Disability Update Report

Form SSA-455 (OMB No. 0960-0511)

Updated Privacy Act Statement

NOTE: We will replace the current PA statement with the text below

Collection and Use of Personal Information

Sections 205(a) and 1631(e)(1)(A) and (B) of the Social Security Act, as amended, and Social Security regulations at 20 C.F.R. 404.1589 and 416.989 authorize us to collect this information. The information you provide will be used to further document your claim and permit a determination about continuing disability.

The information you furnish on this report is voluntary. However, if you do not provide the requested information, a decision based on the evidence in your case can result in a determination that your disability has ceased.

We rarely ever use the information you supply on this report for any purpose other than making a determination relating to your disability. However, we may use it for the administration and integrity of the Social Security programs. We may also disclose information to another person or to another agency as follows:

1. To enable a third party or an agency to assist Social Security in establishing rights to Social Security benefits and/or coverage;

2. To comply with federal laws requiring the release of information from Social Security records (e.g., to the Government Accountability Office and Department of Veterans' Affairs);

3. To make determinations for eligibility in similar health and income maintenance programs at the Federal, state and local level; and

4. To facilitate statistical research and audit activities necessary to assure the integrity and improvement of the Social Security programs (e.g., to the Bureau of the Census and private concerns under contract to Social Security).

We may also use the information you provide in computer matching programs. Matching programs compare our records with records kept by other Federal, State or local government agencies. Information from these matching programs can be used to establish or verify a person's eligibility for Federally funded or administered benefit programs and for repayment of payments or delinquent debts under these programs.

Explanations about these and other reasons why information you provide us may be used or given out are available in Social Security offices or on-line at www.ssa.gov. If you want to learn more about this, contact any Social Security office.