Form 039 2020 039 SSA mySSA Web AccountManagement_09_24_20

E-Government Website Customer Satisfaction Surveys

2020 039 SSA mySSA Web AccountManagement_09_24_20.xlsx

2020 039 SSA mySSA Web AccountManagement_09_24_20

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

Overview

Welcome and Thank You Text
Model Qsts
Current CQs
CQs (08-18-2020)


Sheet 1: Welcome and Thank You Text

Model Instance Name:










SSA My Social Security V3









MID:









Partitioned Yes











Welcome and Thank You Text


















Directions:












This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome text shown in the box below.











Examples




Welcome Text Example
































































Welcome Text

























Thank you for visiting our site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve.

Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.













































































































































































































































Thank You Text Example






















Thank You Text














Thank you for taking our survey and for helping us serve you better.

Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.
















































































































































































































































































































































us


Sheet 2: Model Qsts

Model Name
SSA MySSA V3



Red & Strike-Through: Delete
Model ID
FtssMMEVVU58x8hlxFYwdg4C



Underlined & Italicized: Re-order
Partitioned
Yes - 2 MQ



Pink: Addition
Date
8/19/2019



Blue: Reword










Label Element Questions
Label Satisfaction Questions
Label Future Behaviors





Site Performance (1=Poor, 10=Excellent, Don't Know)

Satisfaction

Recommend (1=Very Unlikely, 10=Very Likely)
1 Site Performance - Speed Please rate the speed that pages and content loaded for you. 16 Satisfaction - Overall What is your overall satisfaction with this application?
(1=Very Dissatisfied, 10=Very Satisfied)
19 Recommend How likely are you to recommend this application to someone else?
2 Site Performance - Completeness Please rate the consistency of complete loading of pages and content. 17 Satisfaction - Expectations How well does this application meet your expectations?
(1=Falls Short, 10=Exceeds)

Use Other Online Services (1=Very Unlikely, 10=Very Likely)
3 Site Performance -Responsiveness Please rate the responsiveness of the pages to your actions. 18 Satisfaction - Ideal How does this application compare to your idea of an ideal application?
(1=Not Very Close, 10=Very Close)
20 Use Other Online Services How likely are you to use other Social Security online services?


Look and Feel (1=Poor, 10=Excellent, Don't Know)





4 Look and Feel - Appeal Please rate the visual appeal of the pages that you visited.





5 Look and Feel - Spacing Please rate the spacing between items on the pages that you visited.





6 Look and Feel - Readability Please rate the legibility of the pages that you visited.







Navigation (1=Poor, 10=Excellent, Don't Know)





7 Navigation - Ease Please rate the ease of finding what you were looking for.





8 Navigation - Layout Please rate the page layout on displaying content and links where you could find them.





9 Navigation - Links Please rate the links on taking you where you needed to go.







Site Information (1=Poor, 10=Excellent, Don't Know)





10 Site Information - Relevance Please rate the relevance to your interests of the information that you found.





11 Site Information - Thoroughness Please rate the thoroughness of the information that you found.





12 Site Information - Readability Please rate the readability of the information that you found.







Account Management (1=Poor, 10=Excellent, Don't Know)





13 Account Management - Simplicity Please rate the simplicity of account management on this site.





14 Account Management - Efficiency Please rate the efficiency of account management on this site.





15 Account Management - Essential Information Please rate the presentation of essential account information.






Sheet 3: Current CQs





red & strike-through: DELETE






SSA My Social Security V3


underlined & italicized: RE-ORDER







FtssMMEVVU58x8hlxFYwdg4C

pink: ADDITION






Partitioned Yes 1/11/2018
blue + -->: REWORDING






SSA My Social Security V3 CUSTOM QUESTION LIST

QID Skip Logic Label Question Text AnswerIDs (DOT) Answer Choices
(limited to 50 characters)
Skip to Type (select from list) Required
Y/N
Special Instructions CQ Label

SBD8779Q001
How often do you access (or plan to access) your my Social Security account?
Once a year
Radio button, one up vertical Y
Access Frequency - NEW





Once every six months










Once every three months










Once a month










More than once a month










Not sure






SZA0375687
Did you create a new my Social Security account today?
Yes, this is my first time accessing my Social Security
Radio button, one up vertical Y
Create mySSA account





No, I had already had a my Social Security account








Have you elected a delivery preference for your notices in Message Center?
Yes A Radio button, one up vertical Y Skip Logic Group Notice preference





No










Don't know







A Did you request to receive both a paper and online copy of notices in Message Center?
Yes B Radio button, one up vertical Y Skip Logic Group Receive paper and online





No










Don't know







B Why did you request to receive both a paper and online copy of notices in Message Center?


Text area, no Char limit N Skip Logic Group Why receive notices both ways

SBD8779Q002
What is your reason for visiting my Social Security today? (Check all that apply)
To get a Benefit Verification Letter A check box, one up vertical Y Skip Logic Group Primary Reason





To access my online notices (e.g., COLA) B,C,D,E,F,G









To view my Benefits and Payment Details










To enroll in or update my direct deposit










To use the myRetirement Calculator U









To change my address with SSA










To print or view my online Social Security Statement H









To make sure my earnings record is correct










To replace my Social Security Card or get a new card I









To check the Status of my recently filed application for benefits










To learn about the benefits to which I might be entitled










To apply only for Social Security or Medicare Only benefits










To report my wages J









To request a replacement SSA-1099 (or SSA-10425) for tax purposes










To add Extra Security to my online account










Just curious – wanted to see what information was contained in my Social Security account










Other Reason for visiting today K





SBD8779Q003 B How difficult or easy was it to access your Cost of Living Adjustment (COLA) notice online?
Very difficult
Radio button, one-up vertical Y Skip Logic Group Ease of access COLA





Somewhat difficult










Neither difficult or easy










Somewhat easy










Very easy






SBD8779Q004 C Do you have any suggestions for improving our online notices?


text, no char limit N Skip Logic Group Improve Online notices

SBD8779Q005 D If you owed us money, would you like the option to make a payment on line?
Yes
Radio button, one-up vertical Y Skip Logic Group Pay online option





No










Don't know/Not applicable






SBD8779Q006 E Are you aware that the communication delivery preference gives you the option to get your notices either electronically or by mail?
Yes L Radio button, one-up vertical Y Skip Logic Group Understand communication delivery preference





No






SBD8779Q007 L How easy or difficult was it to change your communication delivery preference?
Very difficult
Radio button, one-up vertical Y Skip Logic Group Ease of changing communication delivery





Somewhat difficult










Neither easy or difficult










Somewhat easy










Very easy










Don't know/Not applicable






SBD8779Q008 F Are you comfortable receiving notices electronically?
Yes
Radio button, one-up vertical Y Skip Logic Group Comfortable receiving notices online





No










Don't know






SBD8779Q009 G Would you recommend accessing notices online to your family and friends?
Yes
Radio button, one-up vertical Y Skip Logic Group Recommend accessing notices online





No










Don't know/Not applicable






SBD8779Q010 H How often do you review your online Social Security Statement?
This is my first time
Radio button, one-up vertical Y Skip Logic Group Freq View Statement





At least once a year










Every 6 months










Every 3 months or more frequently






SZA0375707 U Did use of the Retirement Calculator help eliminate the need to call our national phone service or visit a local Social Security office?
Yes V,W,X Radio button, one-up vertical Y Skip Logic Group RE eliminated need to call or visit





No










I was exploring the tools available within my Social Security and had not planned to contact SSA.






SZA0375708 V Were the estimates from the Retirement Calculator easy to understand?
Yes
Radio button, one-up vertical Y Skip Logic Group Estimates easy to understand




No










Don't know






SZA0375727 W Please indicate your level of agreement with the following statements: The estimates provided by the Retirement Calculator were displayed in an easy to understand format which allowed me to understand my Social Security Retirement options.
1=Strongly Disagree Y Radio button, scaled, no don't know Y Skip Logic Group RE gave understanding of future earnings





2 Y









3










4










5 =Strongly Agree






SZA0375747 Y What suggestions do you have for displaying retirement estimates?


Text area, no Char limit N Skip Logic Group OE_Preferred format

SZA0375767 X The Retirement Calculator gave me an understanding of how my future earnings may affect my Social Security Retirement benefits.
1=Strongly Disagree Radio button, scaled, no don't know Y Skip Logic Group RE format





2









3










4










5=Strongly Agree






SBD8779Q011 A For which Agency or program do you need a Benefit Verification Letter? (Check all that apply)
Medicare
check box vertical one up Y Skip Logic Group Agency Need





Medicaid










State or Local Department of Social Services










HUD - Federal Housing Admin. (FHA) and/or Section 8 Housing










USDA - SNAP (Food Stamps)










Department of Veterans Affairs










IRS










Court










Want a copy for personal use










Bank or financial institution










Education-related










Medical-related










Healthcare signup and/or verification










Requesting a Retirement Visa from another country










Other agency or program M





SBD8779Q012 M Which "other" agency or program requested your Benefit Verification information?


Text area, no Char limit N Skip Logic Group OPS_Other Agency

SBD8779Q013 K Please tell us what your primary reason was for visiting today:


Text area, no Char limit N Skip Logic Group OPS_Primary Reason

SBD8779Q014 I For which purpose or program do you need a replacement SSN Card? (Check all that apply)
Proof of identity
checkbox vertical, one up Y Skip Logic Group Purpose for SSN Card





Tax purposes










Education-related










Required for my job










Passport










Bank or financial institution










Income assistance










Other (Please specify) N





SBD8779Q015 N Please explain for which purpose or program you need a replacement SSN card.


Text area, no Char limit N Skip Logic Group OPS_Purpose Other

SBD8779Q016 J Who are you reporting wages for?
Myself only
Radio button, one-up vertical Y Skip Logic Group Reporting For





My spouse only O,P








Myself and my spouse O,P








Myself and another individual (not spouse) O,P,Q








Other relative only O,P








Other O,P,Q




SBD8779Q017 Q What is your relationship to the individual you are reporting wages for?


Text area, no Char limit N Skip Logic Group OE_Report For

SBD8779Q018 P What type of benefits does the person you are reporting for receive?
Disability
Radio button, one-up vertical Y Skip Logic Group Benefit Type Reporting





Supplemental Security Income (SSI)










Both Disability and SSI










Don't know






SBD8779Q019 O Was the person you wanted to report wages for listed?
Yes
Radio button, one-up vertical Y Skip Logic Group OE_Relationship





No




SBD8779Q020 J Was the employer listed?
Yes
Radio button, one-up vertical Y Skip Logic Group Employer listed





No




SBD8779Q021 J Are you reporting for more than one employer for the same person?
Yes
Radio button, one-up vertical Y Skip Logic Group Reporting multiple employers





No




SBD8779Q022 J Are you currently working?
Yes
Radio button, one-up vertical Y Skip Logic Group Currently working





No






SBD8779Q023 J How long did it take you to submit your wages?
5 minutes or less
Radio button, one-up vertical Y Skip Logic Group Time Submit Wage





6-10 minutes










11-15 minutes










More than 15 minutes










Unsure










Did not submit wages






SBD8779Q024 J Before today's visit, what other methods have you used to report wages? (Check all that apply)
Field Office
Checkbox, one-up vertical Y Skip Logic Group Other reporting methods





Mail










Fax










Phone










Other






SBD8779Q025 J Do you plan to electronically report additional wages in the future?
Yes R Radio button, one-up vertical Y Skip Logic Group Plan report electronically





No S









Don't know






SBD8779Q026 R How do you plan to report future wages?
Desktop/Laptop

Radio button, one-up vertical Y Skip Logic Group How Report Again





Tablet









Mobile Device









Don't know





SBD8779Q027 S What method do you prefer to use to report your wages?
Field Office
Radio button, one-up vertical Y Skip Logic Group Preferred method reporting





Mail










Fax










Phone










Other






SBD8779Q028 J Were the instructions you received helpful?
Yes
Radio button, one-up vertical Y Skip Logic Group Instructions Helpful





No T





SBD8779Q029 T How can we improve the wage reporting application?


Text area, no Char limit N Skip Logic Group OE_Improve Instructions



Are you currently receiving Special Notice Options (SNO) like Braille, Audio CD, Data CD, or Large Print as your notice format?
Yes A, B, D Radio button, one-up vertical Y Skip Logic Group SNO notice





No










Don't Know







A How satisfied are you with your current SNO format?
1=Very Dissatisfied
Radio button, one-up vertical Y Skip Logic Group Satisfied with SNO notice





2=Somewhat dissatisfied










3=Neither satisfied or dissatisfied










4=Somewhat satisfied










5=Very satisfied







B Do you use your SNO notice?
Yes
Radio button, one-up vertical Y Skip Logic Group Use SNO notice





No










Don't Know







D Would you like to stop receiving your notice in its current SNO format?
Yes E Radio button, one-up vertical Y Skip Logic Group Stop receiving SNO format





No










Don't Know







E Do you know how to change/stop receiving your notice in its current SNO format?
Yes
Radio button, one-up vertical Y Skip Logic Group Know how to stop





No










Don't Know







F Why would you like to stop receiving your notice in its current SNO format?


Text area, no Char limit N Skip Logic Group OE_Why stop SNO in format

SBD8779Q030
Did you register for your my Social Security online or in person?
Registered online on my first attempt A Radio button, one-up vertical Y Skip Logic Group How Registered





Registered online after prior unsuccessful attempts A









Registered with in-person assistance from my local SSA office A,B









Registered using the SSA Express










Not sure or don't remember






SBD8779Q031 A Please select the approximate length of time it took for you complete your registration
Less than 15 minutes
Radio button, one-up vertical Y Skip Logic Group Reg Time





More than 15 but less than 30 minutes










30 minutes or more






SBD8779Q032 B Why did you decide to register in-person?
I was unsuccessful registering online and was required to do so in-person C Radio button, one-up vertical Y Skip Logic Group Reg In person





I preferred registering for a Social Security account in-person at my SSA office C









Employee offered the option for me to register for a Social Security account C





SBD8779Q033 C Please describe your in-person registration experience.


Text area, no char limit N Skip Logic Group OE_In-person Experience

SBD8779Q034
Did you find the instructions for creating a username, password and registering a second factor to be clear?
Yes
Radio button, one-up vertical Y Skip Logic Group Instructions Understand





Partially A









No A





SBD8779Q035 A Please explain what was not clear about any of the instructions.




Text area, no char limit N Skip Logic Group OE_Instructions

SBD8779Q036
Do you have any concerns about the security of the personal information contained in your my Social Security account?
No
Radio Button, One-up Y Skip Logic Group Security Concerns





Yes B





SBD8779Q037 B Please describe your security concerns.


Text area, no char limit N Skip Logic Group OE_Security Concern. OCBO-Cx: Sentiment Analysis

SBD8779Q038
Please indicate your level of agreement with the following statements about your interaction today: I am satisfied with the service I received from the Social Security Administration.
1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Satisfied





2










3










4










Strongly Agree=5






SBD8779Q039
This interaction increased my confidence in the Social Security Administration.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Trust





2










3










4










Strongly Agree=5






SBD8779Q040
My need was addressed.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Quality





2










3










4










Strongly Agree=5






SBD8779Q041
It was easy to complete what I needed to do.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Ease





2










3










4










Strongly Agree=5






SBD8779Q042
It took a reasonable amount of time to do what I needed to do.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Speed





2










3










4










Strongly Agree=5






SBD8779Q043
Did the information obtained during your my Social Security account visit enable you to accomplish what you wanted to do?
Yes
Radio button, one up Yes Skip Logic Group Ability to Accomplish





No






SBD8779Q044
Did you contact Social Security during your online visit?
Yes A Radio button, one-up vertical Y Skip Logic Group Contacted SSA





No






SBD8779Q045 A How did you contact Social Security?
Requested a Call Back
Radio button, one-up vertical Y Skip Logic Group How contacted SSA





Email










Chat with an Online representative B,C,D,E





SBD8779Q046 B How long was your wait to Chat with a representative online?
About what I expected
Radio button, one-up vertical Y Skip Logic Group Click to chat wait





Longer than I expected






SBD8779Q047 C Did the Chat representative answer your question?
Yes
Radio button, one-up vertical Y Skip Logic Group Click to chat answer





Partially










No






SBD8779Q048 D Do you still have to call the 1-800 number or go into a field office?
Yes
Radio button, one-up vertical Y Skip Logic Group Click to chat Call





No






SBD8779Q049 D How satisfied were you with the Chat Service you received today?
Very Satisfied
Radio button, one-up vertical Y Skip Logic Group Click to chat service




Satisfied










Not Satisfied










Very Dissatisfied






SBD8779Q050 D How satisfied were you with the Chat Representative who assisted you today?
Very Satisfied
Radio button, one-up vertical Y Skip Logic Group Click to chat representative




Satisfied










Not Satisfied










Very Dissatisfied






SBD8779Q051 E Please share any other feedback with us regarding your Chat experience today.


Text area, no Char limit N Skip Logic Group Chat Feedback. OCBO-Cx: Sentiment Analysis

SBD8779Q052
Did you use the “Get Help” button or "Call Back" button during your visit today?
Yes, I used the "Get Help" button only
Radio button, one up vertical Y
Get Help Button or Call Back





Yes, I used the "Call Back" button only










Yes, I used both the "Get Help" button and "Call Back" button










No, I used neither






SBD8779Q053
Did you view the "Message Center" section during your visit today?
Yes
Radio button, one up Y Skip Logic Group Message Center





No B





SBD8779Q054 B Do you plan to view the "Message Center" in the future?
Yes
Radio button, one up Y Skip Logic Group Use Message Center Future





No






SBD8779Q055
Please select the category that includes your age:
35 and under
Radio button, one up N
Age





36 to 50










51 to 61










62










63










64










65










66










67










68 to 70










71 or older










Prefer not to answer






SBD8779Q056
Please enter your 5 digit ZIP Code:


Text area, 100 char limit N
OE_ZIP

SBD8779Q057
Do you have any suggestions for improving the my Social Security registration process?


Text area, no char limit N
OE_Improve Reg
OE_Improve Contents. OCBO-Cx: Sentiment Analysis
SBD8779Q058
Do you have any suggestions for improving my Social Security's content and features?


Text area, no char limit N
OE_Improve Contents. OCBO-Cx: Sentiment Analysis


Sheet 4: CQs (08-18-2020)





red & strike-through: DELETE






SSA My Social Security V3


underlined & italicized: RE-ORDER







FtssMMEVVU58x8hlxFYwdg4C

pink: ADDITION






Partitioned Yes 1/11/2018
blue + -->: REWORDING






SSA My Social Security V3 CUSTOM QUESTION LIST

QID Skip Logic Label Question Text AnswerIDs (DOT) Answer Choices
(limited to 50 characters)
Skip to Type (select from list) Required
Y/N
Special Instructions CQ Label

SBD8779Q001
How often do you access (or plan to access) your my Social Security account?
Once a year
Radio button, one up vertical Y
Access Frequency - NEW





Once every six months










Once every three months










Once a month










More than once a month










Not sure






SZA0375687
Did you create a new my Social Security account today?
Yes, this is my first time accessing my Social Security
Radio button, one up vertical Y
Create mySSA account





No, I had already had a my Social Security account






SBD8779Q002
What is your reason for visiting my Social Security today? (Check all that apply)
To get a Benefit Verification Letter A check box, one up vertical Y Skip Logic Group Primary Reason





To access my online notices (e.g., COLA) B,C,D,E,F,G









To view my Benefits and Payment Details










To enroll in or update my direct deposit










To use the myRetirement Calculator U









To change my address with SSA










To print or view my online Social Security Statement H









To make sure my earnings record is correct










To replace my Social Security Card or get a new card I









To check the Status of my recently filed application for benefits










To learn about the benefits to which I might be entitled










To apply only for Social Security or Medicare Only benefits










To report my wages J









To request a replacement SSA-1099 (or SSA-10425) for tax purposes










To add Extra Security to my online account










Just curious – wanted to see what information was contained in my Social Security account










Other Reason for visiting today K





SBD8779Q003 B How difficult or easy was it to access your Cost of Living Adjustment (COLA) notice online?
Very difficult
Radio button, one-up vertical Y Skip Logic Group Ease of access COLA





Somewhat difficult










Neither difficult or easy










Somewhat easy










Very easy






SBD8779Q004 C Do you have any suggestions for improving our online notices?


text, no char limit N Skip Logic Group Improve Online notices

SBD8779Q005 D If you owed us money, would you like the option to make a payment on line?
Yes
Radio button, one-up vertical Y Skip Logic Group Pay online option





No










Don't know/Not applicable






SBD8779Q006 E Are you aware that the communication delivery preference gives you the option to get your notices either electronically or by mail?
Yes L Radio button, one-up vertical Y Skip Logic Group Understand communication delivery preference





No






SBD8779Q007 L How easy or difficult was it to change your communication delivery preference?
Very difficult
Radio button, one-up vertical Y Skip Logic Group Ease of changing communication delivery





Somewhat difficult










Neither easy or difficult










Somewhat easy










Very easy










Don't know/Not applicable






SBD8779Q008 F Are you comfortable receiving notices electronically?
Yes
Radio button, one-up vertical Y Skip Logic Group Comfortable receiving notices online





No










Don't know






SBD8779Q009 G Would you recommend accessing notices online to your family and friends?
Yes
Radio button, one-up vertical Y Skip Logic Group Recommend accessing notices online





No










Don't know/Not applicable






SBD8779Q010 H How often do you review your online Social Security Statement?
This is my first time
Radio button, one-up vertical Y Skip Logic Group Freq View Statement





At least once a year










Every 6 months










Every 3 months or more frequently






SZA0375707 U Did use of the Retirement Calculator help eliminate the need to call our national phone service or visit a local Social Security office?
Yes V,W,X Radio button, one-up vertical Y Skip Logic Group RE eliminated need to call or visit





No










I was exploring the tools available within my Social Security and had not planned to contact SSA.






SZA0375708 V Were the estimates from the Retirement Calculator easy to understand?
Yes
Radio button, one-up vertical Y Skip Logic Group Estimates easy to understand




No










Don't know






SZA0375727 W Please indicate your level of agreement with the following statements: The estimates provided by the Retirement Calculator were displayed in an easy to understand format which allowed me to understand my Social Security Retirement options.
1=Strongly Disagree Y Radio button, scaled, no don't know Y Skip Logic Group RE gave understanding of future earnings





2 Y









3










4










5 =Strongly Agree






SZA0375747 Y What suggestions do you have for displaying retirement estimates?


Text area, no Char limit N Skip Logic Group OE_Preferred format

SZA0375767 X The Retirement Calculator gave me an understanding of how my future earnings may affect my Social Security Retirement benefits.
1=Strongly Disagree Radio button, scaled, no don't know Y Skip Logic Group RE format





2









3










4










5=Strongly Agree






SBD8779Q011 A For which Agency or program do you need a Benefit Verification Letter? (Check all that apply)
Medicare
check box vertical one up Y Skip Logic Group Agency Need





Medicaid










State or Local Department of Social Services










HUD - Federal Housing Admin. (FHA) and/or Section 8 Housing










USDA - SNAP (Food Stamps)










Department of Veterans Affairs










IRS










Court










Want a copy for personal use










Bank or financial institution










Education-related










Medical-related










Healthcare signup and/or verification










Requesting a Retirement Visa from another country










Other agency or program M





SBD8779Q012 M Which "other" agency or program requested your Benefit Verification information?


Text area, no Char limit N Skip Logic Group OPS_Other Agency

SBD8779Q013 K Please tell us what your primary reason was for visiting today:


Text area, no Char limit N Skip Logic Group OPS_Primary Reason

SBD8779Q014 I For which purpose or program do you need a replacement SSN Card? (Check all that apply)
Proof of identity
checkbox vertical, one up Y Skip Logic Group Purpose for SSN Card





Tax purposes










Education-related










Required for my job










Passport










Bank or financial institution










Income assistance










Other (Please specify) N





SBD8779Q015 N Please explain for which purpose or program you need a replacement SSN card.


Text area, no Char limit N Skip Logic Group OPS_Purpose Other

SBD8779Q016 J Who are you reporting wages for?
Myself only
Radio button, one-up vertical Y Skip Logic Group Reporting For





My spouse only O,P








Myself and my spouse O,P








Myself and another individual (not spouse) O,P,Q








Other relative only O,P








Other O,P,Q




SBD8779Q017 Q What is your relationship to the individual you are reporting wages for?


Text area, no Char limit N Skip Logic Group OE_Report For

SBD8779Q018 P What type of benefits does the person you are reporting for receive?
Disability
Radio button, one-up vertical Y Skip Logic Group Benefit Type Reporting





Supplemental Security Income (SSI)










Both Disability and SSI










Don't know






SBD8779Q019 O Was the person you wanted to report wages for listed?
Yes
Radio button, one-up vertical Y Skip Logic Group OE_Relationship





No




SBD8779Q020 J Was the employer listed?
Yes
Radio button, one-up vertical Y Skip Logic Group Employer listed





No




SBD8779Q021 J Are you reporting for more than one employer for the same person?
Yes
Radio button, one-up vertical Y Skip Logic Group Reporting multiple employers





No




SBD8779Q022 J Are you currently working?
Yes
Radio button, one-up vertical Y Skip Logic Group Currently working





No






SBD8779Q023 J How long did it take you to submit your wages?
5 minutes or less
Radio button, one-up vertical Y Skip Logic Group Time Submit Wage





6-10 minutes










11-15 minutes










More than 15 minutes










Unsure










Did not submit wages






SBD8779Q024 J Before today's visit, what other methods have you used to report wages? (Check all that apply)
Field Office
Checkbox, one-up vertical Y Skip Logic Group Other reporting methods





Mail










Fax










Phone










Other






SBD8779Q025 J Do you plan to electronically report additional wages in the future?
Yes R Radio button, one-up vertical Y Skip Logic Group Plan report electronically





No S









Don't know






SBD8779Q026 R How do you plan to report future wages?
Desktop/Laptop

Radio button, one-up vertical Y Skip Logic Group How Report Again





Tablet









Mobile Device









Don't know





SBD8779Q027 S What method do you prefer to use to report your wages?
Field Office
Radio button, one-up vertical Y Skip Logic Group Preferred method reporting





Mail










Fax










Phone










Other






SBD8779Q028 J Were the instructions you received helpful?
Yes
Radio button, one-up vertical Y Skip Logic Group Instructions Helpful





No T





SBD8779Q029 T How can we improve the wage reporting application?


Text area, no Char limit N Skip Logic Group OE_Improve Instructions



Are you currently receiving Special Notice Options (SNO) like Braille, Audio CD, Data CD, or Large Print as your notice format?
Yes A, B, D Radio button, one-up vertical Y Skip Logic Group SNO notice





No










Don't Know







A How satisfied are you with your current SNO format?
1=Very Dissatisfied
Radio button, one-up vertical Y Skip Logic Group Satisfied with SNO notice





2=Somewhat dissatisfied










3=Neither satisfied or dissatisfied










4=Somewhat satisfied










5=Very satisfied







B Do you use your SNO notice?
Yes
Radio button, one-up vertical Y Skip Logic Group Use SNO notice





No










Don't Know







D Would you like to stop receiving your notice in its current SNO format?
Yes E Radio button, one-up vertical Y Skip Logic Group Stop receiving SNO format





No










Don't Know







E Do you know how to change/stop receiving your notice in its current SNO format?
Yes
Radio button, one-up vertical Y Skip Logic Group Know how to stop





No










Don't Know







F Why would you like to stop receiving your notice in its current SNO format?


Text area, no Char limit N Skip Logic Group OE_Why stop SNO in format

SBD8779Q030
Did you register for your my Social Security online or in person?
Registered online on my first attempt A Radio button, one-up vertical Y Skip Logic Group How Registered





Registered online after prior unsuccessful attempts A









Registered with in-person assistance from my local SSA office A,B









Registered using the SSA Express










Not sure or don't remember






SBD8779Q031 A Please select the approximate length of time it took for you complete your registration
Less than 15 minutes
Radio button, one-up vertical Y Skip Logic Group Reg Time





More than 15 but less than 30 minutes










30 minutes or more






SBD8779Q032 B Why did you decide to register in-person?
I was unsuccessful registering online and was required to do so in-person C Radio button, one-up vertical Y Skip Logic Group Reg In person





I preferred registering for a my Social Security account in-person at my SSA office C









Employee offered the option for me to register for a my Social Security account C





SBD8779Q033 C Please describe your in-person registration experience.


Text area, no char limit N Skip Logic Group OE_In-person Experience

SBD8779Q034
Did you find the instructions for creating a username, password and registering a second factor to be clear?
Yes
Radio button, one-up vertical Y Skip Logic Group Instructions Understand





Partially A









No A





SBD8779Q035 A Please explain what was not clear about any of the instructions.




Text area, no char limit N Skip Logic Group OE_Instructions

SBD8779Q036
Do you have any concerns about the security of the personal information contained in your my Social Security account?
No
Radio Button, One-up Y Skip Logic Group Security Concerns





Yes B





SBD8779Q037 B Please describe your security concerns.


Text area, no char limit N Skip Logic Group OE_Security Concern. OCBO-Cx: Sentiment Analysis

SBD8779Q038
Please indicate your level of agreement with the following statements about your interaction today: I am satisfied with the service I received from the Social Security Administration.
1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Satisfied





2










3










4










Strongly Agree=5






SBD8779Q039
This interaction increased my confidence in the Social Security Administration.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Trust





2










3










4










Strongly Agree=5






SBD8779Q040
My need was addressed.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Quality





2










3










4










Strongly Agree=5






SBD8779Q041
It was easy to complete what I needed to do.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Ease





2










3










4










Strongly Agree=5






SBD8779Q042
It took a reasonable amount of time to do what I needed to do.

1=Strongly Disagree
Radio Button, Scale, No don't know Y
A11-Speed





2










3










4










Strongly Agree=5






SBD8779Q043
Did the information obtained during your my Social Security account visit enable you to accomplish what you wanted to do?
Yes
Radio button, one up Yes Skip Logic Group Ability to Accomplish





No






SBD8779Q044
Did you contact Social Security during your online visit?
Yes A Radio button, one-up vertical Y Skip Logic Group Contacted SSA





No






SBD8779Q045 A How did you contact Social Security?
Requested a Call Back
Radio button, one-up vertical Y Skip Logic Group How contacted SSA





Email










Chat with an Online representative B,C,D,E





SBD8779Q046 B How long was your wait to Chat with a representative online?
About what I expected
Radio button, one-up vertical Y Skip Logic Group Click to chat wait





Longer than I expected






SBD8779Q047 C Did the Chat representative answer your question?
Yes
Radio button, one-up vertical Y Skip Logic Group Click to chat answer





Partially










No






SBD8779Q048 D Do you still have to call the 1-800 number or go into a field office?
Yes
Radio button, one-up vertical Y Skip Logic Group Click to chat Call





No






SBD8779Q049 D How satisfied were you with the Chat Service you received today?
Very Satisfied
Radio button, one-up vertical Y Skip Logic Group Click to chat service




Satisfied










Not Satisfied










Very Dissatisfied






SBD8779Q050 D How satisfied were you with the Chat Representative who assisted you today?
Very Satisfied
Radio button, one-up vertical Y Skip Logic Group Click to chat representative




Satisfied










Not Satisfied










Very Dissatisfied






SBD8779Q051 E Please share any other feedback with us regarding your Chat experience today.


Text area, no Char limit N Skip Logic Group Chat Feedback. OCBO-Cx: Sentiment Analysis

SBD8779Q052
Did you use the “Get Help” button or "Call Back" button during your visit today?
Yes, I used the "Get Help" button only
Radio button, one up vertical Y
Get Help Button or Call Back





Yes, I used the "Call Back" button only










Yes, I used both the "Get Help" button and "Call Back" button










No, I used neither






SBD8779Q053
Did you view the "Message Center" section during your visit today?
Yes
Radio button, one up Y Skip Logic Group Message Center





No B





SBD8779Q054 B Do you plan to view the "Message Center" in the future?
Yes
Radio button, one up Y Skip Logic Group Use Message Center Future





No






SBD8779Q055
Please select the category that includes your age:
35 and under
Radio button, one up N
Age





36 to 50










51 to 61










62










63










64










65










66










67










68 to 70










71 or older










Prefer not to answer






SBD8779Q056
Please enter your 5 digit ZIP Code:


Text area, 100 char limit N
OE_ZIP

SBD8779Q057
Do you have any suggestions for improving the my Social Security registration process?


Text area, no char limit N
OE_Improve Reg
OE_Improve Contents. OCBO-Cx: Sentiment Analysis
SBD8779Q058
Do you have any suggestions for improving my Social Security's content and features?


Text area, no char limit N
OE_Improve Contents. OCBO-Cx: Sentiment Analysis

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