Information Collection

Disability Report--Appeal (EDCS)

IC 180151 under ICR 201712-0960-006 · OMB 0960-0144.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0144 can be found here:

Documents and Forms

Document Name Document Type
SSA-3441 - Revised EDCS Screens.pdf Other-Internal Screens
SSA-3441 - Current EDCS Screens.pdf Current SSA-3441 EDCS Screens IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Disability Report--Appeal (EDCS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 405 20 CFR 404.1512 20 CFR 416.1416(c) 20 CFR 404.916(c) 20 CFR 416.912 20 CFR 422.140

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens			SSA-3441 - Revised EDCS Screens.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 476,771	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	476,771	476,771
Annual IC Time Burden (Hours)	357,578	357,578
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-3441 EDCS Screens	SSA-3441 - Current EDCS Screens.pdf	07/23/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.