Addendum to Supporting Statement

Addendum to Supporting Statement

Disability Report - Child

SSA-3820-BK

i3820

EDCS

OMB No. 0960-0577

Collection Revisions

SSA is making the following collection and format revisions to improve the clarity and functionality of the Disability Report – Child:

• We changed “Print or type.” to “Print or write clearly.” on the cover sheet of the paper SSA-3820 because few individuals, if any, use a typewriter to complete the form. EDCS and the i3820 do not have this cover sheet.

• We changed “DOCTOR/HOSPITAL/CLINIC” to “DOCTOR/HMO/THERAPIST/OTHER in the fourth bullet on the cover sheet of the paper SSA-3820 to make it consistent with the wording in the section that the instruction is referencing. EDCS and the i3820 do not have this cover sheet.

• We changed “prescription bottles” to “medicine containers” in the last paragraph on the cover sheet of the paper SSA-3820 because “medicine” refers to more than just prescription drugs (i.e., over-the-counter drugs), and “containers” refer to more than just bottles. EDCS and the i3820 do not have this cover sheet.

• For clarity, we changed the sentence “If you have no phone number, give us a daytime number where we can leave a message for you.” to “If you do not have a number where we can reach you, give us a daytime number where we can leave a message for you” in Section 1, D of the paper SSA-3820. EDCS and the i3820 ask for these numbers in a similar manner.

• For consistency within the paper SSA-3820, we changed the word “SEEN” to “VISIT” each time it is shown in Section 4, C. and E. of the paper SSA-3820.

• We changed the word “bottles” to “containers” in Section 5 of the paper SSA-3820 to include more than one kind of medicine vessel.

• For clarity, we changed “WHEN DONE, OR WHEN IT WILL BE DONE” to “WHEN WAS/WILL TESTS BE DONE” in Section 6 of the paper SSA-3820. EDCS and the i3820 ask this in a similar manner.

• We changed the word “added” to “additional” in Section 10 of the paper SSA-3820 for clarity. EDCS and the i3820 use similar language.

• We added “DATE AND REMARKS” each time we instructed the user to use section 10 in the paper SSA-3820. EDCS and the i3820 use similar language.

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