Category III - Pain/Other Symptoms/Impairment Information

Disability Case Development Information Collections

OMB: 0960-0555

IC ID: 181780

Information Collection (IC) Details

View Information Collection (IC)

Category III - Pain/Other Symptoms/Impairment Information
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.912 20 CFR 404.1512

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Pain Questionnaire Pain Questionnaire Pain Impairment Questions - Revised.pdf No   Paper Only

Income Security General Retirement and Disability

 

2,100,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,100,000 0 0 0 0 2,100,000
Annual IC Time Burden (Hours) 700,000 0 0 0 0 700,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Pain Impairment Questions - Current Pain Impairment Questions - Current.pdf 06/13/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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