Listing of Impairments; 404, Subpart P, Appendix 1 20 CFR 404.1512-404.1515 and 416.912-416.915

ICR 200609-0960-020

OMB: 0960-0642

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2006-09-26
Supplementary Document
2006-09-26
Justification for No Material/Nonsubstantive Change
2006-09-26
Supplementary Document
2006-09-19
IC Document Collections
IC ID
Document
Title
Status
9674
Modified
ICR Details
0960-0642 200609-0960-020
Historical Active 200501-0960-008
SSA
Listing of Impairments; 404, Subpart P, Appendix 1 20 CFR 404.1512-404.1515 and 416.912-416.915
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/07/2006
Retrieve Notice of Action (NOA) 09/28/2006
This change request is approved on the condition that burden hours have not changed and the forms that will be used--which have been cleared under separate OMB numbers--also have not changed. If burden hours or the forms have or will be changed, then ICR revisions will need to be made.
  Inventory as of this Action Requested Previously Approved
03/31/2008 03/31/2008 03/31/2008
1 0 1
1 0 1
0 0 0

The medical evidence documentation described in the listings is used by State Disability Determination Services to assess the alleged disability. The information, together with other evidence, is used to determine if an individual claiming disability benefits has an impairment that meets severity and duration requirements. The respondents are disability applicants and other sources of evidence.

None
None

Not associated with rulemaking

No

1
IC Title Form No. Form Name
Listing of Impairments

  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 1 0 0 0 0
Annual Time Burden (Hours) 1 1 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 [email protected]

  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.
09/28/2006


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