Medical Report (General)

Medical Report (General)

OMB: 0960-0052

IC ID: 8971

Information Collection (IC) Details

View Information Collection (IC)

Medical Report (General)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 416.912-416.915 20 CFR 404.1512-404.1515

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-3826 Medical Report (General) SSA-3826 -- Revised Version.pdf No   Paper Only

Income Security General Retirement and Disability

 

150,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 150,000 0 0 -600,000 0 750,000
Annual IC Time Burden (Hours) 75,000 0 0 -300,000 0 375,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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