TN 6 (12-93)

A. Policy

1. When required

Postentitlement notices are used:

• When an action is taken that affects a beneficiary's benefits or status.

• For a postentitlement action that results from an initial determination as defined in GN 03101.040 - GN 03101.070.

• To inform a beneficiary of certain actions that are not initial determinations such as temporary work deductions (see
  GN 03101.080).

2. Types of notices

Postentitlement notices are:

• Computer-generated notices produced through MADCAP, AJS-3, or other systems.

• Exhibit letters typed on SSA-L2000-C2.

• Form notices

• Dictated letters

B. Procedure

Complete postentitlement notices as follows:

1. Required content and preferred sequence

Include the following in the notice:

1. Date (see NL 00601.010B.1.)

2. Claim Number (see NL 00601.010B.2.)

3. Name and Address of Beneficiary or Representative Payee (see NL 00601.010B.3.)

4. Opening statement

   This is a short introductory statement. Below are examples of opening statements:

   • We are giving new information about Social Security benefits; or

   • We are stopping benefits (suspension); or

   • The beneficiary is no longer qualified (termination); or

   • We have overpaid the beneficiary by a certain amount.

5. Reason for action

   • SSA initiated event, e.g., COLA;

   • SSA detected event, e.g., enforcement;

   • First party report, e.g., work report;

   • Third party report, e.g., neighbor reports marriage of young widow.

   State clearly the nature of the report or event, including significant dates (e.g., date of marriage); and significant money amounts (e.g., reported earnings amount). Provide enough detail for the beneficiary to decide if he/ she agrees with the accuracy of the report or event.

6. Effect on Entitlement or Receipt of Benefits

   • Change in payment status

     Inform the beneficiary of his/her payment status, e.g., benefits resumed, benefits stopped, and the month and year the change is effective.

   • Change in monthly benefit payable (MBP).

     Anytime the MBP is increased or decreased show the effective date and the reason for the change. The check paragraph in the notice shows the new monthly benefit payable.

     Each rate change that is a result of the action currently being taken must be explained. It is not necessary, however, to include historical rate changes; i.e., changes which occurred in the case previously which were explained at the time such as COLA's or ARF's. However, when explaining an overpayment, you must provide all historical information (including MBA's, if appropriate) necessary to fully explain the overpayment amount. (See GN 02201.009.)

     NOTE: Show the MBA in a dual entitlement case when explaining an AERO “increase” that results in a payment decrease.

7. Payment Information

   • See NL 00601.010B.5 and NL 00601.010B.6 for examples of payment information.

     NOTE: In postentitlement notices where there is a change in benefits the payment information comes after the benefit information

   • One-Time Payment Adjustment

     An action can cause the next check to be different from the ongoing MBP, or may result in a one-check-only or prior month accrual. Include an explanation of the adjustment in the retroactive benefits, and any difference between the ongoing MBP and a check resulting from an action.

8. Overpayment or Underpayment

   • If an action results in an overpayment, the notice must state the total amount of the overpayment and explain, in detail, the cause of the overpayment. (See GN 02201.009 for required content.)

   • If an action affects the amount or recovery of a prior overpayment, the notice must explain the change and indicate that the explanation for the cause of the overpayment was contained in a prior notice. (See GN 02210.065.)

   • If an action results in an underpayment, the notice must state the cause of the underpayment, the amount, and its disposition.

9. Change in factor of entitlement, e.g., date of birth.

   Even if the change does not affect current benefits, the beneficiary must be notified of the change since it may affect future benefits.

10. Reporting responsibilities such as:

    • Need to report change in work and earnings if work deductions imposed based on estimate.

    • Need to report total earnings for year when benefits terminated during the year.

11. Future payment (Things to remember)

    When the beneficiary is terminated, suspended or deferred, always inform him/her of what to do or what event to report that could result in reentitlement or resumption of benefits. Some examples:

    • Work suspension — Remind the person to report any change in work or earnings.

    • No child-in-care suspension — Tell person to notify SSA if an entitled child is again in his/her care.

    • Termination of mother/father benefits — Tell person they may receive benefits at age 60 or 50, if disabled.

12. Reconsideration

    If the postentitlement action involves an initial determination, include appeal rights, (See NL 00601.150).

13. Attorney options paragraph

    If the postentitlement action involves an adverse determination, e.g., reduction in benefits, termination, suspension, overpayment, etc. we must advise people of their right to representation if they appeal. Do not include this paragraph if the person is already represented. Do not use this paragraph if the beneficiary lives at a foreign address.

14. Referral, (see NL 00601.010B.8.e.)

2. Enclosure remarks

Show “Enclosure(s)” remark when appropriate.

EXAMPLE:

Enclosures:
SSA-3105
Refund envelope

MADCAP has been programmed to automatically generate the enclosure remark when certain paragraphs are used; e.g., A01, A07, A09, A26, B27.