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Small Claim

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RECIPIENT: 551- 15-0886 TERNESAH F. PEOPLES

TERNESAH F. PEOPLES 662 S. FERRIS AVELOS ANGELES, CA.90022 July 22, 2015, 15:27PAGE1

REDETERMINATION SUMMARY FOR DETERMINING CONTINUING ELIGIBILITY FOR SUPPLEMENTAL SECURITY INCOME PAYMENTS

On April 28, 2015, you doctor provided the following redetermination information to support your continuing eligibility for Supplemental Security Income payments and any federally administered State supplementation under title XVI of the Social Security Act, for benefits under the other programs administered by the Social Security Administration, and where applicable, for medical assistance under title XIX of the Social Security Act. We have stored your redetermination electronically in our records.What You Need To Do If you disagree with any of your statements, you should contact us within

10 days after receiving this summary to let us know.

Summary findings:As of April 28, 2015 your physician provided to the Social Security Administration his annual medical report. This report indicates that as August 1, 2015 you are deemed able to work as provided within the Social Security Administration codes. Therefore as of August 1, 2015 you will no longer receive Social Security Disability benefits.

If you do not agree with your doctors findings; You should file an appeal within 30 days. The failure to file an appeal within this time would forfeit any later claim.