We Need Important Information About Your Eligibility for Social Security Disability Benefits, Our Records Show That You Have Not Received a Decision From the Social Security Administration (SSA)

ICR 200212-3206-001

OMB: 3206-0216

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3206-0216 200212-3206-001
Historical Active 200109-3206-001
OPM
We Need Important Information About Your Eligibility for Social Security Disability Benefits, Our Records Show That You Have Not Received a Decision From the Social Security Administration (SSA)
Revision of a currently approved collection   No
Regular
Approved without change 02/13/2003
Retrieve Notice of Action (NOA) 12/19/2002
Approved for 18 months during which time OPM will work with SSA and OMB to advocate for legislation as discussed in attached OPM memo of 2-13-03, to allow OPM to get this information from SSA rather than burdening annuitants.
  Inventory as of this Action Requested Previously Approved
08/31/2004 08/31/2004 02/28/2003
3,000 0 5,500
250 0 458
0 0 0

The information provided by the annuitant is used by OPM to verify receipt of SSA disability benefits, make necessary adjustments to the FERS disability benefit, and notify the annuitant of any overpayment payable to OPM. It also notifies the annuitant of the responsibility to notify OPM if SSA benefits begin and consequences of non-notification.

None
None


No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000 5,500 0 0 -2,500 0
Annual Time Burden (Hours) 250 458 0 0 -208 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/19/2002


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