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. |
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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. |
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us |
Model Name | SSA MySSA V3 | |||||||
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. |
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 | ||||
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 | ||||
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 | ||||
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 |
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 | ||||
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 | ||||
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 | ||||
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 |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |