Addendum to the Supporting Statement for 0960-0662

Addendum to Supporting Statement for

Form HA-1151 Medical Source Statement of Ability

To Do Work-Related Activities (Physical) and

Form HA-1152 Medical Source Statement of Ability

To Do Work-Related Activities (Mental)

20 CFR 404.1512-404.1513, 416.912-416.913, 404.1517, 416.917

OMB No. 0960-0662

Minor Revisions to the Collection Instrument

SSA is making one revision:

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 The current language, which dates back to the last reprint of the form, is now outdated.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 back of the form.