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Supporting Statement For Form HA-539, Notice Regarding Substitution of Party Upon Death of Claimant
ICR 201708-0960-003 · OMB 0960-0288 · Object 75922101.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Supporting Statement For Form HA-539, Notice Regarding Substitution of Party Upon Death of Claimant |
| Author | 689830 |
| Last Modified By | Writer |
| File Modified | 2017-08-04 |
| File Created | 2026-09-13 |
| Conversion State | complete |
Extracted Text
Justification for Non-Substantive Changes for the HA-539
Notice Regarding Substitution of Party Upon Death of Claimant
20 CFR 404.957(c)(4) and 416.1457(c)(4)
OMB No. 0960-0288
Revisions to the Collection Instrument
• Change #1: Add cover letter to be included with the HA-539 when sending to the family of a claimant who passed away.
Justification #1: This letter will explain to the family of the claimant that there was a pending disability claim at the time of death. If there is an eligible person to assume the role of a substitute party to the claim, then they will need to fill out the provided HA-539 and return it to the hearing office within 10 days, or SSA will dismiss the deceased claimant's hearing request.