DI 60075: Promoting Opportunity Demonstration (POD)
BASIC (02-18)
A. MACADE ENB coding
For cases the POD Automated System (PAS) cannot process, the POD work unit in the processing center (PC) of jurisdiction codes the enclosure notice block (ENB) field on the history (HST) screen with the PAS paragraphs. The Manual Adjustment Credit and Award Data Entry (MACADE) system generates the following notices:
The POD offset notice;
The auxiliary suspense and reinstatement notice;
The POD BRI adjustment notice
The beneficiary and MEF end of year reconciliation (EOYR) notice; and
The EOYR appeal notice.
NOTE: The ENB field begins with “P” for a complete POD notice or “Q” for an incomplete POD notice.
B. POD universal text identifiers (UTI)
1. New Caption DIBC14
Promoting Opportunity Demonstration (POD)
2. New Caption REFC08
If You Have Questions About POD
3. New Caption REFC09
If You Have Questions That Are Not About POD
4. New UTI ALS101
ALS101 is the standard appeals language for any beneficiary enrolled in POD.
New Language:
If you think this information is not correct or you want to report any changes in your work plans or earnings, please get in touch with your benefits counselor at Abt Associates. Please call their toll-free number at 1-888-771-9188 to report any changes.
New Language with Fill-Ins:
If *F1 this information is not correct or *F2 to report any changes in *F3 work plans or earnings, please get in touch with *F4 benefits counselor at Abt Associates. Please call their toll-free number at 1-888-771-9188 to report any changes.
Fill-Ins:
*F1-1 you think
*F1-2 [Beneficiary name] thinks
*F2-1 you want
*F2-2 he wants
*F2-3 she wants
*F3-1 your
*F3-2 his
*F3-3 her
*F4-1 your
*F4-2 his
*F4-3 her
5. New UTI BEN128
Caption: None
Use BEN128 for all POD BRI adjustment notices.
New Language:
We may have let you know earlier that we would increase your benefits to $700.00 per month due to the rise in the cost of living. Because of your participation in the Promoting Opportunity Demonstration (POD), we have refigured your benefits. This notice corrects the calculation to apply the cost of living increase to your original benefit before the reduction for POD earnings. Your new monthly amount (before deductions) is $600.00.
New Language with Fill-Ins:
We may have let *F1 know earlier that we would increase *F2 benefits to *F3 per month due to the rise in the cost of living. Because of *F4 participation in the Promoting Opportunity Demonstration (POD), we have refigured *F5 benefits. This notice corrects the calculation to apply the cost of living increase to *F6 original benefit before the reduction for POD earnings. *F7 new monthly amount (before deductions) is *F8.
Fill-Ins:
*F1-1 you
*F1-2 Name
*F2-1 your
*F2-2 his
*F2-3 her
*F3-1 BRI/MBR monthly benefit amount in $$$$$.¢¢ format
*F4-1 your
*F4-2 his
*F4-3 her
*F5-1 your
*F5-2 his
*F5-3 her
*F6-1 your
*F6-2 his
*F6-3 her
*F7-1 Your
*F7-2 His
*F7-3 Her
*F8-1 New offset amount monthly benefit amount in $$$$$.¢¢ format
6. New UTI BEN134
Caption: Your Benefits
Use BEN134 for all POD End Date of Participation notices.
New Language:
You are no longer eligible for the project because you have had benefits terminated prior to the POD start date of participation. If you are receiving benefit payments based on disability, your payments may stop the first month you do substantial gainful work.
New Language with Fill-Ins:
*F1 no longer eligible for the project because *F2 *F3. If *F4 receiving benefit payments based on disability, *F5 payments may stop the first month *F6 substantial gainful work.
Fill-Ins:
*F1-1 You are
*F1-2 Beneficiary full name is
*F2-1 you have
*F2-2 he has
*F2-3 she has
*F3-1 had benefits terminated prior to the POD start date of participation
*F3-2 participated in another demonstration
*F3-3 moved to a foreign country
*F3-4 received benefits paid by the railroad
*F3-5 elected to receive benefits not based on a disability
*F3-6 no longer met the POD eligibility criteria
*F4-1 you are
*F4-2 he is
*F4-3 she is
*F5-1 your
*F5-2 his
*F5-3 her
*F6-1 you do
*F6-2 he does
*F6-3 she does
7. New UTI BEN135
Caption: Why We Cannot Pay You
Use BEN135 if an auxiliary's benefits end in suspense for the current month.
New Language:
We cannot pay you benefits for January 2017 under the rules of the Promoting Opportunity Demonstration (POD). This is due to John Doe’s work and earnings. This does not change any current benefits you receive.
New Language with Fill-Ins:
We cannot pay *F1 benefits for *F2 under the rules of the Promoting Opportunity Demonstration (POD). This is due to *F3 work and earnings. This does not change any current benefits *F4.
Fill-Ins:
*F1-1 you
*F1-2 [Beneficiary name] possessive
*F2-1 MM/CCYY
*F2-2 MM/CCYY through MM/CCYY
*F3-1 Name (POD participant) possessive
*F4-1 you receive
*F4-2 he receives
*F4-3 she receives
8. New UTI BEN136
Caption: None
Use BEN136 in all POD Earnings Notices that include an underpayment.
New Language:
You will soon receive a check for $500.00. This check is for benefits due to you for January 2017 through March 2017 under the rules of the Promoting Opportunity Demonstration (POD). You are due this check because of a change in your work and earnings. This does not change any current benefits you receive.
New Language with Fill-Ins:
*F1 will soon receive a check for *F2. This check is for benefits due to *F3 for *F4 under the rules of the Promoting Opportunity Demonstration (POD). *F5 due this check because of a change in *F6 work and earnings. This does not change any current benefits *F7.
Fill-Ins:
*F1-1 You
*F1-2 Beneficiary full name
*F2-1 Refund amount in $$$$$.¢¢ format
*F3-1 you
*F3-2 him
*F3-3 her
*F4-1 MM/CCYY
*F4-2 MM/CCYY through MM/CCYY
*F5-1 You are
*F5-2 He is
*F5-3 She is
*F6-1 your
*F6-2 his
*F6-3 her
*F6-4 POD beneficiary's name (possessive)
*F7-1 you receive
*F7-2 he receives
*F7-3 she receives
9. New UTI BEN130
Caption: None
Use BEN130 when a POD EOYR reconsideration results in no change to benefits.
New Language:
Thank you for providing us with information about your earnings for last year. You asked us to determine if there has been a change in the amount of benefits payable to you under POD because of this information. Based on this evidence, we have determined that there is no change to your monthly benefit amount for this period. This decision does not change any benefits you may be currently receiving.
New Language with Fill-Ins:
Thank you for providing us with information about *F1 earnings for last year. *F2 asked us to determine if there has been a change in the amount of benefits payable to *F3 under POD because of this information. Based on this evidence, we have determined that there is no change to *F4 monthly benefit amount for this period. This decision does not change any benefits *F5 may be currently receiving.
Fill-Ins:
*F1-1 your
*F1-2 Beneficiary full name [possessive]
*F2-1 You
*F2-2 He
*F2-3 She
*F3-1 you
*F3-2 him
*F3-3 her
*F4-1 your
*F4-2 his
*F4-3 her
*F5-1 you
*F5-2 he
*F5-3 she
10. New UTI BEN129
Caption: None
Use BEN129 when a POD EOYR reconsideration results in a change to benefits.
New Language:
Thank you for providing us with information about your earnings for the last year. You asked us to determine if there has been a change in benefits payable to you under POD because of this information.
New Language with Fill-Ins:
Thank you for providing us with information about *F1 earnings for the last year. *F2 asked us to determine if there has been a change in benefits payable to *F3 under POD because of this information.
Fill-Ins:
*F1-1 your
*F1-2 Beneficiary full name [possessive]
*F2-1 You
*F2-2 He
*F2-3 She
*F3-1 you
*F3-2 him
*F3-3 her
11. New UTI BEN137
Use as a lead paragraph for all POD EOYR Reconsideration notices.
New Language:
We received a request for an explanation.
New Language with Fill-Ins:
We received a request *F1.
Fill-Ins:
*F1-1 for an explanation
*F1-2 that we not collect the overpayment
*F1-3 that we review our decision
*F1-4 that we review our decision and not collect the overpayment
*F1-5 that we withhold a different amount
12. New UTI BEN138
Use when POD participant's participation period is over.
New Language:
You have been a participant in the Promoting Opportunity Demonstration (POD). The special rules for POD will no longer apply to you beginning July 2021. You asked to be withdrawn from the project. If you are receiving benefit payments based on disability, your payments may stop the first month you do substantial gainful work.
New Language with Fill-Ins:
*F1 been a participant in the Promoting Opportunity Demonstration (POD). The special rules for POD will no longer apply to *F2 beginning *F3. *F4.
Fill-ins:
*F1-1: You have
*F1-2: Beneficiary name has
*F2-1: you
*F2-2: him
*F2-3: her
*F3-1: Date in MM/CCYY format
*F4-1: You asked to be withdrawn from the project. If you are receiving benefit payments based on disability, your payments may stop the first month you do substantial gainful work.
*F4-2: He asked to be withdrawn from the project. If he is receiving benefit payments based on disability, his payments may stop the first month he does substantial gainful work.
*F4-3 She asked to be withdrawn from the project. If she is receiving benefit payments based on disability, her payments may stop the first month she does substantial gainful work.
*F4-4: Null
13. New UTI BEN131
Use in the POD End Date of Participation notice.
New Language:
Your participation period ends June 2021. Payments may end with the month you do substantial gainful work after June 2017.
New Language with Fill-Ins:
*F1 participation period ends *F2. Payments may end with the month *F3 substantial gainful work after *F4.
Fill-ins:
*F1-1: Your
*F1-2: Beneficiary name possessive
*F2-1: Date in MM/CCYY format
*F3-1: you do
*F3-2: he does
*F3-3: she does
*F4-1: Date in MM/CCYY format
14. New UTI BEN132
Use BEN132 in an End of Year Reconciliation notice or an EOYR Reconsideration notice when either notice results in an overpayment or underpayment.
New Language:
This overpayment resulted from the difference in the total amount of earnings that you submitted during 2018 and the actual amount that you earned, during that year. We determined the overpayment after we recalculated your offset based on your actual annual earnings.
New Language with Fill-Ins:
This *F1 resulted from the difference in the total amount of earnings that *F2 submitted during *F3 and the actual amount that *F4 earned, during that year. We determined the *F5 after we recalculated *F6 offset based on *F7 actual annual earnings.
Fill-ins:
*F1-1: overpayment
*F1-2: underpayment
*F2-1: you
*F2-2: he
*F2-3: she
*F3-1: EOYR year in CCYY format
*F4-1: you
*F4-2: he
*F4-3: she
*F5-1: overpayment
*F5-2: underpayment
*F6-1: your
*F6-2: his
*F6-3: her
*F7-1: your
*F7-2: his
*F7-3: her
15. New UTI BEN133
Use BEN133 when a beneficiary has not reported earnings for three months and we send a reminder notice.
New Language:
If you are working and have not submitted your earnings, please contact Abt Associates immediately. We show their contact information under the heading, “If You Have Questions About POD”. If you do not submit earnings, we may pay you incorrect benefit payments.
New Language with Fill-Ins:
If *F1 working and *F2 not submitted *F3 earnings, please contact Abt Associates immediately. We show their contact information under the heading, “If You Have Questions About POD”. If *F4 not submit earnings, we may pay *F5 incorrect benefit payments.
Fill-ins:
*F1-1: you are
*F1-2: Name is
*F2-1: you have
*F2-2: he has
*F2-3: she has
*F3-1: your
*F3-2: his
*F3-3: her
*F4-1: you do
*F4-2: he does
*F4-3: she does
*F5-1: you
*F5-2: him
*F5-3: her
16. New UTI BEN139
Use BEN139 when benefits are offset due to earnings.
New Language:
Based on your offset your monthly benefits are
Amount Date
$800.00 April 2018
New Language with Fill-Ins:
Based on *F1 offset *F2 monthly benefits are
Amount Date
*F3 *F4
Fill-ins:
*F1-1: your
*F1-2: Beneficiary's name possessive
*F2-1: your
*F2-2: his
*F2-3: her
*F3-1: POD MBC for that month in $$$$$.¢¢ format
*F4-1: Date in MM/CCYY format
17. New UTI BEN140
Use BEN140 when more than one month is needed for BEN139. This will continue the columns at the end of the BEN139. No further language required. Repeat as many times as needed.
New Language:
$1000.00 May 2018
New Language with Fill-Ins:
*F1 *F2
Fill-ins:
*F1-1: POD MBC for that month in $$$$$.¢¢ format
*F2-1: Date in MM/CCYY format
18. New UTI BRR081
Caption: None
Use BRR081 if offset results in beneficiary coming out of suspense status in current month.
New Language:
Because of your work and earnings, benefits are payable to you under the rules of the Promoting Opportunity Demonstration (POD). If your work or earnings change, we may not be able to pay some benefits in the future.
New Language with Fill-Ins:
Because of *F1 work and earnings, benefits are payable to *F2 under the rules of the Promoting Opportunity Demonstration (POD). If *F3 work or earnings change, we may not be able to pay some benefits in the future.
Fill-Ins:
*F1-1 your
*F1-2 POD [Beneficiary full name] possessive
*F2-1 you
*F2-2 him
*F2-3 her
*F3-1 your
*F3-2 his
*F3-3 her
19. New UTI BRR082
Use BRR082 if action results in full earnings offset in the current month.
New Language:
Because of your work and earnings, no benefits are payable to you now under the rules of the Promoting Opportunity Demonstration (POD). If your work or earnings change, we may be able to pay some benefits in the future.
New Language with Fill-Ins:
Because of *F1 work and earnings, no benefits are payable to *F2 now under the rules of the Promoting Opportunity Demonstration (POD). If *F3 work or earnings change, we may be able to pay some benefits in the future.
Fill-Ins:
*F1-1 your
*F1-2 POD [Beneficiary full name] possessive
*F2-1 you
*F2-2 him
*F2-3 her
*F3-1 your
*F3-2 his
*F3-3 her
20. New UTI ERN095
Use ERN095 if the participant submitted IRWE above the standard threshold.
New Language:
You have submitted impairment-related work expenses that have raised the threshold to $1000 for January 2018. This threshold will return to $870.00 next month if you do not submit impairment-related work expenses for that month.
New Language with Fill-Ins:
*F1 submitted impairment-related work expenses that have raised the threshold to *F2 for *F3. This threshold will return to *F4 next month if you do not submit impairment-related work expenses for that month.
Fill-ins:
*F1-1: You have
*F1-2: Beneficiary Name has
*F2-1: Total approved IRWE for that month in $$$$$.¢¢ format
*F3-1: Date in MM/CCYY format
*F4-1: TWP rate
21. New UTI ERN096
Use ERN096 whenever earnings are reported by the participant.
New Language:
You submitted earnings of
Amount Date
$4,000.00 April 2017
New Language with Fill-Ins:
*F1 submitted earnings of
Amount Date
*F2 *F3
Fill-ins:
*F1-1: You
*F1-2: Beneficiary Name
*F1-2: Total earnings submitted for that month in $$$$$.¢¢ format
*F1-3: Date in MM/CCYY format
22. New UTI ERN097
Use ERN097 when more than one month is needed for ERN096. This will continue the columns at the end of the ERN096. No further language required. Repeat as many times as needed.
New Language:
$3000.00 May 2018
New Language with Fill-Ins:
*F1 *F2
Fill-ins:
*F1-1: Total earnings submitted for that month in $$$$$.¢¢ format
*F2-1: Date in MM/CCYY format
23. New UTI REF172
Use REF172 in all POD notices.
New Language:
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt Associates answer your questions.
New Language with Fill-Ins:
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt Associates answer your questions.
24. New UTI TER053
Use TER053 in all POD termination notices.
New Language:
You have been receiving $0 in benefits for twelve consecutive months because of work. Therefore, you are no longer disabled as of January 2017 according to POD rules. The last month for which you are eligible to receive benefits is December 2016.
If you receive disability benefits in the future, contact Abt Associates to report earnings. We show their contact information under the heading, “If You Have Questions About POD”.
New Language with Fill-Ins:
*F1 been receiving $0 in benefits for twelve consecutive months because of work. Therefore, *F2 no longer disabled as of *F3 according to POD rules. The last month for which *F4 eligible to receive benefits is *F5.
If *F6 disability benefits in the future, contact Abt Associates to report earnings. We show their contact information under the heading, “If You Have Questions About POD”.
Fill-ins:
*F1-1: You have
*F1-2: Beneficiary’s name has
*F2-1: you are
*F2-2: he is
*F2-3: she is
*F3-1: Date in MM/CCYY format
*F4-1: you are
*F4-2: he is
*F4-3 she is
*F5-1: Date in MM/CCYY format
*F6-1: you receive
*F6-2: he receives
*F6-3: she receives
25. New UTI WDS024
Use WDS024 whenever offset is applied due to earnings.
New Language:
In POD, a qualified individual is provided an opportunity to work and earn over a $870.00 threshold and have $1 of benefits withheld for every $2 earned over this amount.
New Language with Fill-Ins:
In POD, a qualified individual is provided an opportunity to work and earn over a *F1 threshold and have $1 of benefits withheld for every $2 earned over this amount.
Fill-ins:
*F1-1: TWP rate
26. New UTI WDS025
Use WDS025 whenever benefits are offset.
New Language:
We determine how much to reduce your benefit payments under the $1 for $2 offset based on your submitted earnings from the prior month.
Next, we subtract the POD threshold amount from the earnings you submitted and divide the remaining amount by two. This is the monthly offset amount. The monthly offset amount is the amount by which your benefits are reduced under the benefit offset. Based on the earnings you submitted and the computations above, your monthly offset is
Amount Date
$200.00 April 2018
New Language with Fill-Ins:
We determine how much to reduce *F1 benefit payments under the $1 for $2 offset based on *F2 submitted earnings from the prior month.
Next, we subtract the POD threshold amount from the earnings *F3 submitted and divide the remaining amount by two. This is the monthly offset amount. The monthly offset amount is the amount by which *F4 benefits are reduced under the benefit offset. Based on the earnings *F5 submitted and the computations above, *F6 monthly offset is
Amount Date
*F7 *F8
Fill-ins:
*F1-1: your
*F1-2: Beneficiary Name possessive
*F2-1: your
*F2-1: his
*F2-3: her
*F3-1: you
*F3-2: he
*F3-3: she
*F4-1: your
*F4-2: his
*F4-3: her
*F5-1: you
*F5-2: he
*F5-2: she
*F6-1: your
*F6-2: his
*F6-3: her
*F7-1: Monthly offset amount in $$$$$.¢¢ format
*F8-1: date in MM/CCYY format
27. New UTI WDS026
Use WDS026 when more than one month is needed for WDS025. This will continue the columns at the end of the WDS025. No further language required. Repeat as many times as needed.
New Language:
$350.00 May 2018
New Language with Fill-Ins:
*F1 *F2
Fill-ins:
*F1-1: Monthly offset amount in $$$$$.¢¢ format
*F2-1: Date in MM/CCYY format
Sample Notices
1. POD Reminder – No earnings submission for three months
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved]
We are writing to give you new information about the *F1 (Disability) benefits which *F2 (you receive) on this Social Security record.
[INFC08 – Approved] – Things to Remember
[POD UTI BEN133]
If *F1 (you are) working and *F2 (you have) not submitted *F3 (your) earnings, please contact Abt Associates immediately. We show their contact information under the heading, “If You Have Questions About POD”. If *F4 (you do) not submit earnings, we may pay *F5 (you) incorrect benefit payments.
[RCT053 – Approved]
*F1 (You) must promptly report any changes that may affect *F2 (your) benefits. Failure to do so could mean *F3 (you) may have to repay any benefits not due. Let us know if:
*F4 (You) went to work since *F5 (your) last report or *F6 (you return) to work in the future; or
*F7 (You) already reported *F8 (your) work, but *F9 (your) duties or pay changed. (Remember to keep records of work and earnings such as pay statements from the employer); or
*F10 (Your) doctor says *F11 (your) condition has improved even if *F12 (you return) to work now; or
*F13 (You) applied for, start getting or have a change in the amount of *F14 (your) workers compensation or another public disability benefit; or
*F15 (You start) paying for work expenses related to *F16 (your) disability such as special transportation or the amount paid for these work expenses changes or *F17 (you) no longer *F18 (pay) for such expenses. (Remember to keep records and proof of payment for any work expenses.)
[POD Caption REFC08] - If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions That Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
2. POD Earnings Offset Notice
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved]
We are writing to give you new information about the *F1 (Disability) benefits which *F2 (you receive) on this Social Security record.
[POD Caption DIBC14] – Promoting Opportunity Demonstration (POD)
[POD UTI WDS024]
In POD, a qualified individual is provided an opportunity to work and earn over a *F1 (TWP rate) threshold and have $1 of benefits withheld for every $2 earned over this amount.
[CHKC09 – Approved] – Your Benefits
[POD UTI ERN096] Use ERN097 to continue paragraph if more than one month submitted
*F1 (You) submitted earnings of
Amount Date
*F2 (earnings) *F3 (month).
[POD UTI ERN095] Repeat if more than one month of earnings supplied
*F1 (You have) submitted impairment-related work expenses that have raised the threshold to *F2 (approved IRWE amount) for *F3 (month). This threshold will return to *F4 (TWP amount) next month if you do not submit impairment-related work expenses for that month.
[POD UTI WDS025] Use WDS026 to continue paragraph if more than one month submitted
We determine how much to reduce *F1 (your) benefit payments under the $1 for $2 offset based on *F2 (your) submitted earnings from the prior month.
Next, we subtract the POD threshold amount from the earnings *F5 (you) submitted and divide the remaining amount by two. This is the monthly offset amount. The monthly offset amount is the amount by which *F6 (your) benefits are reduced under the benefit offset. Based on the earnings *F7 (you) submitted and the computations above, *F8 (your) monthly offset is
Amount Date
*F9 (POD offset amount) *F10 (first month).
[POD UTI BEN139] Use BEN140 to continue paragraph if more than one month submitted
Based on *F1 (your) earnings *F2 (your) monthly benefits are
Amount Date
*F3 (POD MBC) *F4 (first month)
[PAYC38 – Approved] – What We Will Pay
[RNS034 – Approved]
You will soon receive a payment for $$$$$.¢¢, which is the money you are due through MM/YYYY.
After that you will receive $$$$$.¢¢ on or about the 3rd of each month.
[POD UTI BRR081] Use if offset results in beneficiary coming out of suspense status in current month
Because of *F1 (your) work and earnings, benefits are payable to *F2 (you) under the rules of the Promoting Opportunity Demonstration (POD). If *F3 (your) work or earnings change, we may not be able to pay some benefits in the future.
[POD UTI BRR082] Use if offset ends in suspense in current month
Because of *F1 (Your) work and earnings, no benefits are payable to *F2 (you) now under the rules of the Promoting Opportunity Demonstration (POD). If *F3 (your) work or earnings change, we may be able to pay some benefits in the future.
[POD UTI BEN136] Use if late earnings are submitted and back payment is due
*F1 (You) will soon receive a check for *F2 (PMA amount). This check is for benefits due to *F3 (you) for *F4 (months adjusted) under the rules of the Promoting Opportunity Demonstration (POD). *F5 (You are) due this check because of a change in *F6 (your) work and earnings. This does not change any current benefits *F7 (you receive).
[ALSC01 – Approved] – Do You Think We Are Wrong
[POD UTI ALS101]
If *F1 (you) think this information is not correct or *F2 (you want) to report any changes in *F3 (your) work plans or earnings, please get in touch with *F4 (your) benefits counselor at Abt Associates. Please call their toll-free number at 1-888-771-9188 to report any changes.
Optional paragraphs, only use if Medicare Part B is being deducted from benefits
[HIBC01 - Approved] - Information About Medicare
[HIB187—Approved]
We will continue to deduct Medicare premiums from your monthly checks.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is *1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
3. POD BRI Adjustment Notice
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved]
We are writing to give you new information about the *F1 (Disability) benefits which *F2 (you receive) on this Social Security record.
[POD UTI BEN128]
We may have let *F1 (you) know earlier that we would increase *F2 (your) benefits to *F3 (MBA that appears on MBR) per month due to the rise in the cost of living. Because of *F4 (your) participation in the Promoting Opportunity Demonstration (POD), we have refigured *F5 (your) benefits. This notice corrects the calculation to apply the cost of living increase to *F6 (your) original benefit before the reduction for POD earnings. *F7 (Your) new monthly amount (before deductions) is *F8 (MBA after POD BRI).
[ALSC01 – Approved] – Do You Think We Are Wrong
[POD UTI ALS101]
If *F1 (you) think this information is not correct or *F2 (you want) to report any changes in *F3 (your) work plans or earnings, please get in touch with *F4 (your) benefits counselor at Abt Associates. Please call their toll-free number at 1-888-771-9188 to report any changes.
[POD Caption REFC08– If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
4. POD End of Year Reconciliation Notice
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved] Use if there is an underpayment
We are writing to give you new information about the *F1 (disability) benefits which *F2 (you receive) on this Social Security record.
[OPT161 – Approved] Use if there is an overpayment
We are writing to give *F1 new information about the *F2 (disability) benefits which *F3 (you receive) on this Social Security record. In the rest of this letter, we will tell *F4 (you):
How we paid *F5 (you) *F6 (amount of overpayment) too much in benefits; and
What to do if *F7 (you think) we are wrong about the overpayment.
[CHKC09 – Approved] – Your Benefits
[BEN106 - Approved]
Based on *F1 (your) earnings of *F2 (earnings amount) for *F3 (year of EOYR), we should have paid *F5 (new POD MBC) *F6 (first adjusted month).
[BEN120 – Approved] Use with BEN106 for all subsequent months if more than one month adjusted
[OPT179 – Approved]
We paid *F1 (you) $*F2 (MBC Paid) for *F3 (mm/ccyy, mm/ccyy through mm/ccyy). Since we should have paid *F4 (you) $*F5 (MBC should have been paid) for *F6 (mm/ccyy, mm/ccyy through mm/ccyy), we paid *F7 (you) $*F8 (amount of overpayment/underpayment) *F9 (more, less) than *F10 (you were) due.
[POD UTI BEN132] Use if an underpayment or overpayment is generated
This *F1 (overpayment/underpayment) resulted from the difference in the total amount of earnings that *F2 (you) submitted during *F3 (EOYR year) and the actual amount that *F4 (you) earned, during that year. We determined the *F5 (overpayment/underpayment) after we recalculated *F6 (your) offset based on *F7 (your) actual annual earnings.
[POD UTI BEN138] Use if EOYR is run after POD period is over
*F1 (You have) been a participant in the Promoting Opportunity Demonstration (POD). The special rules for POD will no longer apply to *F2 (you) beginning *F3 (month after POD end date).
[OPTC05 – Approved] – How To Pay Us Back Only used in case of overpayment
[RFU001 – Approved] Use if the current LAF indicates anything other than current pay or deferred
You should refund this overpayment within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Include *F1 (your) claim number (as shown above) on your check or money order.
If you cannot refund the full *F2 (overpayment amount) now, please send:
A partial payment
An explanation of why you cannot pay the full amount now, and
A plan to repay the money.
[RFU012 – Approved] Use if the current LAF indicates current pay or deferred
You should refund this overpayment of *F1 (overpayment amount) within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Include *F2 (your) claim number (as shown above) on your check or money order.
If we do not receive your refund within 30 days, we will hold back *F3 (your) full benefits starting with the payment you would normally receive about *F5 (end date of deferral). We will continue holding back *F6 (your) benefits until we recover the overpayment.
If you cannot refund the full overpayment now or cannot afford to have us hold back *F7 (your) full benefits, you may ask us to hold back a smaller amount each month. Contact us to discuss your plan for repaying the balance. You may need to show us proof of *F8 (your) assets, monthly income, and expenses.
[OPT165 – Approved] Use if REFU012 is used above
We will pay you a monthly check of *F1 (current month benefit) until we start to collect the overpayment.
[ALSC06 – Approved] – Do You Think We Are Wrong About The Overpayment Use for overpayment
[WAV002 – Approved]
You have certain rights with respect to this overpayment and its recovery.
Right to Appeal: If you disagree in any way with this overpayment determination, you have the right, within 60 days of the date you receive this notice, to request that the determination be reconsidered. If you request this independent review of the overpayment determination, please submit any additional information you have which pertains to the overpayment.
-
Right to Request Waiver: You also have the right to request a determination concerning the need to recover the overpayment. An overpayment must be refunded or withheld from benefits unless both of the following are true:
The overpayment was not your fault in any way; and
You could not meet your necessary living expenses if we recovered the overpayment, or recovery would be unfair for some other reason.
If you request waiver, we may need a statement of your assets and monthly income and expenses.
If you request reconsideration and/or waiver within 30 days, the overpayment will not have to be recovered until the case is reviewed. This review is described in more detail on the attached Form SSA-3105, Important Information About Your Appeal and Waiver Rights. The people in any Social Security office will be glad to help you complete the forms for requesting reconsideration (SSA-561-U2, Request for Reconsideration) and/or waiver (SSA-632-F4, Overpayment Recovery Questionnaire).
Even if you do not want to request reconsideration or waiver, please call, write or visit any Social Security office if you have any questions or need more information. Please take this letter with you if you do visit an office.
[ALSC27 – Approved] – If You Want To Appeal
[ALS120 – Approved]
If you disagree with this decision, you have the right to appeal. We will review your case and consider any new facts you have. A person who did not make the first decision will decide your case. We will correct any mistakes. We will review those parts of the decision which you believe are wrong and will look at any new facts you have. We may also review those parts which you believe are correct and may make them unfavorable or less favorable to you.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
5. POD Auxiliary Notice – action ends in suspense
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved] Use if there is an underpayment
We are writing to give you new information about the *F1 (disability) benefits which *F2 (you receive) on this Social Security record.
[OPT161 – Approved] Use if there is an overpayment
We are writing to give *F1 new information about the *F2 (disability) benefits which *F3 (you receive) on this Social Security record. In the rest of this letter, we will tell *F4 (you):
How we paid *F5 (you) *F6 (amount of overpayment) too much in benefits; and
What to do if *F7 (you think) we are wrong about the overpayment.
[CHKC09 – Approved] – Your Benefits
[POD UTI BEN135]
We cannot pay *F1 (you) benefits for *F2 (mm/ccyy) under the rules of the Promoting Opportunity Demonstration (POD). This is due to *F3 (Name of POD participant's) work and earnings. This does not change any current benefits *F4 (you receive).
[OPT169 – Approved] Use if there is an overpayment
Since we paid *F1 (you) *F2 (amount paid) for *F3 (dates paid), we paid *F4 (you) *F5 (amount of overpayment/underpayment) *F6 (more/less) than *F7 (you were) due.
[OPTC05 – Approved] – How To Pay Us Back Only used in case of overpayment
[RFU001 – Approved] Use if the current LAF indicates anything other than current pay or deferred
You should refund this overpayment within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Include *F1 (your) claim number (as shown above) on your check or money order.
If you cannot refund the full *F2 (overpayment amount) now, please send:
A partial payment
An explanation of why you cannot pay the full amount now, and
A plan to repay the money.
[RFU012 – Approved] Use if the current LAF indicates current pay or deferred
You should refund this overpayment of *F1 (overpayment amount) within 30 days. Please make your check or money order payable to "Social Security Administration," and send it to us in the enclosed envelope. Include *F2 (your) claim number (as shown above) on your check or money order.
If we do not receive your refund within 30 days, we will hold back *F3 (your) full benefit starting with the payment you would normally receive about *F5 (end date of deferral). We will continue holding back *F6 (your) benefits until we recover the overpayment.
If you cannot refund the full overpayment now or cannot afford to have us hold back *F7 (your) full benefit, you may ask us to hold back a smaller amount each month. Contact us to discuss your plan for repaying the balance. You may need to show us proof of *F8 (your) assets, monthly income, and expenses.
[OPT165 – Approved] Use if REFU012 is used above
We will pay you a monthly check of *F1 (current month benefit) until we start to collect the overpayment.
[ALSC06 – Approved] – Do You Think We Are Wrong About The Overpayment Use for overpayment
[WAV002 – Approved]
You have certain rights with respect to this overpayment and its recovery.
Right to Appeal: If you disagree in any way with this overpayment determination, you have the right, within 60 days of the date you receive this notice, to request that the determination be reconsidered. If you request this independent review of the overpayment determination, please submit any additional information you have which pertains to the overpayment.
-
Right to Request Waiver: You also have the right to request a determination concerning the need to recover the overpayment. An overpayment must be refunded or withheld from benefits unless both of the following are true:
The overpayment was not your fault in any way; and
You could not meet your necessary living expenses if we recovered the overpayment, or recovery would be unfair for some other reason.
If you request waiver, we may need a statement of your assets and monthly income and expenses.
If you request reconsideration and/or waiver within 30 days, the overpayment will not have to be recovered until the case is reviewed. This review is described in more detail on the attached Form SSA-3105, Important Information About Your Appeal and Waiver Rights. The people in any Social Security office will be glad to help you complete the forms for requesting reconsideration (SSA-561-U2, Request for Reconsideration) and/or waiver (SSA-632-F4, Overpayment Recovery Questionnaire).
Even if you do not want to request reconsideration or waiver, please call, write or visit any Social Security office if you have any questions or need more information. Please take this letter with you if you do visit an office.
[ALSC27 – Approved] – If You Want To Appeal
[ALS023– Approved]
If you disagree with this decision, you have the right to appeal. We will review your case and consider any new facts you have. A person who did not make the first decision will decide your case. We will correct any mistakes. We will review those parts of the decision, which you believe are wrong and will look at any new facts you have. We may also review those parts, which you believe are correct and may make them unfavorable or less favorable to you.
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 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.
You have to ask for an appeal in writing. We will ask you to sign a form SSA-561-U2, called “Request for Reconsideration”. Contact one of our offices if you want help.
Please read the enclosed pamphlet: Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about the appeal.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD UTI REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
6. POD Auxiliary Notice – action puts auxiliary back in pay status
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved]
We are writing to give you new information about the *F1 (disability) benefits which *F2 (you receive) on this Social Security record.
[PAYC38 – Approved] – What We Will Pay
[POD UTI BEN136]
*F1 (You) will soon receive a check for *F2 (amount). This check is for benefits due to *F3 (you) for *F4 (months of backpay) under the rules of the Promoting Opportunity Demonstration (POD). *F5 (You are) due this check because of a change in *F6 (POD participant's) work and earnings. This does not change any current benefits *F7 (you receive).
[ALSC27 – Approved] – If You Want To Appeal
[ALS023– Approved]
If you disagree with this decision, you have the right to appeal. We will review your case and consider any new facts you have. A person who did not make the first decision will decide your case. We will correct any mistakes. We will review those parts of the decision, which you believe are wrong and will look at any new facts you have. We may also review those parts, which you believe are correct and may make them unfavorable or less favorable to you.
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 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.
You have to ask for an appeal in writing. We will ask you to sign a form SSA-561-U2, called “Request for Reconsideration”. Contact one of our offices if you want help.
Please read the enclosed pamphlet: Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about the appeal.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
7. EOYR Reconsideration – no change in benefits
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[POD UTI BEN137]
We received a request *F1 (that we review our decision).
[CHKC09 – Approved] – Your Benefits
[POD UTI BEN130]
Thank you for providing us with information about *F1 (your) earnings for last year. *F2 (You) asked us to determine if there has been a change in the amount of benefits payable to *F3 (you) under POD because of this information. Based on this evidence, we have determined that there is no change to *F4 (your) monthly benefit amount for this period. This decision does not change any benefits *F5 (you) may be currently receiving.
[BEN107 – Approved]
This means we paid *F1 (you) correctly based on the evidence *F2 (you) provided for the reconciliation year.
[ALSC01 – Approved] – Do You Think We Are Wrong
[POD UTI ALS101]
If *F1 (you) think this information is not correct or *F2 (you want) to report any changes in *F3 (your) work plans or earnings, please get in touch with *F4 (your) benefits counselor at Abt Associates. Please call their toll-free number at 1-888-771-9188 to report any changes.
[ALSC27 – Approved] – If You Want To Appeal
[ALS023– Approved]
If you disagree with this decision, you have the right to appeal. We will review your case and consider any new facts you have. A person who did not make the first decision will decide your case. We will correct any mistakes. We will review those parts of the decision, which you believe are wrong and will look at any new facts you have. We may also review those parts, which you believe are correct and may make them unfavorable or less favorable to you.
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 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.
You have to ask for an appeal in writing. We will ask you to sign a form SSA-561-U2, called “Request for Reconsideration”. Contact one of our offices if you want help.
Please read the enclosed pamphlet: Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about the appeal.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
8. EOYR Reconsideration – change in benefits
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[POD UTI BEN137]
We received a request *F1 (that we review our decision).
[CHKC09 – Approved] – Your Benefits
[POD UTI BEN129]
Thank you for providing us with information about *F1 (your) earnings for the last year. *F2 (You) asked us to determine if there has been a change in benefits payable to *F3 (you) under POD because of this information.
[OPT179 – Approved]
We paid *F1 (you) *F2 (MBC Paid) for *F3 (period of EOYR). Since we should have paid *F4 (you) *F5 (MBC should have been paid) for *F6 (period of EOYR), we paid *F7 (you) *F8 (amount of overpayment/underpayment) *F9 (more, less) than *F10 (you were) due.
[POD UTI BEN132]
This *F1 (overpayment/underpayment) resulted from the difference in the total amount of earnings that *F2 (you) submitted during *F3 (EOYR year) and the actual amount that *F4 (you) earned, during that year. We determined the *F5 (overpayment/underpayment) after we recalculated *F6 (your) offset based on *F7 (your) actual POD earnings.
[POD UTI BEN138] Use if EOYR reconsideration is run after POD period is over
*F1 (You have) been a participant in the Promoting Opportunity Demonstration (POD). The special rules for POD will no longer apply to *F2 (you) beginning *F3 (month after POD end date). *F4
[ALSC01 – Approved] – Do You Think We Are Wrong
[RCN021 – Approved]
We changed our earlier decision because of new facts we received.
If you think we are wrong, you have the right to request 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. In the rest of our letter, we will call this person an ALJ. The ALJ will review those parts of the decision, which you believe are wrong. The ALJ will look at any new facts you have and correct any mistakes. The ALJ may also review those parts, which you believe are correct and make them unfavorable or less favorable to you.
You have 60 days to ask for a hearing.
The 60 days start the day after you get this letter.
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. If you want to make a request, please contact one of our offices. We can help you complete the required form.
Please read the enclosed pamphlet, "Your Right To An Administrative Law Judge Hearing And Appeals Council Review Of Your Social Security Case." It contains more information about the hearing.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
9. POD End Date of Participation
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[LIS004 – Approved]
We are writing to give you new information about the *F1 (disability) benefits which *F2 (you receive) on this Social Security record.
[CHKC09 – Approved] – Your Benefits
[POD UTI BEN138]
*F1 (You have) been a participant in the Promoting Opportunity Demonstration (POD). The special rules for POD will no longer apply to *F2 (you) beginning *F3 (first day of the month after POD end date). *F4.
*F4-A: You asked to be withdrawn from the project. If you are receiving benefit payments based on disability, your payments may stop the first month you do substantial gainful work.
*F4-B: He asked to be withdrawn from the project. If he is receiving benefit payments based on disability, his payments may stop the first month he does substantial gainful work.
*F4-C She asked to be withdrawn from the project. If she is receiving benefit payments based on disability, her payments may stop the first month she does substantial gainful work.
*F4-D: Null
[POD UTI BEN134] Use if BEN138 fill-in 4 is A, B, or C)
*F1 (You are) no longer eligible for the project because *F2 (you have) *F3 (no longer met the POD eligibility criteria). If *F4 (you are) receiving benefit payments based on disability, *F5 (your) payments may stop the first month *F6 (you do) substantial gainful work.
[POD UTI BEN131] Use if BEN138 fill-in 4 is D)
*F1 (Your) participation period ends *F2 (POD end date). Payments may end with the month *F3 (you do) substantial gainful work after *F4 (POD end date).
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]
10. POD Termination Notice
Social Security Administration
Retirement, Survivors and Disability Insurance
Date:
Claim Number:
Name and address
[TER039 – Approved]
We are writing to tell *F1 (you) that *F2 (you no longer qualify) for *F3 (disability) benefits beginning *F4 (termination date).
[CHKC09 – Approved] – Your Benefits
[POD UTI TER035]
*F1 (You have) been receiving $0 in benefits for twelve consecutive months because of work. Therefore, *F2 (you are) no longer disabled as of *F3 (termination date) according to POD rules. The last month for which *F4 (you are) eligible to receive benefits is *F5 (month before termination date).
If *F6 (you) receive disability benefits in the future, contact Abt Associates to report your earnings. We show their contact information under the heading, “If You Have Questions About POD”.
[ALSC01 – Approved] – Do You Think We Are Wrong
[POD UTI ALS101]
If *F1 (you) think this information is not correct or *F2 (you want) to report any changes in *F3 (your) work plans or earnings, please get in touch with *F4 (your) benefits counselor at Abt Associates. Please call their toll-free number at 1-888-771-9188 to report any changes.
[ALSC27 – Approved] – If You Want To Appeal
[ALS023– Approved]
If you disagree with this decision, you have the right to appeal. We will review your case and consider any new facts you have. A person who did not make the first decision will decide your case. We will correct any mistakes. We will review those parts of the decision, which you believe are wrong and will look at any new facts you have. We may also review those parts, which you believe are correct and may make them unfavorable or less favorable to you.
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 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.
You have to ask for an appeal in writing. We will ask you to sign a form SSA-561-U2, called “Request for Reconsideration”. Contact one of our offices if you want help.
Please read the enclosed pamphlet: “Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about the appeal.
[POD Caption REFC08] – If You Have Questions About POD
[POD UTI REF172]
If you have any questions about POD, you may call our partner Abt Associates. Their toll-free number is 1-888-771-9188. They will help you by phone or they will set up an appointment with the POD local office that serves your area. When you call, please have this letter with you. It will help the counselors at Abt answer your questions.
[POD Caption REFC09] – If You Have Questions that Are Not About POD
[CTDO – Approved]
If you have any questions, you may call us at *F1 (1-800-772-1213) or call your local Social Security office at *F2 (Local FO#). We can answer most questions over the phone. You may also write or visit any Social Security office. The office that serves your area is located at:
*F3 (FO Address)
*F4 (FO Address)
*F5 (FO Address)
*F6 (FO Address)
If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly.
[Signature]