POD Year 1 Follow-up Survey

1. Advance Letter Notification

Date
NAME
ADDRESS
CITY, STATE ZIP
Dear ,
It is time for the Promoting Opportunity Demonstration (POD) follow up survey. You joined POD about
[Y1: one year/Y2: two years] ago and agreed to be contacted for this survey. The survey will ask about
your experience in POD, your work and training experience, your health, and any services you may have
received in the past year.
The survey should take you about 30 minutes to complete. You will receive a check for completing the
survey. Mathematica Policy Research, an independent research company, was hired by SSA to study
POD and to conduct the survey.
Please use the login information below to access the survey online. This survey can also be accessed by a
mobile device.
Link: www.xxx.xxxx.
User Name: [user name]
Password: [password]
If you complete the survey online, Mathematica will send you a $[Y1: 30/Y2: 35] check. You can
complete the survey by telephone with an interviewer from Mathematica if you prefer. You will receive
a $[Y1: 20/Y2: 25] check if you complete the survey by telephone.
Taking part in this survey is your choice. Your answers will not affect your benefits. We will only use your
answers for research. The answers from all study volunteers will be combined and written up in a report
to SSA. Your name will never be used in any reports. No information will be reported in any way that can
identify you.
Your participation is very important. If you need help to take the survey, please call Mathematica tollfree at 8XX-XXX-XXXX.
You can learn more about POD and this survey at www.podssa.org.
We look forward to hearing from you. Thank you for your help.
John Jones
POD Project Officer
Social Security Administration

1

Privacy Act Statement
Collection and Use of Personal Information

Section 234 of the Social Security Act, as amended, allows us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the
information may prevent you from participating in the Promoting Opportunities Demonstration
(POD) project.
We will use the information you provide to manage your participation in the POD project
and for research and statistics purposes. We may also share your information for the following
purposes, called routine uses:

1.

To contractors and other Federal agencies, as necessary, for the purpose of assisting the
Social Security Administration (SSA) in the efficient administration of its programs;
and

2.

To a congressional office in response to an inquiry from that office made at the request
of the subject of a record.

In addition, we may share this information in accordance with the Privacy Act and other
Federal laws. For example, where authorized, we may use and disclose this information in
computer matching programs, in which our records are compared with other records for various
purposes related to the agency’s administration of Federal benefit programs, including ensuring
proper Federal benefit program payments.
A list of additional routine uses is available in our Privacy Act System of Records Notice
(SORN) 60-0218, entitled Disability Insurance and Supplemental Security Income
Demonstration Projects and Experiments System; 60-0090, entitled Master Beneficiary Record;
60-0103, entitled Supplemental Security Income Record and Special Veterans Benefits; 60-0094,
entitled Recovery of Overpayments, Accounting, and Reporting, and 60-0330, entitled eWork.
Additional information and routine uses, and a full listing of all our SORNs, are available on our
website at www.socialsecurity.gov/foia/bluebook.

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer the survey questions unless we display a valid Office of Management and Budget
(OMB) control number. The OMB control number for this collection is 0960-XXXX; expiration date XX/XX/20XX. We estimate
that it will take about 30 minutes to read the instructions and answer the survey questions. You may send comments about our
time estimate to: Social Security Administration, 6401 Security Blvd, Baltimore, MD 21235-6401

2

2. Advance Email Notification

To: [RESPONDENT EMAIL]
Subject: Please complete your survey for the POD study!

Dear ,
It is time for the Promoting Opportunity Demonstration (POD) follow up survey. You joined POD about
[Y1: one year/Y2: two years] ago and agreed to be contacted for this survey. The survey will ask about
your experience in POD, your work and training experience, your health, and any services you may have
received in the past year.
The survey should take you about 30 minutes to complete. You will receive a check for completing the
survey. Mathematica Policy Research, an independent research company, was hired by SSA to study
POD and to conduct the survey.
Please use the login information below to access the survey online. This survey can also be accessed by a
mobile device.
Link: www.xxx.xxxx.
User Name: [user name]
Password: [password]

If you complete the survey online, Mathematica will send you a $[Y1: 30/Y2: 35] check. You can
complete the survey by telephone with an interviewer from Mathematica if you prefer. You will receive
a $[Y1: 20/Y2: 25] check if you complete the survey by telephone.
Taking part in this survey is your choice. Your answers will not affect your benefits. We will only use your
answers for research. The answers from all study volunteers will be combined and written up in a report
to SSA. Your name will never be used in any reports. No information will be reported in any way that can
identify you.
Your participation is very important. If you need help to take the survey, please call Mathematica tollfree at 8XX-XXX-XXXX.
You can learn more about POD and this survey at www.podssa.org.
We look forward to hearing from you. Thank you for your help.
John Jones
POD Project Officer
Social Security Administration

3

Privacy Act Statement
Collection and Use of Personal Information

Section 234 of the Social Security Act, as amended, allows us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the
information may prevent you from participating in the Promoting Opportunities Demonstration
(POD) project.
We will use the information you provide to manage your participation in the POD project
and for research and statistics purposes. We may also share your information for the following
purposes, called routine uses:

3.

To contractors and other Federal agencies, as necessary, for the purpose of assisting the
Social Security Administration (SSA) in the efficient administration of its programs;
and

4.

To a congressional office in response to an inquiry from that office made at the request
of the subject of a record.

In addition, we may share this information in accordance with the Privacy Act and other
Federal laws. For example, where authorized, we may use and disclose this information in
computer matching programs, in which our records are compared with other records for various
purposes related to the agency’s administration of Federal benefit programs, including ensuring
proper Federal benefit program payments.
A list of additional routine uses is available in our Privacy Act System of Records Notice (SORN) 60-0218,
entitled Disability Insurance and Supplemental Security Income Demonstration Projects and
Experiments System; 60-0090, entitled Master Beneficiary Record; 60-0103, entitled Supplemental
Security Income Record and Special Veterans Benefits; 60-0094, entitled Recovery of Overpayments,
Accounting, and Reporting, and 60-0330, entitled eWork. Additional information and routine uses, and a
full listing of all our SORNs, are available on our website at www.socialsecurity.gov/foia/bluebook.

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer the survey questions unless we display a valid Office of Management and Budget
(OMB) control number. The OMB control number for this collection is 0960-XXXX; expiration date XX/XX/20XX. We estimate
that it will take about 30 minutes to read the instructions and answer the survey questions. You may send comments about our
time estimate to: Social Security Administration, 6401 Security Blvd, Baltimore, MD 21235-6401

4

3. Text Message Reminder
Hello from SSA’s POD study! It is time to complete the POD follow up survey. You signed up for
POD about [Y1: one year/Y2: two years] ago. Please complete the survey on-line about your
experiences in the past year. Mathematica will send you a $[Y1: 30/Y2: 35] check for doing the
survey. Go to www.XXXX.com to take part now. You will need your username and password.
Respond to this text or call Mathematica Policy Research at 8xx-xxx-xxxx for information. Thank
you!

5

4. Reminder postcard

Complete the POD survey TODAY!

www.xxx.xxxx

Mathematica is doing a survey about POD.
Complete the survey on-line and receive $[Y1: 30/Y2: 35]. Call 1-8xx-xxx-xxxx toll-free today to
access your login information for the online survey.
If you prefer, you can also complete the survey by telephone, and you will receive $[Y1: 20/Y2:
25]. Call 1-8xx-xxx-xxxx toll-free today to complete the survey by telephone.
We look forward to hearing from you soon.
OMB Control No.:0960-XXXX Expiration date: xx/xx/20xx

6

5. Reminder letter

Date
NAME
ADDRESS
CITY, STATE ZIP
Dear ,
Please complete the Promoting Opportunity Demonstration (POD) follow up survey today. You joined
POD about [Y1: one year/Y2: two years] ago and agreed to be contacted for this survey. The survey will
ask about your experience in POD, your work and training experience, your health, and any services you
may have received in the past year.
The survey should take you about 30 minutes to complete. If you complete the survey online,
Mathematica will send you a $[Y1: 30/Y2: 35] check.
Please use the login information below to access the survey online. This survey can also be accessed by a
mobile device.
Link: www.xxx.xxxx.
User Name: [user name]
Password: [password]
If you prefer to complete the survey by telephone, please call Mathematica toll-free at 8XX-XXX-XXXX to
speak with an interviewer. You will receive a $[Y1: 20/Y2: 25] check if you complete the survey by
telephone.
Taking part in this survey matters. Hearing from a lot of different people will help us find out whether
the new rules being tested under POD help people. [CONTROL GROUP: Because you were assigned to
the Current SSDI Rules group and the rules that apply to your benefits have stayed the same,]
[TREATMENT GROUPS (T1 or T2): Because you were assigned to the New POD Rules group,] it is very
important that we hear from you. It is only by comparing people’s experiences in all the research groups
that SSA will know if POD makes a positive difference to beneficiaries. SSA will use this information to
decide if POD should be continued and expanded to more states.
Taking part in this survey is your choice. Your answers to the survey will not affect your benefits. We will
only use your answers for research. The answers from all study volunteers will be combined and written
up in a report to SSA. Your name will never be used in any reports. No information will be reported in
any way that can identify you.

7

If you have questions or need help to take the survey, please call Mathematica toll-free at 8XX-XXXXXXX. Mathematica Policy Research, an independent research company, was hired by SSA to study POD
and to conduct the survey.
You can learn more about POD and this survey at www.podssa.org.
We look forward to hearing from you!
POD Survey Team

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer the survey questions unless we display a valid Office of Management and Budget
(OMB) control number. The OMB control number for this collection is 0960-XXXX; expiration date XX/XX/20XX. We estimate
that it will take about 30 minutes to read the instructions, and answer the survey questions. You may send comments about our
time estimate to: Social Security Administration, 6401 Security Blvd, Baltimore, MD 21235-6401

8

6. Reminder email

To: [RESPONDENT EMAIL]
Subject: REMINDER: Please complete your survey for the POD study!
Dear ,
Please complete the Promoting Opportunity Demonstration (POD) follow up survey today. You joined
POD about [Y1: one year/Y2: two years] ago and agreed to be contacted for this survey. The survey will
ask about your experience in POD, your work and training experience, your health, and any services you
may have received in the past year.
The survey should take you about 30 minutes to complete. If you complete the survey online,
Mathematica will send you a $[Y1: 30/Y2: 35] check.
Please use the login information below to access the survey online. This survey can also be accessed by a
mobile device.
Link: www.xxx.xxxx.
User Name: [user name]
Password: [password]
If you prefer to complete the survey by telephone, please call Mathematica toll-free at 8XX-XXX-XXXX to
speak with an interviewer. You will receive a $[Y1: 20/Y2: 25] check if you complete the survey by
telephone.
Your participation is very important. If you have questions or need help to take the survey, please call
Mathematica toll-free at 8XX-XXX-XXXX. Mathematica Policy Research, an independent research
company, was hired by SSA to study POD and to conduct the survey.
Taking part in this survey is your choice. Your answers will not affect your benefits. We will only use your
answers for research. The answers from all study volunteers will be combined and written up in a report
to SSA. Your name will never be used in any reports. No information will be reported in any way that can
identify you.
You can learn more about POD and this survey at www.podssa.org.
We look forward to hearing from you!
POD Survey Team

9

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer the survey questions unless we display a valid Office of Management and Budget
(OMB) control number. The OMB control number for this collection is 0960-XXXX; expiration date XX/XX/20XX. We estimate
that it will take about 30 minutes to read the instructions, and answer the survey questions. You may send comments about our
time estimate to: Social Security Administration, 6401 Security Blvd, Baltimore, MD 21235-6401

10

7. Refusal conversion letter

Date
NAME
ADDRESS
CITY, STATE ZIP
Dear ,
We need your help with an important study of the Social Security Administration (SSA)’s Promoting
Opportunity Demonstration (POD). POD is an SSA program to test rules for the Social Security Disability
Insurance (SSDI) program.
We hired a company called Mathematica Policy Research to help us study POD. Mathematica contacted
you recently to complete a survey about your experiences in the past year, but you decided not to take
part. I am writing today to ask you to think again about doing this survey.
Taking part in this survey matters. Hearing from a lot of different people will help us find out whether
the new rules being tested under POD help people. [CONTROL GROUP: Because you were assigned to
the Current SSDI Rules group and the rules that apply to your benefits have stayed the same,]
[TREATMENT GROUPS (T1 or T2): Because you were assigned to the New POD Rules group,] it is very
important that we hear from you. It is only by comparing people’s experiences in all the research groups
that SSA will know if POD makes a positive difference to beneficiaries. SSA will use this information to
decide if POD should be continued and expanded to more states.
Participation in the survey is voluntary but important. You can skip any question you don’t want to
answer. Your answers will not be shared in any way that reveals who you are. Your answers will be used
only for research. Your answers to the survey will not affect your benefits.
If you complete the 30 minute survey on-line, Mathematica will send you a $[Y1: 30/Y2: 35] check as a
thank you. If you prefer, you can complete the survey by telephone with an interviewer from
Mathematica. You will receive $[Y1: 20/Y2: 25] if you do the interview by telephone.
Below is your login information needed to access the survey online.
Link: www.xxx.xxxx.
User Name: [user name]
Password: [password]
If you need help to take the survey, please call Mathematica toll-free at 8XX-XXX-XXXX. You can learn
more about POD and this survey at www.podssa.org.
I hope that you will choose to participate. Thank you.
John Jones
POD Project Officer
Social Security Administration

11

Privacy Act Statement
Collection and Use of Personal Information

Section 234 of the Social Security Act, as amended, allows us to collect this information. Furnishing us
this information is voluntary. However, failing to provide all or part of the information may prevent your
successful participation in the Promoting Opportunities Demonstration (POD) study.

We will use the information you provide for research and statistics purposes. We may also share your
information for the following purposes, called routine uses:

1. To a congressional office in response to an inquiry from that office made at the request of the
subject of a record; and
2. To a contractor under contract to the Social Security Administration, subject to any restrictions
imposed by 26 U.S.C. 6103 of the Internal Revenue Code, for the performance of research and
statistical activities directly related to this system of records in conducting the demonstrations
and experiments and to provide a statistical database for research studies.
In addition, we may share this information in accordance with the Privacy Act and other Federal laws.

A list of additional routine uses is available in our Privacy Act System of Records Notice (SORN) 60-0218,
entitled Disability Insurance and Supplemental Security Income Demonstration Projects and
Experiments System. Additional information and a full listing of all our SORNs are available on our
website at www.socialsecurity.gov/foia/bluebook.

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer the survey questions unless we display a valid Office of Management and Budget
(OMB) control number. The OMB control number for this collection is 0960-XXXX; expiration date XX/XX/20XX. We estimate
that it will take about 20 minutes to read the instructions, and answer the survey questions. You may send comments about our
time estimate to: Social Security Administration, 6401 Security Blvd, Baltimore, MD 21235-6401

12

8. Mail survey cover letter

Date
NAME
ADDRESS
CITY, STATE ZIP
Dear ,
The Social Security Administration (SSA) is testing new rules for the Social Security Disability Insurance
(SSDI) program under the Promoting Opportunity Demonstration (POD). SSA has hired Mathematica
Policy Research to do a survey to find out whether the new rules being tested under POD help people.
You joined POD about [Y1: one year/Y2: two years] ago and agreed to be contacted for this survey.
Your participation is very important to us. We have tried to reach you to do this survey several times.
We have enclosed the paper survey with this letter for you to complete. Please return it in the enclosed
postage-paid envelope. You will receive a $5 check for completing and returning the paper survey.

If you prefer to complete the survey online, Mathematica will send you a $[Y1: 30/Y2: 35] check. Below
is your login information needed to access the survey online.

Link: www.xxx.xxxx.
User Name: [user name]
Password: [password]

You can complete the survey by telephone with an interviewer from Mathematica. You will receive $[Y1:
20/Y2: 25] if you do the interview by telephone.

Taking part in this survey is your choice. We will only use your answers for research. Your answers to the
survey will not affect your benefits. The answers from all study volunteers will be combined and written
up in a report to SSA. Your name will never be used in any reports and no information will be reported in
any way that can identify you.

13

If you need help to take the survey, please call Mathematica toll-free at 8XX-XXX-XXXX. You can learn
more about POD and this survey at www.podssa.org.
We look forward to talking with you. Thank you for your help.
John Jones
POD Project Officer
Social Security Administration

14

Privacy Act Statement
Collection and Use of Personal Information

Section 234 of the Social Security Act, as amended, allows us to collect this information. Furnishing us
this information is voluntary. However, failing to provide all or part of the information may prevent your
successful participation in the Promoting Opportunities Demonstration (POD) study.

We will use the information you provide for research and statistics purposes. We may also share your
information for the following purposes, called routine uses:

1. To a congressional office in response to an inquiry from that office made at the request of the
subject of a record; and
2. To a contractor under contract to the Social Security Administration, subject to any restrictions
imposed by 26 U.S.C. 6103 of the Internal Revenue Code, for the performance of research and
statistical activities directly related to this system of records in conducting the demonstrations
and experiments and to provide a statistical database for research studies.
In addition, we may share this information in accordance with the Privacy Act and other Federal laws.

A list of additional routine uses is available in our Privacy Act System of Records Notice (SORN) 60-0218,
entitled Disability Insurance and Supplemental Security Income Demonstration Projects and
Experiments System. Additional information and a full listing of all our SORNs are available on our
website at www.socialsecurity.gov/foia/bluebook.

Paperwork Reduction Act Statement
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer the survey questions unless we display a valid Office of Management and Budget
(OMB) control number. The OMB control number for this collection is 0960-XXXX; expiration date XX/XX/20XX. We estimate
that it will take about 10 minutes to read the instructions, and answer the survey questions. You may send comments about our
time estimate to: Social Security Administration, 6401 Security Blvd, Baltimore, MD 21235-64

15