TN 4 (02-95)

A. Description of the SSA-L8166-U2

The SSA-L8166-U2 is a blank form with appeal rights.

B. Process

The system generates an SSA-L8166-U2 when a change occurs that does not change the Federal SSI payment or combined total of the Federal and any State payment (e.g., 10 percent withholding of a recipient's overpayment will begin). The system also generates an SSA-L8166-U2 when a waiver request is approved. Notice language for this situation is in NL 00803.205.

C. When to use

Issue a manual SSA-L8166-U2 to notify:

• A representative payee applicant who has the right to appeal our choice of payee that he/she was not selected as payee;

• A competent adult or emancipated child recipient when a representative payee is selected; or

• A recipient when title II income is adjusted for authorized attorney fees in title XVI offset cases and the title XVI payment is affected.

• A recipient about unconfirmed eligibility when effectuating an appellate reversal;

• A recipient about a decision to collect a penalty.

D. References

• Manual notices for cases involving an attorney - NL 00801.010.

• Notice language for representative payee applicant who is not selected per C. above - NL 00703.824.

• Notice language for competent adult recipient or emancipated child when a representative payee is selected - NL 00703.825.

• Notice language for title XVI offset cases when title II income is adjusted for authorized attorney fees - SI 02006.201 ff.

• Notice language and instructions for unconfirmed eligibility - NL 00804.135, PMTM01 and SI 02301.220.

• Notice language and instructions for collecting a penalty- NL 00804.240, PENM50 and PENM52, and SI 02301.110.