Promoting Opportunity Project (POD)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
POD End of Year (EOYR) Form - Online	Form and Instruction	Removed	Available
POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Online	Form	Unchanged	Available
POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Paper	Form and Instruction	Unchanged	Available
POD Baseline Survey	Form and Instruction	Unchanged	Available
Form POD Informed Conse POD Informed Consent Form	Form	Unchanged	Available
Addendum - 0809.docx	Supplementary Document	Uploaded 2019-04-15	Available
Supporting Statement Part B - 0809.docx	Supporting Statement B	Uploaded 2019-01-09	Available
Supporting Statement Part A - 0809.docx	Supporting Statement A	Uploaded 2019-01-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227828	POD End of Year (EOYR) Form - Online	Form and Instruction	Removed
227827	POD End of Year Reporting (EOYR) Documentation	Other-Letter and Instructions for Submission of Documentation	Modified
227826	POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Online	Form	Unchanged
227825	POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Paper	Form and Instruction	Unchanged
227823	POD Semi-Structured Interviews with Treatment Group Subjects	Other-Interview Topics	Unchanged
227822	POD Onsite Audit of Sample of Case Files in MIS	Other-Interview Topics and Assessment of Implementation Fidelity	Unchanged
227821	POD Staff Interviews with Site Staff	Other-Interview Topics and Explanation	Unchanged
227820	POD Year 2 Follow-up Surveys	Other-Follow-up Surveys	Modified
227812	POD Year 1 Follow-up Survey	Other-Follow-up Surveys	Modified
227810	POD Baseline Survey	Form and Instruction	Unchanged
227805	POD Informed Consent Form	Form	Unchanged

ICR Details

OMB Control No: 0960-0809	ICR Reference No: 201901-0960-002
Status: Active	Previous ICR Reference No: 201805-0960-006
Agency/Subagency: SSA	Agency Tracking No:
Title: Promoting Opportunity Project (POD)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/16/2019
	Date Received in OIRA: 01/22/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	36 Months From Approved	11/30/2020
Responses	85,135	0	83,870
Time Burden (Hours)	21,944	0	20,699
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 823 of the Bipartisan Budget Act of 2015 required SSA to carry out the Promoting Opportunity Demonstration (POD) to test a new benefit offset formula for Social Security Disability Insurance (SSDI) beneficiaries. Therefore, SSA is undertaking POD, a demonstration to evaluate the affect the new policy will have on SSDI beneficiaries and their families in several critical areas. We previously obtained OMB approval for this demonstration, and are in the midst of implementing the project. In this information collection request, we are seeking approval to add new questions to our follow-up surveys. Respondents are SSDI beneficiaries, who will provide written consent before agreeing to participate in the study and before we randomly assign them to one of the study treatment groups.

---

Authorizing Statute(s): US Code: 42 USC 434 Name of Law: Social Security Act
   PL: Pub.L. 114 - 74 823 Name of Law: Bipartisan Budget Act of 2015
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 53352	10/23/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 66330	12/26/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Online	N/A	POD Monthly Earnings & IRWE Reporting Form
POD End of Year Reporting (EOYR) Documentation
POD End of Year (EOYR) Form - Online	N/A	POD End of Year Reporting Form
POD Informed Consent Form	POD Informed Consent Form	Promoting Opportunity Demonstration (POD) Voluntary Participation Consent Form
POD Baseline Survey	N/A	Promoting Opportunity Demonstration (POD) Baseline Questionnaire
POD Year 1 Follow-up Survey
POD Year 2 Follow-up Surveys
POD Staff Interviews with Site Staff
POD Onsite Audit of Sample of Case Files in MIS
POD Semi-Structured Interviews with Treatment Group Subjects
POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Paper	N/A	POD Monthly Earnings & IRWE Reporting Form

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	85,135	83,870	0	1,265	0	0
Annual Time Burden (Hours)	21,944	20,699	0	1,245	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The increase in burden for the POD evaluation stems from an increase in burden for the two follow-up surveys, as we are asking three additional questions (which increases the burden per response by a small amount). In addition, we are also changing the way we use our End of Year Reporting form to include both pre- and post-POD earnings, as well as end of year reporting. This changes both the number of respondents using the form annually, as well as the estimated burden per response, which created an overall increase in the burden for this form. Please see the attached Addendum for more information on these revisions.

---

Annual Cost to Federal Government: $9,487,047

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/22/2019

---