Statement for Determining Continuing Eligibility

Forms and Documents

Document Name	Status
Form SSA-8202 Statement for Determining Continuing Eligibility - Paper Form SSA-8202-BK Form	Modified
Addendum - 0145.docx Supplementary Document	2019-04-02
Supporting Statement - 0145.docx Supporting Statement A	2019-04-02

IC Document Collections

IC ID	Document Title	Status
45420	Statement for Determining Continuing Eligibility - SSI Claims System Other-SSI Claims System - Intranet Screens	Modified
45419	Statement for Determining Continuing Eligibility - Paper Form SSA-8202-BK Form	Modified

ICR Details

OMB Control No: 0960-0145	ICR Reference No: 201903-0960-003
Status: Active	Previous ICR Reference No: 201807-0960-013
Agency/Subagency: SSA	Agency Tracking No:
Title: Statement for Determining Continuing Eligibility
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/01/2019
	Date Received in OIRA: 04/02/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	36 Months From Approved	06/30/2019
Responses	2,031,787	0	2,299,906
Time Burden (Hours)	677,428	0	766,807
Cost Burden (Dollars)	0	0	0

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Abstract: SSA uses Form SSA-8202-BK to conduct low and middle-error profile (LEP/MEP) telephone, or face-to-face redetermination interviews with SSI recipients and representative payees, if applicable. SSA conducts LEP redeterminations interviews on a 6-year cycle, and MEP redeterminations annually. SSA requires the information we collect during the interview to determine whether: (1) SSI recipients met, and continue to meet, all statutory and regulatory requirements for SSI eligibility; and (2) the SSI recipients received, and are still receiving, the correct payment amounts. This information includes non-medical eligibility factors such as income, resources, and living arrangements. To complete Form SSA-8202-BK, the respondents may need to obtain information from employers or financial institutions. The respondents are SSI recipients and their representatives, if applicable.

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Authorizing Statute(s): US Code: 42 USC 1382 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 371	01/25/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 11625	03/27/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Statement for Determining Continuing Eligibility - SSI Claims System
Statement for Determining Continuing Eligibility - Paper Form SSA-8202-BK	SSA-8202	Statement for Determining Continuing Eligibility Supplemental Security Income Payment

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ICR Summary 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	2,031,787	2,299,906	0	0	-268,119	0
Annual Time Burden (Hours)	677,428	766,807	0	0	-89,379	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The decrease in burden hours from 766,807 to 677,428 hours is due to obtaining actual, updated Management Information provided for the respondents who completed the information collection via Form SSA-8202. In addition, the total volume of SSI recipients and SSI claims both reduced since the last renewal, causing an overall decrease in burden hours.

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Annual Cost to Federal Government: $19,321,048

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

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Common Form ICR:  No

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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: 04/02/2019

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