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NL: Notices, Letters and Paragraphs

Effective Dates: 06/18/2013 - Present

BASIC (11-81)

A. Sample form

G-NL_00701.387A

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B. Preparation of form

If the disability examiner or claims authorizer requests this notice, use Form SSA-L250. The source of information for completing the fill-ins for this notice is Form SSA-559, Transmittal Slip for Claims Folder.

Fill-ins:

  1. “Type of Benefit” shown on Form SSA-559.

  2. month and year.

NOTE: Paragraph 258 will be automatically included on Form SSA-L250 by the typist unless dictated information or paragraph 257 is indicated on Form SSA-559.

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