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NL: Notices, Letters and Paragraphs

Effective Dates: 09/19/2012 - Present

TN 3 (05-92)

A. Procedure

If you must issue a manual SSA-L8166-U2 in a computer matching case, use the following chart to find the captions and paragraphs appropriate for the recipient's situation.

NOTE: We labeled the captions with capital letters in alphabetic order as a place-keeping device due to the length of the chart.

B. Why your record changed

(Use this caption if the individual is a 1619(b) participant.)

NL Reference Paragraph Use
NL 00804.175 1239 1619(b) participant has excess income other than earned income.

C. Information about medicaid

(Use this caption only when paragraph 2057 below applies.)

NL Reference Paragraph  
NL 00804.250 2057 1619(b) participant will retain 1619(b) status.

D. Information about your payments

(Mandatory caption when individual is not a 1619(b) participant.)

NL Reference Paragraph Use
NL 00804.240 2525 Tells recipient that this action does not change the payment amount.

E. Your (payment/SSI) is based on these facts

(Mandatory caption - Replace “Payment” with “SSI” when individual is a 1619(b) participant.)

NL Reference Paragraph Use
NL 00804.175 1231 Lead-in preceding list of monthly income in paragraph 1232 below.
1232 Describes type, period and amount of countable income.
1253 Recipient received one-time income payment other than SSI.
1248 Describes type, period and amount of income deemed from spouse or parent(s).
1254 Spouse or parent(s) has one-time income payment other than SSI.
1249 Spouse or parent(s) receives public assistance - No deemed income.
1257 Special income disregards apply.
1252 Overpayment withheld from income other than SSI. (Do not use in the Ninth Circuit.)
NL 00804.250 2058 Tells recipient to check computer matching data within 30 days. (Mandatory paragraph for this caption.) Use paragraph 2056 (NL 00804.250) instead, when individual is a 1619(b) participant.
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