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, and 416.917
OMB No. 0960-0662
Minor Revisions to the Collection Instrument
SSA is making the following revision:
Change #1: We are revising the Privacy Act Statements on Forms HA-1151 and HA-1152.
Justification #1: 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 Statements on Forms HA-1151 and HA-1152.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |