Information Collection

Medical Consultant's Review of Psychiatric Review Technique Form

IC 9731 under ICR 200612-0960-017 · OMB 0960-0677.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0677 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-3023 Medical Consultant's Review of Psychiatric Review Technique Form	Form and Instruction
SSA-3023 Medical Consultant's Review of Psychiatric Review Techni S3023.pdf	Form and Instruction
SSA-3020 (AeDib Fo Medical Consultant's Review of Psychiatric Review Techni MC_Rev_f.pdf	Form

IC Title:

Medical Consultant's Review of Psychiatric Review Technique Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 404.1640 20 CFR 404.1643 20 CFR 404.1645 20 CFR 416.920a 20 CFR 404.1520a

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-3023	Medical Consultant's Review of Psychiatric Review Technique Form	S3023.pdf		No		Paper Only
Form	SSA-3020 (AeDib Form)	Medical Consultant's Review of Psychiatric Review Technique Form	MC_Rev_f.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 344

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	66,736	-1,264	68,000
Annual IC Time Burden (Hours)	13,347	-253	13,600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.