POMS Reference

NL: Notices, Letters and Paragraphs

TN 6 (12-93)

A. Policy

All award and disallowance notices must contain a paragraph which closes all classes of benefits covered by the scope of the application. Otherwise, the application remains open and entitlement may be established at a later date, using the open application instead of a subsequently filed application. (See GN 00204.025). The scope of the application is determined by the wording on its face (see GN 00204.020).

B. Description of closeout paragraphs

Closeout paragraphs are:

1. General award, no other claim pending

For a general award with no other claims pending:

MADCAP – G19

2. Modified closeout on awards, other claim pending

For a modified closeout on an award with other claim pending:

MADCAP – B56

3. Disallowance closeouts

For disallowance closeouts:

Exhibit letters:

The disallowance exhibit letters in NL 00703.900 through NL 00703.917 include a closeout paragraph.

4. Disclaimers for closeout paragraphs - subsequent entitlement

For disclaimers for closeout paragraphs - subsequent entitlement, the most common example is:

A RIB beneficiary with Medicare coverage subsequently becomes entitled to another type of benefit on a different SSN. Advise the beneficiary that this in no way affects Medicare coverage.