In accordance
with 5 CFR 1320, the information collection is approved for three
years.
Inventory as of this Action
Requested
Previously Approved
02/28/2021
36 Months From Approved
02/28/2018
2,762,500
0
3,262,500
981,133
0
1,022,800
0
0
0
SSA uses the information we obtain on
Forms HA-55, HA-504, HA 504-OP1, HA-510, and HA-510-OP1 to manage
the means by which we conduct hearings before an administrative law
judge (ALJ), and the scheduling of hearings with an ALJ. We use the
HA-55, Objection to Appearing by Video Teleconferencing, and its
accompanying cover letter, HA-L2, to allow claimants to opt-out of
an appearance via video teleconferencing (VTC) for their hearing
with an ALJ. The HA-L2 explains the good cause stipulation for
opting out of VTC if the claimant misses their window to submit the
HA-55, and for verifying a new residence address if the claimant
moved since submitting their initial hearing request. SSA uses the
HA-504 and HA 504 OP1, Acknowledgement of Receipt (Notice of
Hearing), and accompanying cover letter, HA-L83 to: (1) acknowledge
the claimants will appear for their hearing with an ALJ; (2)
establish the time and place of the hearing; and (3) remind
claimants to gather evidence in support of their claims. The only
difference between the two versions of the HA-504 is the language
used for the selection check boxes as determined by the type of
appearance for the hearing (in-person, phone teleconference, or
VTC). In addition, the cover letter, HA-L83, explains: (1) the
claimants’ need to notify SSA of their wish to object to the time
and place set for the hearing; (2) the good cause stipulation for
missing the deadline for objecting to the time and place of the
hearing; and (3) how the claimants can submit, in writing, any
additional evidence they would like the ALJ to consider, or any
objections they have on their claims. The HA-510, and HA-510-OP1,
Waiver of Written Notice of Hearing, allows the claimants to waive
their right to receive the Notice of Hearing as specified in the
HA-L83. We typically use these forms when there is a last minute
available opening on an ALJ’s schedule, so the claimants can fill
in the available time slot. If the claimants agree to fill the time
slot, we ask them to waive their right to receive the Notice of
Hearing. We use the HA-510-OP1 at the beginning of our process for
representatives and claimants who wish to waive the 75-day
requirement earlier in the process, and the HA-510 later in the
process for those representatives and claimants who want the full
75 days prior to the scheduled hearing. The respondents are
applicants for Social Security disability payments who request a
hearing to appeal an unfavorable entitlement or eligibility
determination.
US Code:
42
USC 1383 Name of Law: Social Security Act
US Code: 42
USC 405 Name of Law: Social Security Act
US Code: 42 USC 401, 404, 405, 421, 423,
& 405 Name of Law: Social Security Act
US Code: 42 USC 902, 1381, 1381a, 1383, &1383b Name of Law:
Social Security Act
There is a decrease in the
burden level from the last renewal. This decrease is due to our
completion of processing the pending claims for which we sent the
one-time notice. We expect the response level of the remaining
forms to stay the same.
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.
Form HA-510 Waiver of Written Notice of Hearing - HA-510
Addendum - 0671.docx
Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing)