We Need Important Information About Your Eligibility for Social Security Disability Benefits

ICR 202010-3206-010

OMB: 3206-0216

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2020-10-07
Supplementary Document
2020-10-07
Supplementary Document
2020-10-07
Supplementary Document
2020-10-07
Supporting Statement A
2020-10-07
ICR Details
3206-0216 202010-3206-010
Active 201703-3206-013
OPM RI 98-7
We Need Important Information About Your Eligibility for Social Security Disability Benefits
Revision of a currently approved collection   No
Regular
Approved without change 11/23/2020
Retrieve Notice of Action (NOA) 10/16/2020
  Inventory as of this Action Requested Previously Approved
11/30/2023 36 Months From Approved 11/30/2020
4,300 0 4,300
358 0 358
0 0 0

The information provided by the annuitant is used by OPM to verify receipt of SSA disability benefits, make necessary adjustments to the FERS disability benefit, and notify the annuitant of any overpayment payable to OPM. It also notifies the annuitant of the responsibility to notify OPM if SSA benefits begin and the consequences of non-notification. The Privacy Act Statement has been revised due to a review by our Chief Privacy Officer.

US Code: 5 USC Chapter 84, Section 8452 Name of Law: Computation of Disability Annuity
   US Code: 5 USC Chapter 84 Name of Law: Federal Employees Retirement System
  
None

Not associated with rulemaking

  85 FR 16389 03/23/2020
85 FR 48732 08/12/2020
No

  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 4,300 4,300 0 0 0 0
Annual Time Burden (Hours) 358 358 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 -9,568 9,568 0
No
No

$29,200
No
    Yes
    Yes
No
No
No
No
Charles Conyers 202 606-0125 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/16/2020


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