Information Collection

Medical Consultant's Review of Mental Residual Functional Capacity Assessment

IC 43713 under ICR 200905-0960-005 · OMB 0960-0678.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-392-SUP Medical Consultant's Review of Mental Residual Functional Capacity Assessment	Form
SSA-392-SUP Medical Consultant's Review of Mental Residual Functiona SSA 392-SUP.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 404.1645 20 CFR 404.1520a 20 CFR 404.1640 20 CFR 404.1643 20 CFR 416.920

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-392-SUP	Medical Consultant's Review of Mental Residual Functional Capacity Assessment	SSA 392-SUP.pdf		No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 256

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	45,000	45,000
Annual IC Time Burden (Hours)	9,000	9,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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