Authorization to Disclose Information to the Social Security Administration

Forms and Documents

Document Name	Status
Form SSA-827 SSA-827 with wet signature(paper version) Form and Instruction	Modified
Addendum - 0623.docx Supplementary Document	2017-07-31
Supporting Statement - 0623.docx Supporting Statement A	2017-07-31

IC Document Collections

IC ID	Document Title	Status
9639	SSA-827 with wet signature(paper version) Form and Instruction	Modified
197969	SSA-827 - Electronic Versions (EDCS and eAuthorization) Other-Internal Screens	Modified

ICR Details

OMB Control No: 0960-0623	ICR Reference No: 201703-0960-023
Status: Active	Previous ICR Reference No: 201404-0960-019
Agency/Subagency: SSA	Agency Tracking No:
Title: Authorization to Disclose Information to the Social Security Administration
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: 03/15/2018
	Date Received in OIRA: 07/31/2017
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved	03/31/2018
Responses	5,245,077	0	3,363,990
Time Burden (Hours)	804,359	0	528,616
Cost Burden (Dollars)	0	0	0

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Abstract: Sections 223(d)(5)(A) and 1614(a)(3)(H)(i) of the Social Security Act require claimants to provide medical and other evidence the Commissioner of Social Security may require to prove they are disabled. SSA must obtain sufficient evidence to make eligibility determinations for Title II and Title XVI payments. Therefore, the applicant must authorize release of information from various sources to SSA. The applicants use Form SSA 827, or the Internet counterpart, i827, to provide consent for the release of medical records, education records, and other information related to their ability to perform tasks. Once the applicant completes Form SSA-827, or the i827, SSA or the State DDS sends the form to the designated source(s) to obtain pertinent records. The respondents are applicants for Title II and Title XVI disability payments.

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Authorizing Statute(s): US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 423 Name of Law: Social Security Act
   US Code: 42 USC 1382c 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:
	82 FR 18335	04/18/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 29140	06/27/2017
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
SSA-827 with wet signature(paper version)	SSA-827	Authorization To Disclose Information To The Social Security Administration
SSA-827 - Electronic Versions (EDCS and eAuthorization)

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ICR Summary 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	5,245,077	3,363,990	0	0	1,881,087	0
Annual Time Burden (Hours)	804,359	528,616	0	0	275,743	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden increase stems from SSA implementing eAuthorized 827s from the Internet, EDCS and eView, and the HART court case. In addition, beginning FY 2014, accurate reporting of eAuthorizations became available with new management information tools. We still base our estimates of wet signed SSA-827s on educated estimates. FY 2014 also saw an increase in occasions where wet-signed 827s and eAuthorizations were both collected (for the same case). Another aspect of eAuthorizations is the ease by which respondents can submit multiple electronic SSA-827 for the same case. One final reason for increased numbers is the implementation of the iClaim tool, which collects SSA-827s within the iClaim process. We account for the iClaim burden here and not under iClaim (0960-0618). The current count reflects SSA-827s in three formats: wet-signed, eAuthorizations, and iClaim modalities.

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Annual Cost to Federal Government: $36,681

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 07/31/2017

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