NL 00720: Manual Adjustment, Credit and Award Process (MADCAP) Beneficiary Notice Print Program
BASIC (05-11)
CDR001 MEDICAL IMPROVEMENT POSSIBLE (J05)
(System Generated)
Caption: Things To Remember
Doctors and other trained staff decided that (1) (2) disabled under our rules. But, this decision must be reviewed at least once every 3 years. We will send you a letter before we start the review. Based on that review, (3) benefits will continue if (4) still disabled, but will end if (5) no longer disabled.
Fill-in values:
Fill-in (1)
Choice 1: Fullname
Fill-in (2)
Choice 1: are
Choice 2: is
Fill-in (3)
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (4)
Choice 1: you are
Choice 2: she is
Choice 3: he is
Fill-in (5)
Choice 1: you are
Choice 2: she is
Choice 3: he is
CDR002 MEDICAL IMPROVEMENT NOT EXPECTED (J07)
(System Generated)
Caption: Things To Remember
Doctors and other trained staff decided that (1) (2) disabled under our rules. However, we must review all disability cases. Therefore, we will review (3) case in 5 to 7 years. We will send you a letter before we start the review. Based on that review, (4) benefits will continue if (5) still disabled, but will end if (6) no longer disabled.
Fill-in values:
Fill-in (1)
Choice 1: Fullname
Fill-in (2)
Choice 1: are
Choice 2: is
Fill-in (3)
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (4)
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (5)
Choice 1: you are
Choice 2: she is
Choice 3: he is
Fill-in (6)
Choice 1: you are
Choice 2: she is
Choice 3: he is
CDR003 MEDICAL IMPROVEMENT EXPECTED (J08)
(System Generated)
Caption: Things To Remember
The doctors and other trained personnel who decided that (1) disabled expect (2) health to improve. Therefore, we will review (3) case in (4) . We will send you a letter before we start the review. Based on that review, (5) benefits will continue if (6) still disabled, but will end if (7) no longer disabled.
Fill-in values:
Fill-in (1)
Choice 1: Fullname are
Choice 2: is
Fill-in (2)
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (3)
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (4)
Choice 1: Month and Year
Fill-in (5)
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (6)
Choice 1: you are
Choice 2: she is
Choice 3: he is
Fill-in (7)
Choice 1: you are
Choice 2: she is
Choice 3: he is
CDR063 HA/DWB/CDB – SUSPENDED – CDR FAILURE TO COOPERATE (S35)
(Requested)
Caption: Your Benefits
We cannot pay (1) benefits because our records show that (2) did not return information we asked for concerning (3) disability.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary's Name
Choice 2: he
Choice 3: she
Choice 4: you
Fill-in (2) - Systems Generated
Choice 1: he
Choice 2: she
Choice 3: you
Fill-in (3) - Systems Generated
Choice 1: his
Choice 2: her
Choice 3: your
CDR065 APPEAL RIGHTS - HA/DWB/CDB SUSPENDED CDR FAILURE TO COOPERATE (S36)
(Requested)
Caption: Things To Remember
If we stop (1) Social Security disability benefits and you do not give us the information we asked for before (2) , (3) will have to file a new application to get Social Security disability benefits again. If we do not hear from you by this date, we will send you another letter which will give you the information about (4) appeal rights.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary's Name possessive
Choice 2: his
Choice 3: her
Choice 4: your
Fill-in (2) - Requested As A Date In Format shown below
Choice 1: date in the format MM/CCYY
Fill-in (3) - Systems Generated
Choice 1: he
Choice 2: she
Choice 3: you
Fill-in (4) - Systems Generated
Choice 1: his
Choice 2: her
Choice 3: your
CDR066 HA/DWB/CDB – TERMINATED – CDR FAILURE TO COOPERATE (T34)
(Requested)
Caption: Your Benefits
(1) no longer (2) for Social Security disability benefits beginning (3) because our records show that (4) did not return information we asked for during (5) continuing disability review.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary's Name
Choice 2: He
Choice 3: She
Choice 4: You
Fill-in (2) – Systems Generated
Choice 1: qualify
Choice 2: qualifies
Fill-in (3) - Systems Generated
Choice 1: date in the format MMCCYY
Fill-in (4) - Systems Generated
Choice 1: he
Choice 2: she
Choice 3: you
Fill-in (5) - Systems Generated
Choice 1: his
Choice 2: her
Choice 3: your
CDR067 AUXILIARY SUSPENDED BECAUSE HA/DWB/CDB TERMINATED FOR CDR FAILURE TO COOPERATE (T35)
(Requested)
Caption: Your Benefits
We can no longer pay (1) benefits because (2) no longer qualifies for Social Security disability benefits beginning (3) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary's Name
Choice 2: you
Fill-in (2) - Systems Generated
Choice 1: NH-NAME
Fill-in (3) - Systems Generated
Choice 1: date in MMCCYY format