payment
981.2
None
Future Month of Entitlement Case—No Past-Due Benefits Available
981.3
None
Fee Petition Incomplete After District Office Contact
982
None
Representative is Not an Attorney
983
None
Fee Waiver (or Statement That No Fee Will Be Charged) Received After Past-Due Benefits Have Been Withheld
985
2
Prior Payment to Attorney—Additional Benefits Available
986
4
Questionable Attorney-Client Relationship
987
1
J. Medicare
Paragraph
Fill-ins
SMIB Termination Reversal Paragraphs—Computer Generated if Effective Month of Buy-in Precedes Termination Month Shown as “MT” Factor in Item 7 of SSA-101
6K
None
Disallowance of Claim for Hospital Insurance—Not Full Retirement Age
265
1
Disallowance of Claim for Hospital and Medical Insurance Coverage—Not 65—Applicant Filed Under Deemed Insured Provision
266
1
Medical Insurance Beneficiary (“M” BIC) Potential Entitlement as Spouse of Premium Payer
267
1
Covered or Potentially Covered Under the Federal Employees Health Benefits Act of 1959—Deemed Insured
272
None
Applied Before Beginning of Initial Enrollment Period
274
None
Not a Resident of One of the 50 States or the District of Columbia
278
1
Special QC's Requirement for Entitlement to HI Under Deemed Insured Provisions—Full Retirement Age In or After 1968
284
2
Chronic Renal Disease Disallowance—Opening Paragraphs
290
1
Disability Established—Health Insurance Coverage Date Begins More Than 2 Months After the Current Operating Month, HI/SMI Begins in Same Month
295
1
Medicare Termination—Revised Date of Entitlement
297
1
to Disability Benefits
297
1
Lead-in Paragraph—Medical Premiums Due
368
2
Suspension of Benefits or Payment Deferred Beyond Current Year—Combined Payments—A and B Beneficiaries Enrolled Under SMI (A Worked)
703R
None
Deferred Payment Action—To Recover Overpayment Liable for Premiums
704
None
Deferred Payment Action—To Recover Overpayment Redeferred for Premiums Due
705
None
One-Check-Only Followed by a Suspension-Combined Check Situation (A Worked)—Both A and B Enrolled in SMI
707
1
One-Check—Only Followed by a Deferred Payment Action in Current Year
708
1
To Secondary Beneficiary-Monthly Benefit Payable Less Than $1
709
5
To Secondary Beneficiary—Monthly Benefit Payable is Same as Premium
710
2
To Secondary Beneficiary—Monthly Benefit Payable is Less Than Premium
711
6
Representative Payee for HI and/or SMI Enrollee
716
3
Termination of Monthly Benefits and HI With SMI Entitlement Transferred to New Account
718
None
Explanation of Medicare Premiums and Deductions Under Public Law (P.L.) 97-248, Sec. 278
719
None
~~No Longer Entitled to SSI—Special Age 72 Payments Resumed~~
~~725~~
1
~~Beneficiary Now Resident of U.S.—Special Age 72 Payments Resumed~~
~~726~~
2
~~Governmental Pension Less Than Special Age 72 Payment~~
~~727~~
2
Discontinuance of State Buy—In Due to Non-Payment of SSI
728
None
Continuance of State Buy-In When SSI Payments Stopped
729
None
DIB Terminates—HI/SMI Coverage Terminates—No Refunds on Remittance Due
741
1
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists—No DIB Overpayment or Underpayment
742
4
DIB Terminates From Suspense—DIB Underpayment HI/SMI Premiums for Month Following Month of Notice to be Deducted From DIB Underpayment—Beneficiary Not Billed for SMI Premiums (to be used in conjunction with paragraph No. 741)
743
3
DIB Terminates From Suspense—DIB Underpayment for Months—HI/SMI Premiums for Month Following Month of Notice to be Deducted From DIB Underpayment—Beneficiary Not Billed for SMI Premiums
743(A)
4
DIB Terminates From Suspense—No DIB Overpayments or Underpayments Beneficiary Billed for SMI Premiums—Premium Arrearage Exists (to be used in conjunction with paragraph No. 741)
744
4
DIB Terminates From Suspense—DIB Underpayment—Beneficiary Billed for SMI Premium—Premium Arrearage Exists Which Will be Deducted From the Next Check (to be used in conjunction with paragraph No. 741)
745
4
DIB Terminates From Suspense—DIB Underpayment for Multiple Months—Beneficiary Billed for SMI Premiums—Premium Arrearage Exists Which Will be Deducted From the Next Check
745(A)
5
DIB Terminates—HI Coverage Terminates—No SMI Coverage
746
1
SMI Refund Paragraph (to be used in conjunction with paragraph No. 741 when excess premiums will be refunded by SOBER)
747
None
Medicare Ineligibility Paragraph (to be used when beneficiary's DOST and DOCA are prior to the date of entitlement to HI/SMI. It is also to be used when a Future Cessation Date (FCD) equal to or earlier than the date of entitlement to HI/SMI is being established.)
748
None
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists Along With DIB Overpayment
749
3
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists for One Month Along With DIB Overpayment
749(A)
3
DIB Terminates—HI/SMI Coverage Terminates—Premium Arrearage Exists for Prior Months Along With DIB Overpayments
749(B)
4
DIB Terminated From Suspense—DIB Overpayment Exists—Beneficiary Billed for SMI Premiums—Premium Arrearage Exists (to be used in conjunction with paragraph No. 741)
750
3
DIB Terminated-Excess SMI Premiums Used to Reduce Overpayment
751
4
DIB Terminated From Suspense—DIB Underpayment for One Month—Excess Premiums to be Refunded by SOBER
752
6
DIB Terminated From Suspense—DIB Underpayment for Multiple Months—Excess Premiums to be Refunded by SOBER
752(A)
7
HI and SMI Coverage for RD Beneficiaries (Dialysis)
790
None
Closed Period—Entitlement/Termination (Dialysis)
791
3
HI/SMI Termination Due to RD Cessation (Dialysis)
792
2
Equitable Relief—RD Termination Cases—DOTH is Earlier Than DOTS—Beneficiary Not Notified Timely (Dialysis)
793
4
HI and SMI Coverage for RD Beneficiaries (Transplant)
794
2
HI/SMI Termination Due to RD Cessation (Transplant)
795
2
Equitable Relief-RD Termination Cases—DOTH is Earlier Than DOTS—Beneficiary Not Notified Timely (Transplant)
796
4
NH—Capacity for SGA
850
1
NH—Impairment Not Severe—Medical Consideration Alone
851
None
NH—Impairment Not Severe—Medical Consideration Alone (Date ER Last Met)
852
1
NH or Disabled Child—Impairment Not Expected to Last 12 Months
853
None
NH or Disabled Child—Impairment Did Not Last 12 Months
854
None
Disabled Child—Impairment Not Severe—Medical Consideration Alone or Condition Disabling But Did Not Exist Before Age 22 (Over Age 22)
855
None
Disabled Child—Impairment Not Severe—Medical Consideration Alone or Condition Disabling But Did Not Exist Before Age 22 (Under Age 22)
856
None
Disabled Child—Capacity for SGA—Vocational Consideration (Over Age 22)
857
None
Disabled Child—Capacity for SGA—Vocational Consideration (Under Age 22)
858
None
NH—Not Disabled Before Insured Status Expired
859
2
NH—Not Insured at Alleged Onset Or Later
860
None
Disabled Widow(er)'s Prescribed Period Expired Before Alleged Onset
861
2
NH—Explanation of Disability Requirement
862
None
Disabled Widow(ers)—Explanation of the Disability Requirement and the Prescribed Period
863
None
Expiration of Widow(er)'s Prescribed Period
864
2
Childhood Disability—Law Paragraph—Claimant Age 22 or Over
865
None
Childhood Disability—Law Paragraph—Claimant Not Yet Age 22
866
None
Widow(ers), Mother, Father or Surviving Divorced Spouse Entitled to Survivors Benefits—Claim Filed for Medicare Coverage—Explanation of Disability Requirement for Medicare Coverage
867
None
Widow(ers) Not Disabled—Lack of Severity
868
None
Widow(ers)—Not Disabled at Any Time Prescribed Period Requirement Met For Deemed Entitlement to Medicare Coverage
869
1
NH—Disabled Widow(ers) or Child—Applicant Does Not Want to Continue Development of Claim
870
None
NH—Disabled Widow(ers) or Child—Failure to Follow Prescribed Treatment
872
None
Widow(ers) Not Disabled—Impairment is Severe at Time of Adjudication But Not Expected to Last 12 Months
874
None
Widow(ers) Not Disabled—Impairment No Longer Severe At Time of Adjudication and Did Not Last 12 Months
875
None
NH—Disabled Widow(ers) or Child—Insufficient Evidence Furnished
876
None
NH—Disabled Widow(ers) or Child Fails or Refuses to Submit to Medical Examination
877
None
NH or Widow(er) Has Demonstrated Ability to Engage in SGA Despite Condition
881
None
NH Demonstrated Ability to Engage in SGA Despite Impairment Within 29 Months Before Attaining Full Retirement Age
883
None
NH—Claim Filed After Death—Not Disabled at Any Time Earnings Requirement Met
884
4
NH—Claim Filed After Death—Not Disabled—Lack of Severity
885
3
NH—Claim Filed After Death—Not Disabled—Impairment is Severe At Time of Death But Would Not Have Been Expected to Last 12 Months
886
2
NH—Claim Filed After Death—Not Disabled—Impairment No Longer Severe At Time of Death and Did Not Last 12 Months
887
3
NH—Claim Filed After Death—Insufficient Evidence
888
1
NH—Claim Filed After Death—Denial—Applicant Does
889
2
Not Want To Continue Development of Claim NH—Claim Filed After Death—Denial—Impairment Was Severe But Claimant Failed to Follow Prescribed Treatment
890
4
NH—Claim Filed After Death—Not Disabled At Any Time Earnings Requirement Met—Medical Consideration Alone
891
4
NH—Claim Filed After Death—Not Disabled—Lack of Severity—Medical Consideration Alone
892
2
DIB or CDB Medical Cessation
893
2
DIB or CDB Cessation—Work Activity (No Trial Work Period)
894
2
DIB or CDB Cessation—Whereabouts Unknown or Failure to Cooperate—Required Information Not Submitted
895
2
DIB or CDB Cessation—Whereabouts Unknown or Failure to Cooperate—Requested Medical Examination Not Taken
896
2
Disability Ends Prior to Beginning of Medicare Coverage
897
None
Disability Ends After Medicare Coverage Begins
898
None
CDB Reentitlement Notice
899
1
Medicare Coverage Termination
901
1
DWB Cessation—Medical Evidence Indicates Ability to Perform SGA
902
2
Medicare Termination—Disability Ends Prior to Medicare Coverage
903
None
Medicare Termination—Disability Ends After Medicare Coverage Begins
904
1
State Agency and M.D. Participation in Decision
914
None
Prior Freeze Not Affected by Current Denial
916
None
Periodic Review Scheduled
917
None
Lead-In Language for Closed Period and Later Onset Date Allowances
918
None
Disability Requirement and 7-Year Period Attachment
919
None
Disability and Earnings Requirement Attachment
920
None
Dual Entitlement—Subsequent Award—Medicare Awarded Previously and Will Continue on First Account
940
None
K. Extended Period of Eligibility
Paragraph
Fill-ins
EPE Case—Cessation—9 Months of Trial Work Complete Beneficiary Performing SGA
905
3
EPE Case—Explanation of 15-Month Reinstatement Period
906
None
EPE Case—Impairment-Related Work Expenses Not Allowed As Claimed
907
None
EPE Case—Impairment-Related Work Expenses Insufficient to Reduce Earnings Below SGA
908
None
EPE Case—9 Months of Trial Work Complete—Medical Review—Disability Continues
909
None
EPE Case—9 Months of Trial Work Complete—Medical Review—Disability Ceases
910
1
EPE Case—Medicare Has Begun Prior to End of TWP
911
None
EPE Case—If 24th Month of Entitlement Has Not Been Reached Prior to End of TWP
912
1
Expiration of Disability Insured Status
913
2
L. General Miscellaneous
Paragraph
Fill-ins
Change of Payee—Former Representative Payee An Individual
35R
1
Change of Payee—Former Representative Payee an Agency or Institution
35(A) R
1
Applicant Not Entitled to Underpayment—Not on Priority List
50(D)
2
Applicant Not Entitled to Underpayment—Another Individual Higher in the Order of Priority Who is Eligible to Receive Underpayment
50(E)
3
No Underpayment Exists—Request for Payment Denied
50(F)
None
U.S. Federal Income Tax Withheld from Underpayment Paid to Nonresident Alien
51
2
Award Amended to Exclude Disability Period
70
None
Exclusion of Disability Period Does Not Increase Benefit
71
None
Primary Benefits Based on Transitionally Insured Status
73
1
Address Paragraph for ALJ, ODO, PSC, OHA
160
1
Fee Petition Paragraph for Court Cases
161
None
Applicant Not Entitled to Monthly Benefits—Worker Not Fully Insured
201
2
To Husband or Widower—W/E or S/E Person Not Fully and Currently Insured
202
2
Spouse Not Yet 62 and No Child in Care Age 16 or Under or Disabled
205(B)R
None
Child 18 or Over Not Disabled or a Full-Time Student
209
1
Child Paid by Employer While Attending School
209(A)
None
School Does Not Qualify As an Educational Institution
209(B)
1
Widow/Widower Under 60—No Child “In-Care” —Child Entitled to Benefits
212
1
If the Widow/Widower May Become Entitled to Benefits at Age 60, Add the Following
212(A)
1
Surviving Divorced Spouse Not Entitled, Child Requirement Not Met
213(A)
1
Disallowance for More Than One Reason but Insufficient Proof in File to Make Decision
240
1
Insured Individual Died After Deportation
244
None
Wife, Child, or Husband Disallowed Because W/E Not Entitled to RIB or DIB
245
None
Denial of Requests for Withdrawal of Claim—Requested Consent Statements Absent
251
None
Denial of Request for Withdrawal—Refund Not Made
252
1
Withdrawal Approved, New Award Made—Notice to Person Whose Entitlement is Nullified
255
4
Withdrawal Approved—Notice to Wife, Husband or Child Whose Entitlement is Nullified
256
4
Insert Paragraph for Form SSA-L250 (SSA-L850)—Withdrawal Approved After Award
257
None
Insert Paragraph for Form SSA-L250 (SSA-L850)—Withdrawal Approved Before Adjudication
258
None
Wife or Widow—Under 72—W/E Transitionally Insured
261
2
Widow Age 72 or Over Disallowed—No Transitional Insured Status—W/E Attained 65 or Died Before 1957
263
3
Request for Change of Address—Claimant Entitled to Hospital Insurance Benefits But Not Monthly Benefits
264
None
Not a Resident of U.S.—Deemed Insured
270
None
Not a U.S. Citizen and Does Not Meet Alien Residency Requirement—Deemed Insured
271
None
Claim Disallowed For Nonmedical Reasons—Disability Determination Unnecessary
288
None
Lead-in Paragraph
306
2
Reconsideration Paragraph
307
2
Hearing Paragraph
308
1
Right to File Subsequent Application
309
1
DIB—Not Qualified Before Full Retirement Age—Substantial Gainful Work313(A)
None
Disability Denial—General Closeout Paragraph
314
None
Description of Earnings Requirement—Special Insured Status Requirements for Subsequent Period of DIB
320.9
None
Allowance—Subsequent Period of DIB, Special Insured Status—Benefits Payable 5/83, First Possible Month of Entitlement Earlier
321
1
Applicant Mentions Another Disability Program
351
None
Reexamination Scheduled—Beneficiary Hospitalized
354
1
Statutory Blindness—DIB Allowance Under 1972 Amendments—First Month of Entitlement Restricted to 01/73
358
2
Initial Notice—Reference to Follow-up Notice if Title II Underpayment or Overpayment Involved
365
None
Lead-in Paragraph—Underpayment of Title II Benefits Involved
366
2
Lead-in Paragraph—Overpayment of Title II Benefits Involved
367
2
DIB—Rate Increase—Two Rates Payable
372
None
DIB—Rate Increase—Change in Disability Period
374
None
Claimant Insured for RIB—No RIB Claim Filed
378
None
Information Concerning Hospital and Medical Insurance—Claimant Age 63-64 3 /4
379
None
DIB and DWB Applications Filed
380R
None
Freeze or DIB Continuance (After Full Retirement Age)
388
None
DWB Cessation—Medical Improvement
396
3
DIB Cessation—Overpayment Involved
397
3
DIB Cessation—Overpayment Involved—SMI Premiums Included in Overpayment
397(A)
4
DIB Cessation—Underpayment Involved for One Month
398
3
DIB Cessation—Underpayment Involved for Multiple Months398(A)
4
Title II “Lead-in” Paragraph
399
None
Request for Refund
399(A)
1
Disability Ceases—Payments Continue
408
2
Personalized Notice Lead-In
409
None
Title II VR Cessation-Auxiliaries in Separate Households—Payments Continue
410
1
Title II-VR Cessation—Auxiliaries in Same Household—Payments Continue
411
1
Combined Check—Primary or Auxiliary Beneficiary Dies—Check for Month Subsequent to Month of Death Outstanding
679R
None
SSA-1560-U4 Return Address Paragraph SEPSC
731
None
Reference to Title XVI Claim—Dual Entitlement Case (Title XVI Disclaimer Paragraphs)
842
None
Multiple Claims—Benefits Being Paid on One—Current Claim Being Denied
900
None
Government Pension Total Offset
1000
None
Government Pension Partial Offset
1001
None
M. Continuing Disability Review Cessations
Paragraph
Fill-ins
Lead In - Medical Improvement Cessation - Title II
4000
None
Lead In - Group I Exception - Title II
4001
None
Lead In - Medicare Only - Current Coverage - Medical Improvement
4002
None
Lead In - Medicare Only - Current Coverage - Group I Exception
4003
None
Lead In - Medicare Only - Future Coverage - Medical Improvement
4004
None
Lead In - Medicare Only - Future Coverage - Group I Exception
4005
None
Lead In - Reopening To Cessation - Medical Improvement - Title II
4006
None
Lead In - Reopening To Cessation - Group I Exception - Title II
4007
None
Lead In - Reopening To Closed Period - Medical Improvement - Title II
4008
None
Lead In - Reopening To Closed Period - Group I Exception - Title II
4009
None
Lead In - Medicare Only - Reopening To Cessation - Current Coverage - Medical Improvement
4010
None
Lead In - Medicare Only - Reopening To Cessation - Current Coverage - Group I Exception
4011
None
Lead In - Medicare Only - Reopening To Cessation - Future Coverage - Medical Improvement
4012
None
Lead In - Medicare Only - Reopening To Cessation - Future Coverage - Group I Exception
4013
None
Lead In - Auxiliary Notice
4014
3
Lead In - Group II Exception - Title II
4022
None
Lead In - Later Cessation - Medical Improvement - Title II
4038
2
Lead In - Basis Change Only
4040
None
Referral To Personalized Attachment
4041
None
Benefits/Payments End
4043
2
Benefits End - Auxiliary
4044
3
Medicare Ends
4048
1
Medicare Ends - Medicare Only
4049
2
No Future Medicare Coverage
4051
2
Vocational Rehabilitation - Title II
4052
None
DDS Decision
4054
None
Right to Reconsideration
4056
None
Right To Reconsideration - Disability Cessation - Section 301 Case
4057
None
Benefit Continuation - Medicare Involved - Primary Beneficiary - Title II
4059
None
Benefit Continuation - Auxiliary
4060
1
Benefit Continuation - Medicare Involved - Later Cessation or Basis Change Only
4063
None
Benefit Continuation - Later Cessation or Basis Change Only - Auxiliary
4064
1
Disability Hearing Information
4066
None
If You Need Help With Your Appeal
4069
None
Things To Remember - Title II
4070
None
Things To Remember - Medicare - Current Coverage
4071
None
Things To Remember - Medicare - Future Coverage
4072
None
DO Referral
4078
None
DIB, DI or CDB Medical Cessation – Title II/XVI”
4080
1
Disability Cessation - Clear Cut - Title II
4081
1
DIB, DWB or CDB Cessation - Whereabouts Unknown or Failure to Cooperate - Required Information Not Submitted - Title II
4082
1
DIB, DWB, CDB Cessation - Whereabouts Unknown or Failure to Cooperate - Requested Medical Examination Not Taken - Title II
4083
1
Medical Cessation - Advances in Medical Therapy or Technology - Title II/ Title XVI
4084
1
Medical Cessation - Advances in Vocational Therapy or Technology - Title II /Title XVI
4085
1
Medical Cessation - New or Improved Diagnostic or
4086
1
Evaluative Techniques - Title II/Title XVICessation - Prior Determination in Error - Title II/Title XVI
4087
1
Cessation - Fraud - Title II/Title XVI
4088
1
Failure to Follow Prescribed Treatment - Title II/Title XVI
4095
1
DWB Medical Cessation - Title II
4096
1
Benefit Continuation Rights - Medicare Not Involved
4097
None
Appeal Rights - Face-to-Face Hearing - Reopening to a Later Onset
4098
None
Appeals Rights - ALJ Hearing - Title II
4104
None
Benefits End - Later Cessation - Title II
4115
2
Lead In - Reopening To Later Cessation - No Medical Improvement - Title II
4116
2
Lead In - Reopening To Cessation - Group II Exception - Title II
4127
None
Right To Reconsideration (Foreign Claim)
4131
None
Right To Reconsideration - Auxiliary (Foreign Claim)
4132
None
Right To Reconsideration - Award Notice - Revision To Later Onset (Foreign Claim)
4133
None
General Closing Paragraph (Foreign Claim)
4134
1
Disability Hearing Information (Foreign Claim)
4135
None
Auxiliary Notice - Lead In - Allowance To Denial
4158
2
Lead In - Allowance to Denial - Title II
4159
None
Right To Reconsideration - Award Notice
4160
None
Lead In - Affirmation of a Denial
4170
None
Lead In - Affirmation of a Later Onset
4171
1
Lead In - Affirmation of a Closed Period
4172
2
Appeal of the Earlier Decision
4173
None
DDS Decision - Foreign Version
4175
None
Appeals Rights - ALJ Hearing Formal Remands
4176
None
How An ALJ Hearing Works
4177
None
How An ALJ Hearing Works - Foreign Version
4178
None
DO Referral - Foreign Version
4179
None
Notice Enclosures - Cessation - Title II
4180
None
Notice Enclosures - Cessation - Title II
4181
None
Notice Enclosures - Basis Change Only
4186
None
Notice Enclosures - Basis Change Only
4187
None

POMS Reference

NL 00708.005: Usage Chart for Numbered Paragraphs