Disability Report--Appeal (EDCS) - Individual Respondents

Disability Report-Appeal

Documents and Forms

Document Name Document Type
SSA-3441 EDCS Screenshots.pdf Other-Internal Screens

Information Collection (IC) Details

IC Title:	Disability Report--Appeal (EDCS) - Individual Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.916(c) 20 CFR 416.912 20 CFR 422.140 20 CFR 405 20 CFR 404.1512 20 CFR 416.1416(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internal Screens			SSA-3441 EDCS Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 208,831	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	208,831	-267,940	476,771
Annual IC Time Burden (Hours)	156,623	-200,955	357,578
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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