Psychiatric Review Technique - 20 CFR 404.1520(a), 20 CFR 416.920(a)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-2506-BK Psychiatric Review Technique	Form	Modified	Available
Supporting Statement--0413.doc	Supporting Statement A	Uploaded 2006-08-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9264	Psychiatric Review Technique - 20 CFR 404.1520(a), 20 CFR 416.920(a)	Form	Modified	Psychiatric Review Technique

ICR Details

OMB Control No: 0960-0413	ICR Reference No: 200608-0960-002
Status: Historical Active	Previous ICR Reference No: 200308-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Psychiatric Review Technique - 20 CFR 404.1520(a), 20 CFR 416.920(a)
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
Retrieve Notice of Action (NOA)	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	1,070,940	0	1,253,703
Time Burden (Hours)	267,735	0	313,426
Cost Burden (Dollars)	0	0	0

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Abstract: The SSA-2506-BK assists the DDSs in evaluating mental impairments by helping to: organize and present the mental findings in a clear, concise and consistent manner; consider and evaluate all aspects of mental impairment relevant to the individual's ability to perform work-related mental functions; and identify additional evidence needed to determine impairment severity. The respondents are the 52 State DDSs administering the Title II and Title XVI programs.

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Authorizing Statute(s): None

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
Psychiatric Review Technique - 20 CFR 404.1520(a), 20 CFR 416.920(a)	SSA-2506-BK	Psychiatric Review Technique

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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	1,070,940	1,253,703	0	0	-182,763	0
Annual Time Burden (Hours)	267,735	313,426	0	0	-45,691	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 decrease in burden hours was a result of recalculating the incidence of mental disability claims based on current 2005 fiscal year statistical data.

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Annual Cost to Federal Government: $23,839,631

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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