672 2013 672 iClaims v3

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Overview

v3 Model Qsts (EN)
Current v3 CQs (EE)
Element Rotations

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Sheet 1: v3 Model Qsts (EN)

Model Instance Name:
SSA iClaim v3
MID:		VgpBBYx9l8JxIFgJlY1Ikg4C
Partitioned No					Element rotation scheme has been added
FPI Included(Y/N)?
Date:		6/6/2013
SSA iClaim v3
Model questions utilize the ACSI methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS	FPI
		NOTE: All questions under each element are required. Element questions are partitioned among surveys.
		REQUIRED ELEMENTS (common to all websites)
	MQ Label			MQ Label			MQ Label		Y?
		Site Information (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Recommend (1=Very Unlikely, 10=Very Likely)
	Site Information - Thoroughness	Please rate the thoroughness of information provided in this application.		Satisfaction - Overall	What is your overall satisfaction with this application? (1=Very Dissatisfied, 10=Very Satisfied)		Recommend	How likely are you to recommend this application to someone else?
	SiteInformation - Understandable	Please rate how understandable this application’s information is.		Satisfaction - Expectations	How well does this application meet your expectations? (1=Falls Short, 10=Exceeds)			Use Other Online Services (1=Very Unlikely, 10=Very Likely)
	SiteInformation - Answers	Please rate how well the application’s information provides answers to your questions.		Satisfaction - Ideal	How does this application compare to your idea of an ideal application? (1=Not Very Close, 10=Very Close)		Use Other Online Services	How likely are you to use other Social Security online services?
		Site Performance (1=Poor, 10=Excellent, Don't Know)
	Site Performance - Consistency	Please rate how quickly pages load in this application.
	Site Performance - Errors	Please rate the consistency of speed from page to page in this application.
	Site Performance - Loading	Please rate the ability to load pages without getting error messages in this application.
		Navigation (1=Poor, 10=Excellent, Don't Know)
	Navigation - Organized	Please rate how well the application is organized.
	Navigation - Options	Please rate the options available for navigating this application.
	Navigation - Layout	Please rate how well the application layout helps you find what you are looking for.
	Navigation - Clicks	Please rate the number of clicks to get where you want in this application.
		Plain Language (1=Poor, 10=Excellent, Don't Know)
	Plain Language - Clear	Please rate the clarity of the wording in this application.
	Plain Language - Understandable	Please rate how well you understand the wording in this application.
	Plain Language - Concise	Please rate this application on its use of short, clear sentences.

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Sheet 2: Current v3 CQs (EE)

Model Instance Name:

red & strike-through: DELETE

SSA iClaim v3

underlined & italicized: RE-ORDER

MID: xZAAEQw81gIo1Vo4Noc1Rw4C

pink: ADDITION

Date:

7/15/2011

blue + -->: REWORDING

violet (bold): SKIP-LOGIC

SSA iClaim v3 CUSTOM QUESTION LIST

QID

Skip Logic Label

Question Text

Answer Choices (limited to 50 characters)

Skip To

Type (select from list)

Single or Multi

Required Y/N

Special Instructions

CQ Label

BJL2230

Please rate your impression of the level of security in completing tasks on this application.

BJL2230A01

1 = Poor

Radio Button Scale Has Don’t Know

Single

Y

Level of Security

BJL2230A02

2

BJL2230A03

3

BJL2230A04

4

BJL2230A05

5

BJL2230A06

6

BJL2230A07

7

BJL2230A08

8

BJL2230A09

9

BJL2230A10

10 = Excellent

BJL2230A11

Don't know

BJL2231

What type of benefits were you applying for?

BJL2231A01

Retirement

M, Q, R, X, Y, Z, U, E, W

Dropdown (Select-one)

Single

Y

Skip Logic Group

Type of Benefits

BJL2231A02

Disability

M, Q, R, X, Y, Z, U, E, G, W

BJL2231A03

Spouse's

M, Q, R, X, Y, Z, U, E, W

BJL2231A04

Medicare only

M, Q, R, X, Y, Z, U, E, W

BJL2231A05

I am not applying today

BJL2232

M

How did you learn about the Social Security online application? (Select all that apply.)

BJL2232A01

Social Security website

Checkbox One Up Vertical

Multi

Y

Skip Logic Group

Learn About Online App

Types

BJL2232A02

Friend, spouse, relative, neighbor or acquaintance

BJL2232A03

Social Security employee

B

BJL2232A04

Another website or search engine

BJL2232A05

News (TV, radio, newspaper or Internet)

BJL2232A06

Advertisement

BJL2232A07

Social Security statement

BJL2232A08

Community Group or Association

BJL2232A09

Other, please specify

A

BJL2233

A

Please specify how you learned of Social Security online.

Text area, no char limit

N

Skip Logic Group

OE_Learn about online app

BJL2234

B

How did you make contact with a Social Security employee?

BJL2234A01

Visited a local Social Security office

Radio Button One Up Vertical

Single

Y

Skip Logic Group

Contact SSA Employee

BJL2234A02

Called a local Social Security office

BJL2234A03

Called the national 800 number

BJL2234A04

Other, please specify

D

BJL2235

D

Please describe the way you made contact with a social security employee.

Text field, <100 char

N

Skip Logic Group

OE_Contact SSA Employee

BJL2236

Q

Did you complete your application today?

BJL2236A01

Yes, I completed my new application today

C

Radio Button One Up Vertical

Single

Y

Skip Logic Group

Complete App

BJL2236A02

Yes, I restarted and completed my earlier application today

C

BJL2236A03

No, I did not complete my new application, but I plan to complete it later

C

BJL2236A04

No, I did not complete my re-started earlier application, but I plan to complete it later

C

BJL2236A05

No, I do not plan to complete my application at all

C

BJL2236A06

I'm not applying for benefits today

BJL2237

C

For whom are you filing this online application for Social Security benefits?

BJL2237A01

Myself

Radio Button One Up Vertical

Single

Y

Skip Logic Group

Whose Behalf

BJL2237A02

My spouse

BJL2237A03

My parent

BJL2237A04

Another relative

BJL2237A05

My friend

BJL2237A06

My client

BJL2237A07

Other

BJL2238

R

If you stopped working on your application, please tell us why. (Select all that apply.)

BJL2238A01

I finished my application today

Checkbox One Up Vertical

Multi

Y

Skip Logic Group

Why Stopped App

BJL2238A02

Needed to find documents/other information for my application

BJL2238A03

Too many questions

BJL2238A04

Takes too long

BJL2238A05

Too complicated to use without help

BJL2238A06

My medical/physical condition prevents me from working on the computer for long periods

BJL2238A07

Application wouldn't accept empty/blank fields

BJL2238A08

Received an error message or was "kicked out" of the application

BJL2238A09

I had a problem entering dates or other information in some of the pages

BJL2238A10

Other Reason

zz

BJL2239

zz

Please tell us the other reason you stopped working on your application.

Text area, no char limit

N

Skip Logic Group

OE_Stopped Application

BJL2240

X

Did you visit the Social Security home page (www.socialsecurity.gov) today?

BJL2240A01

Yes

Dropdown (Select-one)

Single

Y

Skip Logic Group

Homepage

BJL2240A02

No

BJL2241

Y

Did you use the SEARCH box on our website to find what you needed?

BJL2241A01

Yes

Dropdown (Select-one)

Single

Y

Skip Logic Group

Search

BJL2241A02

No

BJL2242

Z

Please tell us how easy it was for you to find the application for benefits.

BJL2242A01

I had little or no difficulty getting to the application

Radio Button One Up Vertical

Single

Y

Skip Logic Group

Find app

BJL2242A02

I found it somewhat difficult to find the application

Z1

BJL2243

Z1

I found it somewhat difficult to find the application because: (Select all that apply.)

BJL2243A01

I did not know where to begin looking

Checkbox One Up Vertical

Multi

Y

Skip Logic Group

Difficult to Find

BJL2243A02

It was not clear to me where the links would lead

BJL2243A03

The information did not seem to be organized in a logical manner

BJL2243A04

I used the search function but the results didn’t seem to apply.

BJL2243A05

Other reason (please describe)

Z2

BJL2244

Z2

Please explain the reason you found it somewhat difficult to find the application.

Text area, no char limit

N

Skip Logic Group

OE_Difficult to Find

BJL2245

U

How did you arrive on the Social Security website today?

BJL2245A01

Typed ssa.gov or socialsecurity.gov into the browser

Dropdown (Select-one)

Single

Y

Skip Logic Group

Arrive

BJL2245A02

Did a search (i.e. Google, Bing, Yahoo)

BJL2245A03

Followed a link from medicare.gov

BJL2245A04

Followed a link from another website

BJL2246

E

Please rate the clarity of the instructions provided for this Social Security online application.

BJL2246A01

1 = Not At All Clear

F

Radio Button Scale Has Don’t Know

Single

Y

Skip Logic Group

Clarity of Instructions

BJL2246A02

2

F

BJL2246A03

3

F

BJL2246A04

4

F

BJL2246A05

5

F

BJL2246A06

6

BJL2246A07

7

BJL2246A08

8

BJL2246A09

9

BJL2246A10

10 = Very Clear

BJL2246A11

Don't know

BJL2247

F

What part of the instructions was not clear?

Text area, no char limit

N

Skip Logic Group

OE_Clarity of Instructions

BJL2248

G

Did you complete the Online Disability Report today?

BJL2248A01

Yes

Radio Button One Up Vertical

Single

Y

Skip Logic Group

Disability Report

BJL2248A02

No

BJL2248A03

Don't recall

BJL2249

W

Do you have any other problems with this Social Security Online application that weren't covered in earlier questions, or any suggestions on how we can improve it? (Please do not include any personal information in your answer.)

Text area, no char limit

N

Skip Logic Group

Other Problems

BJL2250

What influenced your decision to use our online benefit application? (Select all that apply.)

BJL2250A01

I did not want to go to an SSA field office

Checkbox One Up Vertical

Multi

Y

Skip Logic Group

Influenced Decision Benefits

BJL2250A02

I did not want to do business over the phone

BJL2250A03

I prefer to use online services as much as possible

BJL2250A04

I learned about filing online while visiting socialsecurity.gov

BJL2250A05

Someone from SSA recommended filing online

BJL2250A06

A friend, relative, or colleague recommended filing online

BJL2250A07

I knew that if I had a question, I could then call or visit SSA

BJL2250A08

I am filing on behalf of another person

A

BJL2250A09

Other, please specify

B

BJL2251

B

Please specify what influenced your decision to file for benefits online.

Text area, no char limit

N

Skip Logic Group

OE_Influenced Decision

BJL2252

A

Please specify your role.

BJL2252A01

I am a non-profit professional

Radio button, one-up vertical

Single

Y

Skip Logic Group

Role

BJL2252A02

I am a for-profit professional

BJL2252A03

I am a friend or relative

BJL2252A04

Other, please specify

C

BJL2253

C

Please describe your role.

Text field, <100 char

N

Skip Logic Group

OE_Role

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Sheet 3: Element Rotations

Base Element Order	Version 2	Version 3	Version 4
Site Information	Plain Language	Navigation	Site Performance
Site Performance	Navigation	Site Information	Plain Language
Navigation	Site Performance	Plain Language	Site Information
Plain Language	Site Information	Site Performance	Navigation
1	11	7	4
2	12	8	5
3	13	9	6
4	7	10	11
5	8	1	12
6	9	2	13
7	10	3	1
8	4	11	2
9	5	12	3
10	6	13	7
11	1	4	8
12	2	5	9
13	3	6	10