Information Collection

Disability Update Report (Telephone Interview Process)

IC 243650 under ICR 202009-0960-004 · OMB 0960-0511.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0511 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-455 Disability Update Report (Telephone Interview Process)	Form and Instruction
SSA-455 Disability Update Report SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf	Form and Instruction
SSA-455 - Current (Fillable and Submittable for COVID-19 Situation).pdf SSA-455 - Current (Fillable and Submittable for COVID-19 Situation)	IC Document

IC Title:

Disability Update Report (Telephone Interview Process)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.1589-1595 20 CFR 416.988-.996

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-455	Disability Update Report	SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-455 - Current (Fillable and Submittable for COVID-19 Situation)	SSA-455 - Current (Fillable and Submittable for COVID-19 Situation).pdf	09/15/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.