Addendum To The Supporting Statement 0960-0742

Addendum to Supporting Statement

Request for reinstatement (Title II)

SSA-371

20 CFR 401.1592b-20 CFR 404.1592f

OMB No. 0960-0742

TERMS OF CLEARANCE

OMB approves this collection formerly in violation of PRA consistent with SSA

responses on 4/26/07 and 5/16/07. SSA will include in the section on representative payees, a clarification, revised to say: "This information is ONLY needed if your provisional benefits will be sent to your prior representative payee."

SSA has met the Terms of Clearance. SSA included in the section on representative payees, a clarification, revised to say: "This information is ONLY needed if your provisional benefits will be sent to your prior representative payee."

Revision to the Collection Instrument

Change 1

We are inserting a statement: “For persons who are entitled to any other SSA benefits based on disability or blindness:

I understand that if SSA denies my request for reinstatement because I have medically improved my current entitlement to SSA benefits will be reviewed and may terminate.”

Justification 1

We are adding this statement because of an approved suggestion. The new statement provides respondents with additional information so that they may make an informed choice to file for EXR.

• We will start using the new version immediately after OMB approval;

• The Field offices may use the old version until the new version is released.

Change 2

We are changing the format of one sentence. Currently, the statement “FOR INDIVIDUALS WHO HAVE EXTENDED MEDICARE COVERAGE” is capitalized. We are amending the format to “For persons who have extended Medicare coverage”

Justification 2

We are amending this sentence for consistency, and to eliminate the term “individuals.”

We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.

SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on the first page of the form.