Supplemental Security Income-Quality Review Case Analysis

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-8508-BK Supplemental Security Income-Quality Review Case Analysis	Form	Modified	Available
Collections of Information Employing Statistical Methods Form SSA.doc	Supporting Statement B	Uploaded 2011-06-07	Available
Addendum to Supporting Statement 0133.doc	Supplementary Document	Uploaded 2011-06-07	Available
OMB_Supporting_Statement__0133_(revised)[1].doc	Supporting Statement A	Uploaded 2011-06-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
9113	Supplemental Security Income-Quality Review Case Analysis	Form	Modified
196447	e8508	Other-e8508	New

ICR Details

OMB Control No: 0960-0133	ICR Reference No: 201103-0960-001
Status: Historical Active	Previous ICR Reference No: 200807-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: Supplemental Security Income-Quality Review Case Analysis
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/18/2011
	Date Received in OIRA: 06/16/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2014	36 Months From Approved	10/31/2011
Responses	4,500	0	4,500
Time Burden (Hours)	4,500	0	4,500
Cost Burden (Dollars)	0	0	0

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Abstract: To assess the Supplemental Security Income (SSI) program and ensure the accuracy of its payments, SSA conducts legally mandated periodic SSI case analysis quality reviews. SSA uses Form SSA–8508 to conduct these reviews, collecting information on operating efficiency, the quality of underlying policies, and the effect of incorrect payments. SSA also uses the data to determine SSI program payment accuracy rates, which is a performance measure for the agency's service delivery goals. The respondents are recipients of SSI payments selected for the quality reviews.

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Authorizing Statute(s): US Code: 42 USC 1382 Name of Law: Social Security Act
   US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 16847	03/25/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 31671	06/01/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Supplemental Security Income-Quality Review Case Analysis	SSA-8508-BK	Supplemental Security Income--Quality Review Case Analysis
e8508

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,500	4,500	0	0	0	0
Annual Time Burden (Hours)	4,500	4,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: There has been a decrease in burden hours. This change stems from the implementation of the electronic form, which will decrease our dependency on the paper version.

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Annual Cost to Federal Government: $1,070,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/16/2011

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