Request for Reconsideration--Disability Cessation--20 CFR 404.409 & 20 CFR 416.1409

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement--0349.doc	Supporting Statement A	Uploaded 2006-08-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9232	Request for Reconsideration--Disability Cessation--20 CFR 404.409 & 20 CFR 416.1409	Other-Revised PRA Statement for Form SSA-789-U4	Modified

ICR Details

OMB Control No: 0960-0349	ICR Reference No: 200608-0960-001
Status: Historical Active	Previous ICR Reference No: 200308-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Reconsideration--Disability Cessation--20 CFR 404.409 & 20 CFR 416.1409
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/02/2006
	Date Received in OIRA: 08/08/2006
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2009	36 Months From Approved	10/31/2006
Responses	49,000	0	49,000
Time Burden (Hours)	10,617	0	10,045
Cost Burden (Dollars)	0	0	0

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Abstract: Form SSA-789 is used by claimants to request reconsideration of a determination and to indicate whether or not they wish to appear at a disability hearing. This form can also be used to submit any additional information/evidence for use in the reconsidered determination and to indicate if an interpreter is needed for the hearing. SSA will use this information to either arrange for a hearing or to prepare a decision based on the evidence of record. The respondents are applicants for Social Security benefits or SSI payments.

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Authorizing Statute(s): US Code: 42 USC 405 Name of Law: Public Health and Welfare; Evidence, Procedure and Certification for Payments
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 30464	05/26/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 43270	07/31/2006
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Request for Reconsideration--Disability Cessation--20 CFR 404.409 & 20 CFR 416.1409	SSA-789	Request for Reconsideration--Disability Cessation

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ICR Summary of Burden

table that charts list of burden

	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	49,000	49,000	0	0	0	0
Annual Time Burden (Hours)	10,617	10,045	0	0	572	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The slight increase in the annual reporting burden from 10,045 to 10,617 is due to an increase in the number of minutes SSA estimates as the response time. Previously SSA had estimated that some cases would take longer for the public to respond than others, however, we have reevaluated this estimate to average the time it will take for all the respondents to complete this form.

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Annual Cost to Federal Government: $75,460

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/08/2006

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