Non-Substantive Change Request for 0960-0622

Justification for Non-Substantive Changes for Form SSA-561-U2

Request for Reconsideration

20 CFR 404.907-404.921, 416.1407-416.1421, 418.1009, and 418.1325

OMB No. 0960-0622

Revisions to the Collection Instruments

Individuals can use the paper form SSA-561-U2 or the Internet i561 to file a reconsideration request on a non-medical or initial disability determination. The i561 is the electronic version of the paper form SSA-561-U2 and is part of the agency’s iAppeals application. The iAppeals application is available on the SSA.gov website, and allows individuals to file an appeal over the Internet. The iAppeals application also includes the i501 (Request for Hearing by Administrative Law Judge; OMB #0960-0269), i520 (Request for Review of Hearing Decision/Order; OMB #0960-0277) and i3441 (Disability Report; OMB #0960‑0144).

As part of our non-medical appeals process, we require individuals to submit an appeal form, either the SSA-561 (i561), Request for Reconsideration; or the HA-501 (i501), Request for Hearing. To request Appeals Council Review of non-medical or initial disability determination we require the respondent to complete the HA-520 (i520), Request for Review of Hearing Decision/Order, only.

As part of our initial disability determination reconsideration and hearings appeals process, we require individuals to submit both an appeal form (either the SSA-561/i561, Request for Reconsideration; or the HA-501/i501, Request for Hearing) along with the SSA‑3441/i3441, Disability Report – Appeal. To ensure we obtain all of the information we need to process an appeal submitted through iAppeals, we implemented the single submission process in March 2015. Single submission requires individuals to complete and simultaneously submit the appeal request (i561 or i501) and disability report (i3441) to file an appeal on an initial disability determination through iAppeals. To ensure individuals understand the requirements for filing a reconsideration or hearing for an initial disability determination through iAppeals, we provide a detailed Terms of Service (TOS) page and ask respondents to acknowledge they read and understood the TOS for using iAppeals to file an appeal. We have alert language throughout iAppeals that explains when an individual did not submit an appeal, and details the requirements for submitting an appeal. We also have a “Submit” tab that identifies the need for an individual to take an action to submit an appeal.

The revisions we made to the i561 (electronic form) require a change. However, these revisions are not relative to the paper form SSA-561-U2. Therefore, we are not incorporating our updates to the i561 to the paper version. In addition, the revisions we made to the paper Form SSA-561-U2 are not relative to the i561; therefore, we are not incorporating our updates to the SSA-561-U2 to the electronic version.

Revisions to the Collection Instrument – i561

• Change #1: We hyphenated the word “re-entry” on the following screens:

  • Getting Ready Screen: What you need to know before you begin

  • Identification Screen

  • Save and Exit Screen

  • Return to a Saved Appeal Screen

  • Forgot or Lost Re-entry Number Screen

Justification #1: We hyphenated the word re-entry to make the spelling of it consistent with how we spell it in our iClaims application and, thereby, more familiar to respondents.

• Change #2: In Number 2 on the Getting Ready Screen: What you need to know before you begin, we added the option to print the checklist and added the following words, “or print,” to identify that option.

Justification #2: We added the option to print the checklist as a convenience to respondents. The ability to print the “Information You Need to Complete Your Disability Appeal” page allows respondents to keep track of the information that they have already gathered or need to gather in order to complete their appeal requests.

• Change #3: In Number 5 on the Getting Ready Screen: What you need to know before you begin, we added a link to the re-entry number that provides additional information about the re-entry number.

Justification #3: We added this link to highlight the importance and purpose of the re‑entry number, in particular, for respondents who do not complete and submit their appeals in a single session.

• Change #4: We added language about the Submit button on the Submit tab - Attach Files screen on the Terms of Service Screen: I Acknowledge, bullet 4.

Justification #4: We added information about the Submit tab because it is a new tab and further alerts respondents of the need to take the action of selecting the Submit button in order to file their appeal requests with us.

• Change #5: We made “Yes” the default answer for the “Would you like us to email you the re-entry number?” question on the Identification Screen.

Justification #5: The re-entry number is of particular importance to respondents who do not complete their appeal request in a single session. If the respondents neglect to print their re-entry numbers, our capturing the email address can ensure they will receive the re-entry numbers to access, complete, and submit their appeal requests to us. Respondents can still opt not to provide their email addresses. However, without the re-entry number, the respondents would have to re-start the appeal process. If the respondents have a Social Security account, they may access it to retrieve the re-entry number to complete and submit the appeal request through iAppeals. A respondent may also create a, “my Social Security,” account to retrieve the re-entry number to complete the appeal request through iAppeals.

• Change #6: On the Save and Exit screen, we added – “Your appeal request has not been submitted and it will not be processed at this time.”

Justification #6: We added this language to ensure the respondents understand that if they exit the application at this point, they have not submitted the appeal request and thereby, we will not process it.

• Change #7: On the Save and Exit screen, we added, “‘Yes’ I want to Exit’ saves the information you have entered for your appeal request and allows you to complete and submit your appeal request later.”

Justification #7: We added this language to ensure the respondents understand they may save the information they already entered for the appeal request, but they will need to return to iAppeals and finish entering the information for the appeal request to submit the request.

• Change #8: We added the Submit tab.

Justification #8: We added the Submit tab to alert respondents that they will need to access it in order to select the Submit button to submit the appeal request.

• Change #9: We re-named the Review screen to Summary Review.

Justification #9: We added the word Summary to alert respondents that the information provided on the screen is a summary of the information they entered for the appeal request and to give them an opportunity to review and, if necessary, edit the information before submitting the appeal request to us.

• Change #10: We moved the alert message to the top of the Summary Review screen and added information about the Submit tab to the alert message.

Justification #10: We moved the alert message to top of the screen to alert respondents at the beginning of the screen, that they have not submitted their appeal request and have time to review and, if necessary, edit the information. Once the respondents complete the review, they will need to select the Submit tab and select the Submit button to submit their appeal request.

• Change #11: We placed the Attach Files screen under the Submit tab.

Justification #11: We placed the attach files screen behind the Submit Tab because the last thing that a respondent does is attach evidence, and submit it along with the appeal request.

• Change #12: We added information about how to submit paper evidence to the Attach Files screen.

Justification #12: We added information about how to submit paper evidence so respondents know they are not limited to submitting electronic evidence only. In addition, the respondents also know they still may gather and submit additional evidence later if they need to do so.

• Change #13: We updated the alert message at bottom Attach Files screen that explains the Submit button and Save and Exit button.

Justification #13: We added the language to alert respondents that we will not process their appeal requests until they select the Submit button and, thereby, submit the appeal to us. We added language that explains to respondents that if they select to Save and Exit, they have not submitted the appeal request to us and the information that they entered will temporarily remain in iAppeals.

Revisions to the Collection Instrument – SSA-561-U2

• Change #1: We corrected the POMS cross-reference for question #2 in the first box of the “TO BE COMPLETED BY SOCIAL SECURITY ADMINISTRATION” section.

Justification #1: We archived the previous POMS section because of a re-write and consolidation of sections.

SSA will implement these changes to the i561 and SSA-561-U2 upon OMB approval.

These actions do not affect the public reporting burden.

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