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Social Security Administration
Claim Information

MAIN ST CINCINNATI, OH 45202-327 4 Date: 22,20L4 C1aim Number: 401-86-8182



This is to inform you that you may be found to be medically disabled by the State Agency for Supplemental Security Income (SSI) benefits.
To be eligible for SSI payments,

it is necessary to conduct an interview with you on JuIy

16,2014 at 9:00AM. A representative called and confirmed this appointment date and time with you prior to it being scheduled

If you have any questions, please call 866-572-8376 EXT 10854 and ask for Ms. Vizgirda.




anty 4/auktrafi'o,r

Supplemental Security Income ffi @

Social Security Administration
NotICe of Change

in Paymenf

550 ST ROOM 2000

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Date: November 30, 201,tr Claim Number: 401-86-8182 DI

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We are writing to tell you about changes in your Supplemental Security Income (SSI) payments. The rest of tliis letter will tell you more about this chanEe. This letter also includes how to find information about affordable



months where payment amounts change. a J! tn We explain how 'we fig,rred the nlonthly payment amount on the-iverkslteet at the end of this letter. - The erplanation shows how your income, other than any SSI payments, affects your SSI payment. We include explanations only for

Information About Your SSI Payments

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The amount due you beginning January 2015 will be $733.00. The amount due you is being raised because the law provides for an increase in Supplemental SeEurity Income payments iir January 2015 there was an increase in the cost-of-living during the past year.


If You lVork or lVant to Return to lYork o N N


There are special rules that help people with disabilities return to work without losing their SSI benefits and Medicaid. You must follow these rules and report your earnings, or you may have to repay a large part of your benefitl. When you report your earnings, we will give you a receipt to verify your report. Keep this receipt with your other important papers from us.

See Next Page
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MailingDate: lll28l20l4

WCB931 Caseworker: CASE BANK 3031 REAPPLICATIONS Case Number: 5105393903 Phone: (513) 946-1000 Ext: AG Name: TROY L PETTY






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8523 (Rev. 4/L4l


PRINT SEQ. ooo25o1



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