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SOCIAL SECURITY ADMINISTRATION _____________________________________________________________ | |
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Refer to: TAHB [SSN] [XSSN] |
Office of Hearings and Appeals 5107 Leesburg Pike Falls Church, VA 22041-3255] | |
Last Update: 9/1/05 (Transmittal II-6-13)
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SOCIAL SECURITY ADMINISTRATION _____________________________________________________________ | |
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Refer to: TAHB [SSN] [XSSN] |
Office of Hearings and Appeals 5107 Leesburg Pike Falls Church, VA 22041-3255] | |
[Representative's First Name, Middle Initial and Last
Name]
[Address]
[City, State
Zip]
Dear [Mr./Ms. [Representative's Last Name]]:
Re: [Claimant's Name and Address]
On [insert date], the Appeals Council [denied a request for review of the Administrative Law Judge's decision] OR [issued a decision]. The Council has now received [a request that we reopen and change the decision] OR [more information about the facts and the law in this case] [and] [more evidence].
Under our rules, we may reopen (look again at) and change a determination or decision within certain time limits for any of the following reasons.
New and material evidence.
A clerical error.
The evidence considered in making the determination or decision clearly shows that there was an error.
We found no reason under our rules to reopen and change the decision. This means that the [Administrative Law Judge's] OR [Appeals Council's] decision is the final decision of the Commissioner of Social Security in your case.
[Discuss arguments/additional evidence and explain why reopening is not warranted. If the only issue is expiration of the reopening period for title XVI use paragraph below; no further explanation is necessary.]
[Insert the following if reopening period for title XVI has expired:
The time limit for reopening a decision on a claim for Supplemental Security Income is two years from the date of the notice of the initial determination. The information you sent was received more than two years after the notice dated [insert date]. This means we cannot reopen the decision on the claim for Supplemental Security Income because the time limit has expired.
Under our rules, you do not have the right to court review of our denial of your request for reopening.
If You Have Any Questions
If you have any questions, you may call, write, or visit any Social Security office. If you do call or visit an office, please have this notice with you. The telephone number of the local office that serves your area is [Insert area code and number of servicing Field Office]. Its address is:
[Field Office Address]
[City, State ZIP]
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[Name] | |
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Administrative Appeals Judge |
cc:
[Claimant's Name]
[Address]
[City, State
Zip]
[If claimant is unrepresented, letter will be addressed to claimant and “Re” line and “cc” will be deleted.]