TN 9 (08-95)

A. Policy

1. Introduction

To comply with the settlement reached in Cruz v. Califano, and to be responsive to Spanish-speaking persons, SSA provides Spanish notices to those who meet certain criteria and choose to receive Spanish notices or those who request Spanish notices.

2. Criteria

Any one of the following criteria determines whether the individual, including the representative payee, should receive Spanish notices:

• The application shows the claimant was born in a country or territory where Spanish is the predominant language (e.g., Mexico, Puerto Rico).

• The claimant has a Hispanic surname.

• The claimant lives in a known Spanish-speaking area (e.g., “Little Havana” or “East Los Angeles”).

• The interview is conducted in Spanish or with the assistance of a Spanish translator.

• The claimant has difficulty speaking English but is fluent in Spanish.

• The claimant requests notification in Spanish.

• The claimant meets none of the criteria, but there are circumstances which indicate that Spanish notices would be helpful and the claimant would like to receive them.

NOTE: The criteria listed above also apply to the representative payee, even if the claimant/recipient does not meet the criteria or does not wish to receive Spanish language notices. (See NL 00601.600 for title II.)

3. Changing Decision

Recipients/representative payees may change their decision regarding receipt of Spanish notices at any time.

4. Pamphlets

Use Spanish versions of title XVI pamphlets with manual Spanish SSA-L8025's and SSA-L8030's.

B. Procedure — Meets Criteria

1. General

1. Tell individuals who meet the criteria listed above (in NL 00801.025A.2.) that they may receive Spanish notices.

2. Ask these individuals if they wish to receive Spanish notices. If they do, see NL 00801.025B.2. below. (If they do not, see NL 00801.025B.3. below.)

NOTE: If an individual and/or the representative payee choose to receive Spanish language notices, both the individual and the representative payee will receive a Spanish and an English version of each notice.

2. Spanish Notices Requested

1. Systems Input— To identify on the record an individual who should be sent Spanish notices. On MSSICS, indicate language type on the ADDR screen.

   For PE, see IC instructions, except that in PE transmit only one FV entry per person ID code. Also, for PE transmit a maximum of two FV entries (one for each member of a couple), separated by a comma.

2. Changing Decision— Inform the claimant that his/her decision to receive Spanish notices will be maintained in SSA's records and that the decision can be changed at any time. Also state that a request to stop receiving Spanish notices should be reported to an FO or teleservice center.

3. Spanish notices are computer-generated in most awards, nonmedical denials, and most PE situations. However, the system does not send certain one-time notices (such as notices issued in court cases) in Spanish.

   The DDS provides Spanish notice cover letters in IC and PE situations for disallowances, denials, or when a reconsideration affirmation is reached. (Spanish notice cover letters are not sent for awards even though the decision may be partially adverse.)

3. Spanish Notices Declined

1. Individual Meets Criteria But Does Not Want Spanish Notices— If the individual meets one or more criteria but states that he/she does not want Spanish notices, honor the request and do one of the following:

   • Obtain a signed “Waiver of Option to Receive Notices in Spanish” (Form SSA-381-SP). If the claimant refuses to sign the waiver, document the decision on a Report of Contact.

     OR

   • In MSSICS, place in the associated remarks screen the language in English that is on the SSA-381-SP, as follows:

     “I have been advised that the Social Security Administration is making certain notices available in the Spanish language. I prefer to receive notices only in the English language. I understand that if I change my mind, I can request to receive available notices in the Spanish language.”

2. Individual Does Not Speak Spanish— If the claimant meets one or more of the first three criteria, but does not speak Spanish (for example, a Vietnamese person living in a known Spanish- speaking area), do not send Spanish notices and do one of the following:

   • Prepare a Report of Contact to document that the claimant does not want Spanish notices.

     OR

   • In MSSICS, document that the claimant does not want Spanish notices on the file documentation part of the associated remarks screen.

4. Request for Hearing or Request for Review of Hearing Decision

If an individual files a Request for Hearing (HA-501-U5), or Request for Review of Hearing Decision/Order (HA-520-U5), and meets any of the criteria listed above, state whether the individual wants to receive Spanish notices in the section of the form that gives the reason for filing a hearing or a review.

C. Procedure — Manual Notices

1. Manual Notices — Spanish Cover Letters

1. Use the Document Processing System (DPS) when you must manually prepare Spanish Cover Letters IC or PE notices for claimants requiring Spanish notices, for example, in a force payment case. Prepare the notice with the appropriate Spanish cover letter on top of the English notice. (For manual overpayment notices, if you are Spanish speaking you may prepare a complete Spanish overpayment notice, see NL 00801.025C.2.).

2. On the Spanish cover letter, type the addressee's name and address, FO address, date (the date should be the same for both the English notice and the Spanish cover letter) and claim number. Under the caption “If You Have Any Questions,” type the FO contact name and telephone number in the blanks.

   NOTE: For SSI manual overpayment and waiver denial notices prepared in the teleservice centers, under the caption “If You Have Any Questions,” type “un representante de SSI” [an SSI representative] and the national 800 telephone number in the blanks.

3. Place the Spanish cover letter on top of the English notice. (Each Spanish cover letter form number corresponds with the form number of its respective English notice.)

4. Retain a copy of the notice and annotate the file to reflect that a Spanish cover letter was sent.

2. Manual Overpayment Notices — Complete Spanish Notice

For manual overpayment notices, if you are Spanish speaking you may prepare a complete Spanish overpayment notice, using forms SSA-L8170-U3-SP, SSA-L8171-U3-SP, SSA-L8172-U2-SP, SSA-L8173-U2-SP, and SSA-L8174-U2-SP. These forms are available on Document Processing System (DPS) . (If you are not Spanish speaking, see NL 00801.025C.1. for use of Spanish cover letters.)

3. Pamphlets

Remember to use Spanish versions of title XVI pamphlets with manual Spanish SSA-L8025's and SSA-L8030's.

D. Exhibits

The English version of the following Spanish cover letters are exhibited in English to ensure that the correct notice is used by non-Spanish speaking users. Both versions of the cover letters with their respective appeal and/or waiver rights are available in the Document Processing System (DPS) .

1. SSA-L-8025-CL-SP, Notice of Award (English Version)

Social Security Administration

Supplemental Security Income

Notice of Award

Address:
Date:
Claim Number:

                              

Attached is a letter in English about our decision that you are eligible for SSI benefits. The letter tells why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If you Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You must ask us for a review within 60 days of the date you receive this notice. You can give us more information if you feel it may be helpful.

On the following pages is information that tells you more about your right to appeal this decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is _________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your entire case, even the parts you agree with. We will also consider any new facts you have and then will make a new decision. The new decision could be more favorable to you than the one you already have. But, keep in mind that the new decision also could be the same as or less favorable than the decision you already have.

•  You have 60 days to ask for an appeal.

•  The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How to Appeal

There are two ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

• Case Review You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decided your case. This is the only kind of appeal you can have to appeal a medical decision.

• Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosures:

English Version of SSA-Ll8025-U2

English and Spanish Versions of “When You Get SSI...

What You Need To Know”

2. SSA-L8030-CL-SP, Notice of Disapproved Claim (English Version)

Social Security Administration

Supplemental Security Income

Notice of Disapproved Claim

Address:
 Date:
Claim Number

                             

                              

Attached is a letter in English about our decision that you are not eligible for SSI benefits. The letter tells why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You must ask us for a review within 60 days of the date you receive this notice. You can give us more information if you feel it may be helpful.

On the following pages is information that tells you more about your right to appeal this decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for ______________________. Our telephone number is ___________________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

• You have 60 days to ask for an appeal.

• The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason for waiting more than 60 days to ask for an appeal.

• To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are two ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

• Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case. This is the only kind of appeal you can have to appeal a medical decision.

• Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

Please read the enclosed pamphlet, “Your Right to Question the Decision Made on Your Claim.” It contains more information about the appeal.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

New Application

You have the right to file a new application at any time, but filing a new application is not the same as appealing this decision. If you disagree with this decision and you file a new application instead of appealing you might lose some benefits, or not qualify for any benefits. So, if you disagree with this decision, you should file an appeal within 60 days.

Enclosures:

English Version of SSA-L8030-U2

English and Spanish Versions of “Your Right To Question the Decision Made on Your Claim”

 

3. SSA-L8100-CL-SP, Notice of Change in Payment (English Version)

Social Security Administration

Supplemental Security Income

Notice of Change in Payment

                              Address
Date
Claim Number:

Attached is a letter in English about our decision to change the amount of SSI money you were due for past months. The letter gives the months we changed and tells why we made the changes.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask for a hearing. At the hearing, a person who has not seen your case before will look at it. We call this person an Administrative Law Judge. You must ask for a hearing within 60 days of the date you receive this notice.

On the following is information that tells you more about your right to appeal to ask for a hearing.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

If You Disagree With The Decision?

If you disagree with the decision, you have the right to ask for a hearing. At the hearing, a person who has not seen your case before will look at it. That person is an Administrative Law Judge (ALJ). The ALJ will review your case and consider any new facts you have.

•  You have 60 days to ask for a hearing.

•  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for a hearing.

•  You have to ask for a hearing in writing. We'll ask you to sign a Form SSA-501, called “Request for Hearing.” Contact one of our offices if you want help.

How The Hearing Process Works

The ALJ will mail you a letter at least 20 days before the hearing to tell you its date, time and place. The letter will explain the law in your case and tell you what has to be decided. Since the ALJ will review all the facts in your case, it is important that you give us any new facts as soon as you can.

The hearing is your chance to tell the ALJ why you disagree with the decision in your case. You can give the ALJ new evidence and bring people to testify for you. The ALJ also can require people to bring important papers to your hearing and give facts about your case. You can question these people at your hearing.

It Is Important To Go To The Hearing

It is very important that you go to the hearing. If for any reason you can't go, contact the ALJ as soon as possible before the hearing and explain why. The ALJ will reschedule the hearing if you have a good reason.

If you don't go to the hearing and don't have a good reason for not going, the ALJ may dismiss your request for a hearing.

If You Want Help With Your Hearing

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your hearing.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosures:

English Version of SSA-L8030-U2

 

4. SSA L8151-CL-SP, Notice of Change in Payment (English Version)

Social Security Administration

Supplemental Security Income

Notice of Change in Payment

                              Address
Date
Claim Number:

Attached is a letter in English about our decision to change the amount of SSI money you were due for past months. The letter tells why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You must ask for a review within 60 days of the date you receive this notice. You can give us more information if you feel it may be helpful.

On the following is information that tells you more about your right to appeal this decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

•   You have 60 days to ask for an appeal.

•  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out this form.

How To Appeal

There are two ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

•  Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case. This is the only kind of appeal you can have to appeal a medical decision.

Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosures:

English Version of SSA-L8151-U2

 

5. SSA-L8155-CL-SP, Notice of Planned Action (English Version)

Social Security Administration

Supplemental Security Income

Notice of Planned Action

                              Address
Date
Claim Number:

Attached is a letter in English about our decision to reduce or stop your SSI benefits. The letter tells you why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

•  If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You ask us for a review within 60 days of the date you receive this notice. You can give us more information if you feel it will be helpful.

On the following is information that tells you more about your right to appeal this decision.

•  We will not stop or reduce your check if you appeal within 10 days of receiving this letter.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

•  You have 60 days to ask for an appeal.

•  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

Appeal In 10 days To Keep Getting The Same Check

If you appeal within 10 days, you will continue to get the same check amount until we decide your case.

•  The 10 days start the day after you get this letter.

•  If you lose your appeal, you might have to pay back some or all of this money.

However, even if you appeal in 10 days, we may reduce or stop the check as shown on page 1 of the attached letter if both of the following are true:

•  Our new decision is the same as the one appealed, and

•  We send or give you a letter with our new decision in time to reduce or stop the check.

How To Appeal

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

•  Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

•  Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

•  Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosures:

English Version of SSA-L8155-U2

 

6. SSA-L8165-AIC-CL-SP, Important Information (English Version)

Social Security Administration

Supplemental Security Income

Important Information

                              Address
Date
Claim Number:

You asked the Administrative Law Judge (ALJ) to review our decision about your SSI. The ALJ decided in your favor and sent you a letter about that decision. Attached is a letter in English that tells you more about the decision and your eligibility for benefits.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You ask us for a review within 60 days of the date you receive this notice. You can give us more information if you feel it will be helpful.

On the following pages is information that tells you more about your right to appeal this decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case, even the parts you agree with. We also will consider any new facts you have and then will make a new decision. The new decision could be more favorable to you than the one you already have. But, keep in mind that the new decision also could be the same as or less favorable than the decision you already have.

•  You have 60 days to ask for an appeal.

•  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are two ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case. This is the only kind of appeal you can have to appeal a medical decision.

Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosures:

English Version of SSA-L8165-U2

English and Spanish Versions of “When You Get SSI...

  What You Need To Know”

 

7. SSA-L8166-APE-CL-SP, Important (English Version)

Social Security Administration

Supplemental Security Income

Important Information

                              Address
Date
Claim Number:

You asked the Administrative Law Judge (ALJ) to review our decision about your SSI. The ALJ decided in your favor and sent you a letter about that decision. Attached is a letter in English that tells you more about the decision and your eligibility for benefits.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You ask us for a review within 60 days of the date you receive this notice. You can give us more information if you feel it will be helpful.

On the following pages is information that tells you more about your right to appeal this decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is  __________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

•  You have 60 days to ask for an appeal.

•  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. This form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are two ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

•  Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case. This is the only kind of appeal you can have to appeal a medical decision.

•  Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8166-U2

 

8. SSA-L8170-CP-SP, Notice of Overpayment (English Version)

Social Security Administration

Supplemental Security Income

Important Information

                              Address
Date
Claim Number:

Attached is a letter in English about our decision that we paid you too much SSI money for past months. The letter tells you the months you were overpaid and why you were overpaid. It also tells you how you can pay us back.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You may also ask us for waiver of your overpayment. Waiver means you do not have to pay us back the amount you were overpaid.

•  You must ask for a review within 60 days of the date you receive this notice. On the following pages is information that tells you more about your right to appeal this decision or ask for waiver.

•  You can ask for waiver of your overpayment at any time.

If you ask for waiver of your overpayment or appeal this decision in the next 30 days, we won't withhold money form your check to pay back the overpayment until we make a new decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Your Right To Ask For Waiver And Appeal

You must pay us back unless we decide you shouldn't have to pay us back or we're wrong about the overpayment. If you think you shouldn't have to pay us back or you disagree with the decision about the overpayment, you can:

•  Ask for a waiver,

•  Ask for an appeal, or

•  Do both.

If you ask for waiver or appeal in the next 30 days, we won't change your check until we decide your case.

If You Think You Should Not Have To Pay Us Back

You may not have to pay us back. Sometimes we can waive the collection of an overpayment, which means you won't have to pay us back. For us to waive the collection of your overpayment, two things have to be true.

•  It wasn't your fault that you got too much Social Security money.

                      AND

•  Paying us back would mean that you can't pay your bills for food, clothing, housing, medical care, or other necessary expenses, or it would be unfair for some other reason.

If you think these are true about you, contact my Social Security office. You can ask for waiver at any time by completing the waiver form and returning it to us. The form is called Request for Waiver of Recovery or Changes in Repayment Rate, Form SSA-632. We will be happy to help you fill out the form. If you ask for waiver in the next 30 days, we will not withhold your benefits until we decide if we can waive collection. If you ask for waiver after that time, we will stop collecting the overpayment while we decide if we can waive collection.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

•  You have 60 days to ask for an appeal. If you ask in the next 30 days, we won't change your check until we decide your case.

•  Both the 30 day and the 60 day periods start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. This form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

•  Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

•  Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

•  Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8170-U2

 

9. SSA-L8171-CL-SP, Notice Of Overpayment (English Version)

Social Security Administration

Supplemental Security Income

Notice of Overpayment

                              Address
Date
Claim Number:

Attached is a letter in English about our decision that we paid you too much SSI money for past months. The letter tells you the months you were overpaid and why you were overpaid. It also tells you how you can pay us back.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You may also ask us for waiver of your overpayment. Waiver means you do not have to pay us back the amount you were overpaid.

• You must ask for a review within 60 days of the date you receive this notice. On the following pages is information that tells you more about your right to appeal this decision or ask for waiver.

• You can ask for waiver of your overpayment at any time.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Your Right To Ask For Waiver And Appeal

You must pay us back unless we decide you shouldn't have to pay us back or we're wrong about the overpayment. If you think you shouldn't have to pay us back or you disagree with the decision about the overpayment, you can:

• Ask for a waiver,

• Ask for an appeal, or

• Do both.

If You Think You Should Not Have To Pay Us Back

You may not have to pay us back. Sometimes we can waive the collection of an overpayment, which means you won't have to pay us back. For us to waive the collection of your overpayment, two things have to be true.

• It wasn't your fault that you got too much Social Security money.

                          AND

• Paying us back would mean that you can't pay your bills for food, clothing, housing, medical care, or other necessary expenses, or it would be unfair for some other reason.

If you think these are true about you, contact my Social Security office. You can ask for waiver at any time by completing the waiver form and returning it to us. The form is called Request for Waiver of Recovery or Changes in Repayment Rate, Form SSA-632. We will be happy to help you fill out the form. If you ask for waiver in the next 30 days, we will not withhold your benefits until we decide if we can waive collection. If you ask for waiver after that time, we will stop collecting the overpayment while we decide if we can waive collection.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

• You have 60 days to ask for an appeal. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for an appeal.

• To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. This form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are three ways to appeal.You can pick the one you want. If you meet with us in person, it may help us decide your case.

• Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

• Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

• Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8171-U2

 

10. SSA-L8172-CL-SP, Notice of Overpayment (English Version)

Social Security Administration

Supplemental Security Income

Notice of Overpayment

                              Address
Date
Claim Number:

Attached is a letter in English about our decision that we paid you too much SSI money for past months. The letter tells you the months you were overpaid and why you were overpaid. It also tells you how you can pay us back.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You may also ask us for waiver of your overpayment. Waiver means you do not have to pay us back the amount you were overpaid.

• You must ask for a review within 60 days of the date you receive this notice. On the following pages is information that tells you more about your right to appeal this decision or ask for waiver.

• You can ask for waiver of your overpayment at any time.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Your Right To Ask For Waiver And Appeal

You must pay us back unless we decide you shouldn't have to pay us back or we're wrong about the overpayment. If you think you shouldn't have to pay us back or you disagree with the decision about the overpayment, you can:

• Ask for a waiver,

• Ask for an appeal, or

• Do both.

If You Think You Should Not Have To Pay Us Back

You may not have to pay us back. Sometimes we can waive the collection of an overpayment, which means you won't have to pay us back. For us to waive the collection of your overpayment, two things have to be true.

• It wasn't your fault that you got too much Social Security money.

                           AND

• Paying us back would mean that you can't pay your bills for food, clothing, housing, medical care, or other necessary expenses, or it would be unfair for some other reason.

If you think these are true about you, contact my Social Security office. You can ask for waiver at any time by completing the waiver form and returning it to us. The form is called Request for Waiver of Recovery or Changes in Repayment Rate, Form SSA-632. We will be happy to help you fill out the form. If you ask for waiver in the next 30 days, we will not withhold your benefits until we decide if we can waive collection. If you ask for waiver after that time, we will stop collecting the overpayment while we decide if we can waive collection.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

• You have 60 days to ask for an appeal.

• The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for an appeal.

• To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. This form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8171-U2

 

11. SSA-L8173-CL-SP, Overpayment Information (English Version)

Social Security Administration

Supplemental Security Income

Overpayment Information

                              Address
Date
Claim Number:

Attached is a letter in English about our decision not to waive your SSI overpayment. This means that you have to pay this money back. The letter tells you why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision.

•  You must ask for a review within 60 days of the date you receive this notice. On the following pages is information that tells you more about your right to appeal this decision.

•  If you appeal in the next 30 days, we won't withhold money from your check to pay back the overpayment until we make a new decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for ______________________. Our telephone number is _________________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

• You have 60 days to ask for an appeal. If you ask in the next 30 days, we won't change your check until we decide your case.

• Both the 30 day and the 60 day periods start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for an appeal.

• To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

• Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

• Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

• Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8173-U2

  

12. SSA-L8174-CL-SP, Overpayment Information (English Version)

Social Security Administration

Supplemental Security Income

Overpayment Information

                              Address
Date
Claim Number:

Attached is a letter in English about our decision not to waive your SSI overpayment. This means that you have to pay this money back. The letter tells you why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us to review (appeal) this decision. You must ask for a review within 60 days of the date you receive this notice.

On the following pages is information that tells you more about your right to appeal this decision.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for __________________. Our telephone number is __________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

•  You have 60 days to ask for an appeal.

•  The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

•  You must have a good reason if you wait more than 60 days to ask for an appeal.

•  To appeal, you must fill out a form called “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

How To Appeal

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

• Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

• Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

• Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8173-U2

  

13. SSA-L-8455-CL-SP Notice of Reconsideration (English Version)

Social Security Administration

Supplemental Security Income

Notice of Reconsideration

                              Address
Date
Claim Number:

You asked us to review our decision that you are not eligible for SSI. After our review we now find that you are eligible to receive SSI. Attached is a letter in English that tells why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us for a hearing. At the hearing, a person who has not seen your case before will look at it. We call this person an Administrative Law Judge. You must ask for a hearing within 60 days of the date you receive this notice.

On the following pages is information that tells you more about your right to ask for a hearing.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for ________________________. Our telephone number is ______________________.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to ask for a hearing before an Administrative Law Judge (ALJ). The ALJ will review your entire case, even the parts you agree with. The ALJ also will consider any new facts you have and then will make a new decision. The new decision could be more favorable to you than the old one you already have. But, keep in mine that the new decision also could be the same as or less favorable than the decision you already have.

• You have 60 days to ask for a hearing.

• The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for a hearing.

• You have to ask for a hearing in writing. We'll ask you to sign a Form SSA-501, called “Request for Hearing.” Contact one of our offices if you want help.

How The Hearing Process Works

The ALJ will mail you a letter at least 20 days before the hearing to tell you its date, time and place. The letter will explain the law in your case and tell you what has to be decided. Since the ALJ will review all the facts in your case, it is important that you give us any new facts as soon as you can.

The hearing is your chance to tell the ALJ why you disagree with the decision in your case. You can give the ALJ new evidence and bring people to testify for you. The ALJ also can require people to bring important papers to your hearing and give facts about your case. You can question these people at your hearing.

Please read the enclosed Pamphlet “Your Right To An Administrative Law Judge Hearing And Appeals Council Review Of Your Social Security Case.” It has more information about the hearing.

It Is Important To Go To The Hearing

It is very important that you go to the hearing. If for any reason you can't go, contact the ALJ as soon as possible before the hearing and explain why. The ALJ will reschedule the hearing if you have a good reason.

If you don't go to the hearing and don't have a good reason for not going, the ALJ may dismiss your request for a hearing.

If You Want Help With Your Hearing

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your hearing.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosure:

English Version of SSA-L8455-U2

English and Spanish Versions of “Your Right To An Administrative Law Judge Hearing and Appeals Council Review Of Your Social Security Case”

 

14. SSA-L-8456-CL-SP Notice of Reconsideration (English Version)

Social Security Administration

Supplemental Security Income

Notice of Reconsideration

                              Address
Date
Claim Number:

You asked us to review our decision that you are not eligible for SSI. After our review we now find that you are eligible to receive SSI. Attached is a letter in English that tells why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us for a hearing. At the hearing, a person who has not seen your case before will look at it. We call this person an Administrative Law Judge. You must ask for a hearing within 60 days of the date you receive this notice.

On the following pages is information that tells you more about your right to ask for a hearing.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for ______________________. Our telephone number is _______________________.

If You Disagree With The Decision

If you disagree with the decision, you have the right to ask for a hearing. At the hearing, a person who has not seen your case before will look at it. That person is an Administrative Law Judge (ALJ). The ALJ will review your case and consider any new facts you have.

• You have 60 days to ask for a hearing.

• The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for a hearing.

• You have to ask for a hearing in writing. We'll ask you to sign a Form SSA-501, called “Request for Hearing.” Contact one of our offices if you want help.

How The Hearing Process Works

The ALJ will mail you a letter at least 20 days before the hearing to tell you its date, time and place. The letter will explain the law in your case and tell you what has to be decided. Since the ALJ will review all the facts in your case, it is important that you give us any new facts as soon as you can.

The hearing is your chance to tell the ALJ why you disagree with the decision in your case. You can give the ALJ new evidence and bring people to testify for you. The ALJ also can require people to bring important papers to your hearing and give facts about your case. You can question these people at your hearing.

Please read the enclosed Pamphlet “Your Right To An Administrative Law Judge Hearing And Appeals Council Review Of Your Social Security Case.” It has more information about the hearing.

It Is Important To Go To The Hearing

It is very important that you go to the hearing. If for any reason you can't go, contact the ALJ as soon as possible before the hearing and explain why. The ALJ will reschedule the hearing if you have a good reason.

If you don't go to the hearing and don't have a good reason for not going, the ALJ may dismiss your request for a hearing.

If You Want Help With Your Hearing

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your hearing.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

New Application

You have the right to file a new application at any time, but filing a new application is not the same as appealing this decision. If you disagree with the decision and you file a new application instead of appealing, you might lose some benefits, or not qualify for any benefits. So, if you disagree with this decision, you should file an appeal within 60 days.

Enclosure:

English Version of SSA-L8456-U2

English and Spanish Versions of “Your Right To An Administrative Law Judge Hearing and Appeals Council Review Of Your Social Security Case” 

 

15. SSA-L8457-CL-SP, Notice of Reconsideration (English Version)

Social Security Administration

Supplemental Security Income

Notice of Reconsideration

                              Address
Date
Claim Number:

                              

                              

You asked us to review our decision about your SSI. Attached is a letter in English that tells you why we made our decision.

If you cannot read the attached English letter, please ask someone to help you translate it. If you cannot find help, you can ask any Social Security office to help you translate your notice.

If You Disagree With The Decision

If you do not agree with our decision, you have the right to ask us for a hearing. At the hearing, a person who has not seen your case before will look at it. We call this person an Administrative Law Judge. You must ask for a hearing within 60 days of the date you receive this notice.

On the following pages is information that tells you more about your right to ask for a hearing.

If You Have Any Questions

If you have any questions you may call, write, or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for ___________________. Our telephone number is ___________________.

If You Disagree With The Decision

If you disagree with the decision, you have the right to ask for a hearing. At the hearing, a person who has not seen your case before will look at it. That person is an Administrative Law Judge (ALJ). The ALJ will review your case and consider any new facts you have.

• You have 60 days to ask for a hearing.

• The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason if you wait more than 60 days to ask for a hearing.

• You have to ask for a hearing in writing. We'll ask you to sign a Form SSA-501, called “Request for Hearing.” Contact one of our offices if you want help.

How The Hearing Process Works

The ALJ will mail you a letter at least 20 days before the hearing to tell you its date, time and place. The letter will explain the law in your case and tell you what has to be decided. Since the ALJ will review all the facts in your case, it is important that you give us any new facts as soon as you can.

The hearing is your chance to tell the ALJ why you disagree with the decision in your case. You can give the ALJ new evidence and bring people to testify for you. The ALJ also can require people to bring important papers to your hearing and give facts about your case. You can question these people at your hearing.

Please read the enclosed pamphlet “Your Right To An Administrative Law Judge Hearing And Appeals Council Review Of Your Social Security Case.” It has more information about the hearing.

It Is Important To Go To The Hearing

It is very important that you go to the hearing. If for any reason you can't go, contact the ALJ as soon as possible before the hearing and explain why. The ALJ will reschedule the hearing if you have a good reason.

If you don't go to the hearing and don't have a good reason for not going, the ALJ may dismiss your request for a hearing.

If You Want Help With Your Hearing

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your hearing.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

Enclosures:

English Version of SSA-L8457-U2

English and Spanish Versions of “Your Right To An Administrative Law Judge Hearing and Appeals Council Review Of Your Social Security Case”

  

E. References

• Systems Coding, NL 00801.025B.2.a.

• Title II Spanish Language Notices, NL 00601.600