Request for Reconsideration--Disability Cessation

SSA will insert the following revised Privacy Act Statement into the form as soon as possible:
Privacy Act Statement
Collection and Use of Personal Information
Sections 205(a) and (b), and 1631(c)(1)(A) and (B) of the Social Security Act, as amended, allow
us to collect this information. Furnishing us this information is voluntary. However, failing to
provide all or part of the information may prevent us from reconsidering a determination on your
claim.
We will use the information to reconsider your eligibility for disability benefits. We may also
share your information for the following purposes, called routine uses:


To third party contacts where necessary to establish or verify information provided by
representative payees or payee applicants; and,



To third party contacts (including private collection agencies under contract with us) for
the purpose of their assisting us in recovering overpayments.

In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notices
(SORN) 60-0009, entitled Hearings and Appeals Case Control System, as published in the
Federal Register (FR) on October 13, 1982, at 47 FR 45589; 60-0010, entitled Hearing Office
Tracking System of Claimant Cases, as published in the FR on January 11, 2006, at 71 FR 1806;
and 60-0089, entitled Claims Folders Systems, as published in the FR on April 1, 2003, at 68 FR
15784. Additional information and a full listing of all our SORNs are available on our website at
www.ssa.gov/privacy.