Incorporation by Reference of Oral Findings of Fact and Rationale in Wholly Favorable Written Decisions

SOCIAL SECURITY ADMINISTRATION
Office of Disability Adjudication and Review
[HO Address]

Refer To: [Clmt SSN]

Date: [Date Issued]

[Clmt Name]
[Clmt Address]

Notice of Decision –Fully Favorable
Combined
into one
paragraph;
updated
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Removed "This

I carefully reviewed the facts of your case and made a fully favorable decision on your
application(s) for a period of disability, disability insurance benefits, and Supplemental Security
Income filed on **[APPLICATION DATE]**. I stated the basis for my decision at your hearing
held on **[DATE OF HEARING]**. I adopt the findings of fact and reasons that I gave at the
hearing. Please read this notice of decision.
(Conditional Language Step 3)
I found you disabled as of **[DATE OF DISABILITY ONSET]**. Your impairment or
combination of impairments is so severe that it medically equals the requirements of one of the
impairments listed in the Listing of Impairments.
(Conditional Language Step 5)
I found you disabled as of **[DATE OF DISABILITY ONSET]** because your impairment or
combination of impairments is so severe that you cannot perform any work existing in significant
numbers in the national economy.
If you would like more information about my decision, I can provide you with a record of my
oral decision. You must ask for this record in writing. You may mail or bring your request to any
Social Security or hearing office. Please put the Social Security number shown above on your
request.

Decision is
Fully Favorable
To You"
heading

Another office will process my decision and decide if you meet the non-disability requirements
for Supplemental Security Income payments. That office may ask you for more information. If
you do not hear anything within 60 days of the date of this notice, please contact your local
office. The contact information for your local office is at the end of this notice.

Moved the
section "The

If You Disagree With My Decision

Appeals
Council May

If you disagree with my decision, you may file an appeal with the Appeals Council.

Review The
Decision On Its

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How To File An Appeal

Own" (see
bottom of p.2)

Form HA-L82 (03-2010)

See Next Page

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Page 2 of 3

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To file an appeal you must ask in writing that the Appeals Council review my decision. You may
use our Request for Review form (HA-520) or write a letter. The form is available at
www.socialsecurity.gov. Please put the Social Security number shown above on any appeal you
file. If you need help, you may file in person at any Social Security or hearing office.
Please send your request to:
Appeals Council
Office of Disability Adjudication and Review
5107 Leesburg Pike
Falls Church, VA 22041-3255

Revised
placement for
clarification
purposes
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Time Limit To File An Appeal

Revised

You must file your written appeal within 60 days of the date you get this notice. The Appeals
Council assumes you got this notice 5 days after the date of the notice unless you show you did
not get it within the 5-day period.

language

The Appeals Council will dismiss a late request unless you show you had a good reason for not
filing it on time.
Replaced "Time
To Submit New

What Else You May Send Us

Evidence" with
this section.

You may send us a written statement about your case. You may also send us new evidence. You
should send your written statement and any new evidence with your appeal. Sending your
written statement and any new evidence with your appeal may help us review your case sooner.
How An Appeal Works

Revised
language
to better
explain the

The Appeals Council will consider your entire case. It will consider all of my decision, even the
parts with which you agree. Review can make any part of my decision more or less favorable or
unfavorable to you. The rules the Appeals Council uses are in the Code of Federal Regulations,
Title 20, Chapter III, Part 404 (Subpart J) and Part 416 (Subpart N).

process

The Appeals Council may:
•
•
•
•

Deny your appeal,
Return your case to me or another administrative law judge for a new decision,
Issue its own decision, or
Dismiss your case.

The Appeals Council will send you a notice telling you what it decides to do. If the Appeals
Council denies your appeal, my decision will become the final decision.
Moved this
section from

The Appeals Council May Review My Decision On Its Own

p.1; revised
language

Form HA-L82 (03-2010)

See Next Page

Page 3 of 3
The Appeals Council may review my decision even if you do not appeal. If the Appeals Council
reviews your case on its own, it will send you a notice within 60 days of the date of this notice.
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title

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When There Is No Appeals Council Review
If you do not appeal and the Appeals Council does not review my decision on its own, my
decision will become final. A final decision can be changed only under special circumstances.
You will not have the right to Federal court review.
If You Have Any Questions

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We invite you to visit our website located at www.socialsecurity.gov to find answers to general
questions about social security. You may also call (800) 772-1213 with questions. If you are deaf
or hard of hearing, please use our TTY number (800) 325-0778.
If you have any other questions, please call, write, or visit any Social Security office. Please have
this notice and decision with you. The telephone number of the local office that serves your area
is **[FIELD OFFICE PHONE NUMBER]**. Its address is:
**[FIELD OFFICE ADDRESS]**

Administrative Law Judge

Date

Form HA-L82 (03-2010)