NL: Notices, Letters and Paragraphs
TN 24 (12-94)
1080. Situation Where Used:
Used on SSA-L8025's where eligibility is awarded based on recipient's agreement to file for other benefits.
To receive Supplemental Security Income payments, we notified (you) that (you) must apply for (1) (2) to which (you) might become entitled. If (you) do not file for those benefits by (3) , (you) cannot be eligible for Supplemental Security Income payments. (You) should notify us when the other agency makes its determination. If (you) receive other benefits, it may be necessary to refigure the amount of (your) Supplemental Security Income payment because the benefits will be considered in counting (your) income.
(1) | Choice 1 - a Department of Veterans Affairs compensation |
Choice 2 - railroad retirement benefits | |
Choice 3 - a Department of Veterans Affairs pension | |
Choice 4 - Workmen's compensation | |
Choice 5 - black lung benefits | |
Choice 6 - a union or private employer pension | |
Choice 7 - a civil service pension | |
Choice 8 - unemployment insurance benefits | |
(2) | Choice 1 - , |
Choice 2 - and | |
Choice 3 - Null | |
(3) | (Month/Day/Year) |
1081. Situation Where Used:
Used on SSA-L8030's where claimant did not take action to obtain other benefits or payments.
We notified (you) that, to be eligible for Supplemental Security Income payments, (you) must apply for and take all necessary steps to obtain any other benefits or payments for which (you) may qualify. Since (you) have not taken the necessary action, (you) do not meet this requirement of the law.
1606. Situation Where Used:
Used on SSA-L8025's where claimant is eligible (but no payment is due) based on recipient's agreement to file for other benefits.
To become eligible under the Supplemental Security Income program, we notified (you) that (you) must apply for (1) to which (you) might become entitled. If (you) do not file for those benefits, (you) cannot be eligible under the Supplemental Security Income program. (You) should notify us when the other agency makes its determination. If (you) do receive those benefits, it may be necessary to determine whether (you) are still eligible under the Supplemental Security Income program.
(1) | Choice 1 - a Department of Veterans Affairs compensation |
Choice 2 - railroad retirement benefits | |
Choice 3 - a Department of Veterans Affairs pension | |
Choice 4 - Workmen's compensation | |
Choice 5 - black lung benefits | |
Choice 6 - a union or private employer pension | |
Choice 7 - a civil service pension | |
Choice 8 - unemployment insurance benefits |
2080. Situation Where Used:
Payments were suspended for failure to file for other benefits. Subsequently, claimant took the necessary steps to obtain other benefits or payments.
Since (you) have filed for and taken the necessary steps to obtain other benefits or payments (you) may be entitled to receive, (you) are eligible for Supplemental Security Income (1) effective (2) . You should notify us promptly of any determination or payment received by (you) .
(1) | Choice 1 - payments |
Choice 2 - Null | |
(2) | (Month/Year) |
2081. Situation Where Used:
Recipient did not file the required application or take the necessary steps to obtain other benefits or payments.
We notified (you) that in order to be eligible for Supplemental Security Income (1) (you) must apply for, and take all necessary steps to obtain, any other benefits or payments for which (you) may qualify. Since (you) have not taken the necessary action, (you) do not meet this requirement of the law.
(1) | Choice 1 - payments |
Choice 2 - Null |
2082. Situation Where Used:
Recipient did not file the required application or take the necessary steps to obtain other benefits or payments. Ineligibility for a month or period is shown.
We notified (you) that in order to be eligible for Supplemental Security Income (1) (you) must apply for, and take all necessary steps to obtain, any other benefits or payments for which (you) may qualify. Since (you) have not taken the necessary action, (you) do not meet this requirement of the law (2) .
(1) | Choice 1 - payments |
Choice 2 - Null | |
(2) | Choice 1 - for (Month/Year) |
Choice 2 - for (Month/Year) through (Month/Year) | |
Choice 3 - for (Month/Year) on |