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Pension claim: medical evidence needed

Department of Veterans Affairs · source: GSA plainlanguage.gov archive, _pages/examples/notices/pension-medical-evidence.md (already plain; shown there only as the improved version) · 12 critical facts of 17

Placeholders in the agency's template were filled with made-up values; see the notice's source file in the repo.

Rewrites

Haiku, grade 6: 11 of 12 critical facts kept · grade 4.0

What the judge found lost or changed

The rewrite

Dear Mr. Whitfield: We received your request for a pension. The law says we must ask you for more information. We will use this information to decide if we can pay you a pension. **What we need from you** Please send us a medical report from a doctor or clinic you have visited in the last six months. The report should explain why you cannot work. Take this letter and the enclosed Doctor's Guide to your doctor. **When we need it** We must receive the doctor's report by August 15, 2025. If we do not get it by that date, we will have to say no to your request. **Your privacy** We will keep your information private. In a few special cases, we may have to share it. We will not share it with the public without your permission. The enclosed form explains your privacy rights. If you have questions, call us for free at 1-800-827-1000. If you are deaf or hard of hearing, call 1-800-829-4833. When you call, have this letter with you. Sincerely, Enclosures: Your Privacy Rights Doctor's Guide
Sonnet, grade 6: 10 of 12 critical facts kept · grade 2.5

What the judge found lost or changed

The rewrite

Dear Mr. Whitfield: We got your request for a pension. We need more facts from you before we can decide if we can pay you a pension. **What we need from you** Please send us a medical report from a doctor or clinic you have seen in the last six months. The report should explain why you cannot work. Take this letter and the Doctor's Guide that comes with it to your doctor. The guide will help your doctor know what to write. **When we need it** We must get the doctor's report by August 15, 2025. If we do not get it by then, we will have to deny your request for a pension. **Your privacy** We keep your information private. In a few special cases, we may have to share it. We will not share it with the public unless you say we can. We have included a form called "Your Privacy Rights." It explains your rights. **Questions?** Please call us. The call is free. - Phone: 1-800-827-1000 - If you are hard of hearing (TDD): 1-800-829-4833 Please keep this letter with you when you call. Sincerely, Enclosures: Your Privacy Rights Doctor's Guide
Opus, grade 6: 11 of 12 critical facts kept · grade 2.6

What the judge found lost or changed

The rewrite

Dear Mr. Whitfield: We got your request for a pension. Before we can decide if we can pay you, we need more information from you. The law says we must ask for it. **What we need from you** We need a report from a doctor or clinic you went to in the last 6 months. The report must explain why you can't work. Here is what to do: 1. Take this letter to your doctor. 2. Also take the "Doctor's Guide" that came with this letter. 3. Ask your doctor to write the report. **When we need it** We must get the doctor's report by **August 15, 2025**. If we don't get it by then, we will have to say no to your pension request. **We keep your information private** The information you send us is private. We will not share it with the public unless you say it's okay. In a few special cases, the law may make us share it. We put a paper in with this letter called "Your Privacy Rights." It tells you more about how we keep your information safe. **Questions?** Call us for free at **1-800-827-1000**. If you are deaf or hard of hearing, you can use our text phone (TDD) line at **1-800-829-4833**. Please have this letter with you when you call. Sincerely, **Papers in this envelope:** - Your Privacy Rights - Doctor's Guide
Sonnet, grade 4: 11 of 12 critical facts kept · grade 1.7

What the judge found lost or changed

The rewrite

Dear Mr. Whitfield: We got your claim for a pension. We need more facts from you before we can decide if we can pay you. **What we need** Please send us a report from a doctor or clinic. You must have been there in the last six months. The report should tell why you can't work. Take this letter to your doctor. Take the Doctor's Guide too. It is in the envelope with this letter. **When we need it** We must get the report by August 15, 2025. If we do not get it by then, we will have to say no to your claim. **Your right to privacy** What you tell us is private. In a few special cases, we may have to share it. But we will not share it with the public unless you say it is okay. We put a form in the envelope. It tells you about your privacy rights. **Questions?** Call us for free at 1-800-827-1000. If you have trouble hearing, call our TDD line at 1-800-829-4833. Please have this letter with you when you call. Sincerely, Enclosures: Your Privacy Rights Doctor's Guide
Sonnet, grade 8: 12 of 12 critical facts kept · grade 2.9

The judge found nothing lost.

The rewrite

Dear Mr. Whitfield: We got your claim for a pension. The law says we must ask you for more information. This will help us decide if we can pay you a pension. **What we need from you** Please send us a medical report from a doctor or clinic you have seen in the last six months. The report should explain why you can't work. Take this letter and the enclosed Doctor's Guide with you to your doctor. **When we need it** We must get the doctor's report by August 15, 2025. If we don't get it by then, we will have to deny your claim. **Your right to privacy** The information you give us is private. In a few special cases, we may have to share it. We will not share it with the public unless you say we can. We have included a form called "Your Privacy Rights." It explains your rights in more detail. **Questions?** Call us toll-free at 1-800-827-1000. If you are deaf or hard of hearing, call our TDD line at 1-800-829-4833. Please have this letter with you when you call. Sincerely, Enclosures: Your Privacy Rights Doctor's Guide
Sonnet, grade 6, 'keep everything' prompt: 11 of 12 critical facts kept · grade 2.2

What the judge found lost or changed

The rewrite

Dear Mr. Whitfield: We got your claim for a pension. The law says we must ask you for more information. This will help us decide if we can pay you a pension. **What we need from you** Please send us a medical report. It must come from a doctor or clinic you saw in the last six months. The report should show why you can't work. Take this letter and the Doctor's Guide to your doctor. The Doctor's Guide came in the same envelope as this letter. **When we need it** We must have the doctor's report by **August 15, 2025**. If we do not get it by that date, we will have to turn down your claim. **Your right to privacy** What you tell us is private. In a few special cases, we might have to share it. We will not share it with the general public unless you say we can. We have included a form called "Your Privacy Rights." It explains your rights. **How to reach us** If you have questions, call us. The call is free. - Phone: 1-800-827-1000 - TDD phone for people who are hard of hearing or deaf: 1-800-829-4833 Please have this letter with you when you call. Sincerely, Enclosures: - Your Privacy Rights - Doctor's Guide
Rewrite tool (Sonnet, grade 6): 12 of 12 critical facts kept · grade 3.5

The judge found nothing lost.

The rewrite

Dear Mr. Whitfield: **We need more information about your pension claim** We have your claim for a pension. The law says we must ask you for more information. What you tell us will help us decide if we can pay you a pension. **What we need from you** - Send us a medical report from a doctor or clinic. - You must have visited that doctor or clinic in the past six months. - The report should show why you can't work. - Take this letter to your doctor. Also take the Doctor's Guide that comes with it. **When we need it** We need the doctor's report by **August 15, 2025**. If we do not get the report by that date, we will have to turn down your claim. **Your right to privacy** - The information you give us is private. - In a few special cases, we might have to give it out. - We will not give it to the general public unless you say we can. - We attached a form called "Your Privacy Rights." It explains your privacy rights. **Questions?** - Call us toll-free at **1-800-827-1000**. - If you have trouble hearing, use our TDD number: **1-800-829-4833**. - Please have this letter with you when you call. Sincerely, Enclosures: - Your Privacy Rights - Doctor's Guide

The original letter

Highlighted: the passages behind the 12 critical facts.

Dear Mr. Whitfield: We have your claim for a pension. Our laws require us to ask you for more information. The information you give us will help us decide whether we can pay you a pension. ### What we need Send us a medical report from a doctor or clinic that you visited in the past six months. The report should show why you can't work. Please take this letter and the enclosed Doctor's Guide to your doctor. ### When we need it We need the doctor's report by August 15, 2025. We'll have to turn down your claim if we don't get the report by that date. ## Your right to privacy The information you give us is private. We might have to give out this information in a few special cases. But we will not give it out to the general public without your permission. We've attached a form which explains your privacy rights. If you have any questions, call us toll-free by dialing 1-800-827-1000. Our TDD number for the hearing impaired is 1-800-829-4833. If you call, please have this letter with you. Sincerely Enclosures: Your Privacy Rights Doctor's Guide