1st Party Internet Social Security Benefits Application (iClaim)

English iClaim – AllElse Final Screen Package

English iClaim AllElse

Screen Package
Version 1.6

Social Security Administration

May 20, 2011

Table of Contents

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1. Pages 4

1.1. Changes to Document 4

1.2. ent002_Welcome 5

1.3. ini001-r3_Preparers Contact Info 6

1.4. ini001-r3_Preparers Contact Info Foreign 7

1.5. ini001-d3_Preparers Contact Info 8

1.6. ini001-d3_Preparers Contact Info Foreign 9

1.7. ini002-d1_Applicant Identification 10

1.8. ini002-d1_01_Applicant Identification 11

1.9. apn001-d1_Application Number 12

1.10. apn001-m1_Application Number 13

1.11. adi003-1_Disability 14

1.12. fam003-d1_Children 15

1.13. ear005-1-b_Other_Pensions_Annuities 16

1.14. ear005-1-e_Other_Pensions_Annuities 17

1.15. ear005-r1-c_Other_Pensions_Annuities 18

1.16. wst001-1-a_When to Start Retirement Benefits 19

1.17. wst001-1-a_01_When to Start Retirement Benefits 20

1.18. bni002-r1_b_Benefit Information 21

1.19. bni003-1_Benefit Information 22

1.20. bni004-1_Benefit Information 23

1.21. bni005-1_Benefit Information 24

1.22. dsq001-1_Ability To Work 25

1.23. dsq002-1_Disability Payments 26

1.24. dsq003-1_Dependents 27

1.25. dsq004-1_Authorization 29

1.26. rem001-m_Remarks 30

1.27. rem002-r1-cancellation 31

1.28. ovs001-d1-b_Overall Summary 32

1.29. ovs001-r1-e_Overall Summary 36

1.30. ovs001-m1-g_Overall Summary 42

1.31. ovs001-d3-d_Overall Summary 45

1.32. ovs001-r3-c_Overall Summary 50

1.33. ovs001-m3-f_Overall Summary 56

1.34. snd001-d1_Send This Application 58

1.35. snd001-m1_Send This Application 59

1.36. snd001-d3_Send This Application 60

1.37. snd001-m3_Send This Application 61

1.38. snd001-r3_Send This Application 62

1.39. rec001-d1-b_Evidence and Receipt 63

1.40. rec001-r1-e_Evidence and Receipt 68

1.41. rec001-m1-g_Evidence and Receipt 73

1.42. rec001-r3-c_Evidence and Receipt 77

1.43. rec001-d3-d_Evidence and Receipt 82

1.44. rec001-m3-f_Evidence and Receipt 87

1.45. wtn001- d1_What's Next 90

1.46. wtn001- d1_What's Next-Expanded 91

1.47. wtn001- m1_What's Next 93

1.48. wtn001- r3_What's Next 95

1.49. wtn001- d3_What's Next 96

1.50. wtn001- m3_What's Next 98

2. Messages 100

2.1. MSG-Confirm Delete of Table Entry 100

2.2. msg006_YouCannotApplyforMedicareOnly 101

2.3. msg017_SignIn Problem 102

2.4. msg025_Your Time Has Expired 103

2.5. msg029_LimitOnNumberOfRestartsOnPartialApplication 104

2.6. msg030_We Are Processing Your Request 105

2.7. msg047-a_Change Your Answer 106

2.8. msg047-b_Change Your Answer 107

2.9. msg113_Limit on Number of Requests 108

2.10. msg151_Cannot Match Your Zip Code 109

1. Pages

   1. Changes to Document

5/16/2011:

• Based on Based on the PAS Forum information gathering session the following changes have been made to the Welcome and What’s Next pages

  • ENT001 – language and page layout changes

    • Myself link goes to:http://www.socialsecurity.gov/info/isba/disability/firstpartydib.htm

    • Someone else link goes to: http://www.socialsecurity.gov/info/isba/disability/thirdpartytype.htm

    • Changed the button label from “Continue Application” to “Return to a Saved Application”

    • Modified the links in the “You may also want to review” section

• Page template change

  • Language removed: Form Approved

  • Expiration date removed

  • Footer added with links

• WTN001 – all pages first and third party – language placement changes. Helpful Information, Medicare Information, and Helpful Health Care Websites will be displayed “collapsed” by default. The Contact Information will be displayed “expanded” by default.

  • Disability version:

    • modified language in the “What’s Next” section

    • Added link for video

    • Link for Adult Disability Checklist goes to: http://www.ssa.gov/hlp/radr/10/ovw001-checklist.htm,

    • Provide language to offer a Spanish-speaking applicant an alternative to exiting the application.

• Correction to REM002-R1, language change from “Sign Now” to “Submit Now”

5/20/11

• Updated the ENT002 screen with the correct Privacy Act Statement

2. ent002_Welcome

3. ini001-r3_Preparers Contact Info

4. ini001-r3_Preparers Contact Info Foreign

5. ini001-d3_Preparers Contact Info

6. ini001-d3_Preparers Contact Info Foreign

7. ini002-d1_Applicant Identification

8. ini002-d1_01_Applicant Identification

9. apn001-d1_Application Number

10. apn001-m1_Application Number

11. adi003-1_Disability

12. fam003-d1_Children

13. ear005-1-b_Other_Pensions_Annuities

14. ear005-1-e_Other_Pensions_Annuities

15. ear005-r1-c_Other_Pensions_Annuities

16. wst001-1-a_When to Start Retirement Benefits

17. wst001-1-a_01_When to Start Retirement Benefits

18. bni002-r1_b_Benefit Information

19. bni003-1_Benefit Information

20. bni004-1_Benefit Information

21. bni005-1_Benefit Information

22. dsq001-1_Ability To Work

23. dsq002-1_Disability Payments

24. dsq003-1_Dependents

25. dsq004-1_Authorization

26. rem001-m_Remarks

27. rem002-r1-cancellation

28. ovs001-d1-b_Overall Summary

29. ovs001-r1-e_Overall Summary

30. ovs001-m1-g_Overall Summary

31. ovs001-d3-d_Overall Summary

32. ovs001-r3-c_Overall Summary

33. ovs001-m3-f_Overall Summary

34. snd001-d1_Send This Application

35. snd001-m1_Send This Application

36. snd001-d3_Send This Application

37. snd001-m3_Send This Application

38. snd001-r3_Send This Application

39. rec001-d1-b_Evidence and Receipt

40. rec001-r1-e_Evidence and Receipt

41. rec001-m1-g_Evidence and Receipt

42. rec001-r3-c_Evidence and Receipt

43. rec001-d3-d_Evidence and Receipt

44. rec001-m3-f_Evidence and Receipt

45. wtn001- d1_What's Next

Default display will show Contact information expanded and all other sections collapsed.

46. wtn001- d1_What's Next-Expanded

47. wtn001- m1_What's Next

48. wtn001- r3_What's Next

49. wtn001- d3_What's Next

50. wtn001- m3_What's Next

2. Messages

   1. MSG-Confirm Delete of Table Entry

2. msg006_YouCannotApplyforMedicareOnly

3. msg017_SignIn Problem

4. msg025_Your Time Has Expired

5. msg029_LimitOnNumberOfRestartsOnPartialApplication

6. msg030_We Are Processing Your Request

7. msg047-a_Change Your Answer

8. msg047-b_Change Your Answer

9. msg113_Limit on Number of Requests

10. msg151_Cannot Match Your Zip Code

Page 62 of 62 Version 1.6

Last Updated: 5/20/2011