Information Collection Request

Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook

ICR 201312-0960-008 · OMB 0960-0189 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form SSA-2930 SSA-2930 Form Modified Available
Form SSA-2930-BK SSA-2930-BK (Abbreviated Information Requested per FY 2012 Study) Form and Instruction Removed Repair queued
Form SSA-8510 SSA-8510 Form Unchanged Repair queued
Form SSA-820-F4 SSA-820 and SSA-821 Form Unchanged Available
Form SSA-2935 SSA-2935 Form and Instruction Modified Available
Form SSA-85 SSA-85 Form Unchanged Repair queued
Form SSA-8552 SSA-8552 Form Modified Available
Form SSA-4659 SSA-4659 Form Modified Repair queued
Form SSA-2932 (revised) SSA-2932 Form Removed Repair queued
Form SSA-2931(revised) SSA-2931 Form Modified Available
Supporting_Statement_Part_B.docx Supporting Statement B Uploaded 2014-01-24 Available
supporting statement 0189 (revised).docx Supporting Statement A Uploaded 2014-05-13 Available
Addendum 0189.docx Supplementary Document Uploaded 2014-05-13 Available
IC Document Collections
IC IDCollectionTypeStatusForm
9153 SSA-2930 Form Modified
200775 SSA-2930-BK (Abbreviated Information Requested per FY 2012 Study) Form and Instruction Removed
195245 SSA-8510 Form Unchanged
195231 SSA-820 and SSA-821 Form Unchanged
190343 iClaim Stewardship Questions Other-follow-up stewardship questions Removed
183776 SSA-2935 Form and Instruction Modified
183775 SSA-85 Form Unchanged
183774 SSA-8552 Form Modified
183773 SSA-L8554-U3 Other-Notice Modified
183772 SSA-L8553-U3 Other-Notice Modified
183771 SSA-L8552-U3 Other-Notice Modified
183770 SSA-L8551-U3 Other-Notice Modified
183769 SSA-L8550-U3 Other-Notice Modified
183268 SSA-4659 Form Modified
183266 SSA-2932 Form Removed
183264 SSA-2931 Form Modified
ICR Details
0960-0189 201312-0960-008
Historical Active 201201-0960-002
SSA
Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook
Revision of a currently approved collection   No
Regular
Approved without change 08/14/2014
Retrieve Notice of Action (NOA) 05/14/2014
  Inventory as of this Action Requested Previously Approved
08/31/2017 36 Months From Approved 08/31/2014
18,100 0 20,424
2,582 0 2,786
0 0 0

SSA collects information on Forms SSA-2930, SSA-2931, and SSA-2932 to establish a national payment accuracy rate for all cases in payment status, and to serve as a source of information regarding problem areas in the Retirement and Survivors Insurance (RSI) and Disability Insurance (DI) programs. SSA also uses the information to measure the accuracy rate for newly adjudicated RSI/DI cases. SSA collects information on Form SSA-4659 to evaluate and determine the effectiveness of the annual earnings test, and uses the results in developing ongoing improvements in the process. SSA sends each beneficiary an appointment letter for the interview. About 25 percent of respondents will have face-to-face contact reviews and receive one of the following letters for an appointment: SSA-L8550-U3 (Appointment Letter- Sample Individual), SSA-L8551-U3 (Appointment Letter- Sample Family), or the SSA-L8552-U3 (Appointment Letter-Rep Payee). The other 75 percent of respondents will receive a notice for a telephone contact review: either the SSA-L8553-U3 (Beneficiary Telephone Contact), or the SSA-L8554-U3 (Rep Payee Telephone Contact) notice. To help the beneficiary prepare for the interview, we include three forms with each notice: 1) SSA-85 (Information Needed to Review Your Social Security Claim) that lists the information the respondents will need to gather to prepare for the interview. 2) SSA-2935 (Authorization to the Social Security Administration to Obtain Personal Information) so SSA can obtain information to verify the correctness of the payment to the beneficiary. 3) SSA-8552 (Interview Confirmation) to confirm or reschedule the interview if necessary. The respondents are a statistically valid sample of all RSI/DI beneficiaries in current pay status or their representative payees. The respondents are a statistically valid sample of all RSI/DI beneficiaries in current pay status or their representative payees. This ICR is for a non-substantive change request.

US Code: 42 USC 428 Name of Law: Social Security Act
   US Code: 42 USC 1382c Name of Law: Social Security Act
   US Code: 42 USC 1395o Name of Law: Social Security Act
   US Code: 42 USC 405 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  79 FR 889 01/07/2014
79 FR 15782 03/21/2014
No

  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 18,100 20,424 0 -1,424 -900 0
Annual Time Burden (Hours) 2,582 2,786 0 -170 -34 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Changing Forms
There is an increase in burden hours. This change stems from the discontinuation of the iClaim Stewardship Questionnaire in 2013.

$3,317
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/14/2014