Supporting Statement for Form SSA-3462
Record of Supplemental Security Income Inquiry
20 CFR 416.345
OMB No. 0960-0140
A. Justification
1. Section 1631(e) of the Social Security Act provides that the Commissioner of Social Security will prescribe requirements with respect to filing applications for Supplemental Security Income (SSI). The Social Security Administration (SSA) may, under certain circumstances provided in 20 CFR 416.345 of the Code of Federal Regulations, use the date of an oral inquiry about SSI eligibility as the filing date of an application.
2. Form SSA-3462 will be completed by SSA personnel based on information furnished by a SSI claimant or other interested person via either telephone or personal interview. SSA uses the information on the form to determine potential eligibility for SSI benefits. SSA often receives inquiries from interested parties (e.g., social workers or relatives), about potential SSI eligibility for other persons. Respondents are Individuals who inquire about SSI eligibility for themselves or on behalf of someone else.
3. The SSA-3462 is currently available as a paper form and as part of SSA’s Modernized Supplemental Security Income Claims System (MSSICS). An SSA employee collects information during a personal interview and keys the information directly into MSSICS. We estimate that approximately 98% of the information is taken using MSSICS. Due to the high risk of payment error, SSA will not be making an Internet application of the SSA-3462 at this time. We will revisit this form as better technology is developed.
4. The information recorded on Form SSA-3462 is necessary to protect the claimant's earliest possible date of inquiry. However, if an applicant decides to file a formal application with SSA, some of the information requested on Form SSA-3462 may be entered and verified on Form SSA-8000-BK (Application for SSI, OMB Control No. 0960-0229), Form SSA-8001-F5 (Short Form SSI Application, OMB Control No. 0960-0444) and on the MSSICS screens associated with those forms.
Taking an application is the preferred means for closing out an oral inquiry. However, management may permit service representatives (SRs) to screen for SSI ineligibility. Form SSA-3462 documents the oral inquiry and serves as an interviewing guide for SRs to screen for ineligibility in those offices where SRs perform such screening. The claimant (or the person inquiring on behalf of the claimant) is the only available source of this information.
5. This collection does not have a significant impact on a substantial number of small businesses or other small entities.
6. Without use of Form SSA-3462, SSA might not be able to protect an individual's potential right to SSI payments at the earliest possible date (and to Medicaid in some States). In addition, if this information SSA did not collect this information, some SSI recipients might not receive all payments to which they are eligible under 20 CFR 416.345. Therefore, we cannot collect this information less frequently. There are no technical or legal obstacles that prevent burden reduction.
7. There are no special circumstances that would cause this information collection to be conducted in a manner that is not consistent with 5 CFR 1320.5.
The 60-day advance Federal Register Notice published on August 22, 2008, at 73 FR 49730, and SSA has received no public comments. The second Notice published on November 26, 2008, at 73 FR 72102. There have been no outside consultations with members of the public.
Prior to publication of the second Federal Register Notice, SSA’s Office of the General Counsel revised the Privacy Act Statement on the SSA-3462. Due to these changes, the 30-day shows this as a Revision rather than the Extension as stated in the 60-day Notice.
9. SSA provides no payment or gifts to the respondents.
10. The information requested is protected and held confidential in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974) and OMB Circular No. A-130.
11. The information collection does not contain any questions of a sensitive nature.
12. There are 500,000 respondents that complete Form SSA-3462 annually. The estimated response time is 5 minutes, for a total of 41,667 burden hours. There is no cost burden calculated for this collection
13. There is no known cost burden to the respondents.
14. The annual cost to the Federal Government is approximately $5,220. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
The decrease in the public reporting burden by 136,175 is due to a reassessment of our burden estimate. We reassessed recent figures and found that we have been using the same burden data for several years.
16. SSA will not publish the results of the information collection.
17. OMB has granted SSA an exemption from the requirement to print the expiration date for OMB approval on its program forms. SSA produces millions of public-use forms, many of which have a life cycle longer than that of an OMB approval. SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis). OMB granted this exemption so that SSA would not need to destroy otherwise useable editions of forms because OMB’s approval has expired. In addition, we avoid Government waste because we will not need to destroy and reprinted stocks of forms.
18. SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
B. Collections of Information employing Statistical Methods
We do not use statistical methods for this information collection.
| File Type | application/msword |
| Author | 673560 |
| Last Modified By | Davidson, Liz |
| File Modified | 2008-11-26 |
| File Created | 2008-11-26 |