This ICR is approved consistent with the 12-19-07 memo and the agreed-upon revisions to the instrument to minimize respondent burden. Although this ICR has undergone numerous revisions in the past, the revisions have not been substantive enough to make previous editions obsolete. As per the 12-19-07 memo, previous versions of this form continue to be used until the stock is used up. For this reason, SSA is not required to print the expiration date for the OMB control number on these forms. However, should this form undergo more substantive changes in the future, SSA agrees to consider printing the expiration date on the forms.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
02/28/2011
36 Months From Approved
01/31/2008
3,350,554
0
2,116,667
3,552,823
0
2,257,667
0
0
0
The Disability Report-Adult collects medical and other evidence which is used to determine whether an adult's impairment is disabling, and consequently, if that adult is entitled to Title II and/or Title XVI disability payments from the Social Security Administration. The information can be collected through the following ways: a paper form, in an SSA field office, an Internet version, and a new Internet version designed to be completed by professional advocacy groups. The respondents are adult disability applicants or their representatives.
There is an increase in the public reporting burden since this was last approved by OMB. The change is due to several factors. A major factor is that we have been able to compile more accurate data since we prepared the previous Supporting Statement. Other factors are increased use of the EDCS 3368, i3368 and i3368-PRO, and the additional time it takes respondents to use the i3368 and i3368-PRO over the time it takes for use of the EDCS 3368 and paper SSA-3368.
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.
Form SSA-3368 Disability Report - Adult, 20 CFR 404.1512 and 416.912
0960-0579-OMB Passback (2).doc
Disability Report - Adult, 20 CFR 404.1512 and 416.912 (Paper)