I-2-8-102.Exhibit – Supplemental Security Income Notice: Payment Continuation (Starting Payments While Case Is Appealed; Individual Did Not Previously Receive Continued Payments)

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From: Social Security Administration

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Date:

Social Security Number:

YOUR CHECKS MAY BEGIN AGAIN.

Supplemental security income (SSI) disability payments may be continued until an appeal of the decision that you are no longer disabled is decided by an Administrative Law Judge. If you were also receiving Social Security disability benefits before, these benefits may start again.

WHY YOUR CHECKS DID NOT CONTINUE BEFORE WHEN YOU WERE APPEALING YOUR CASE.

You either had decided that you did not want your checks to continue, or you asked too late and we were not able to find a good reason for the delay.

WHY YOUR CHECKS MAY START AGAIN.

A decision was made before during your appeal that you were not disabled (or your case was dismissed). Because your case has now been sent back to an Administrative Law Judge for further action, this decision (or dismissal order) is no longer in effect. Therefore, you may now choose again whether or not you want to have your checks continue until a new decision is made.

WHAT DO YOU HAVE TO DO TO RECEVE THESE CHECKS?

If you want to receive checks until a new decision is made, you must contact any Social Security Office to make a request in writing within 10 days after receiving this notice. If you cannot come into a Social Security Office, you must call within 10 days after receiving this notice. If you were receiving Social Security disability checks, these checks will also start again if you make this request.

If you wait longer than 10 days, you will not receive checks until a new decision is made, unless you have a good reason for not contacting us within that time.

IF YOU WANT CHECKS, WE WILL NEED MORE INFORMATION.

To make sure your SSI check is the right amount, we will be contacting you for additional information we need, such as your living arrangements, money you receive, and things you own. After we consider this information, we will send you checks for all months for which you are eligible, beginning with the month your case was sent back to the Administrative Law Judge. These payments will continue until a new decision is made.

WHAT HAPPENS AFTER A DECISION IS MADE?

If you are found to be not disabled (or if your case is dismissed), you will be asked to pay back the disability checks you received while you were appealing your case. But you will have the right to ask that you not be required to pay them back.

If you are found to be disabled, any money you are due will be paid.

WHAT TO DO IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE.

Call or visit any Social Security Office. If you visit an office, please take this notice. It will help us answer your questions.