Information Collection

Request for Reconsideration--Disability Cessation

IC 9232 under ICR 202102-0960-003 · OMB 0960-0349.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0349 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-789 Request for Reconsideration--Disability Cessation	Form
Form SSA-789 Request for Reconsideration--Disability Cessation Request for Reconsideration--Disability Cessation	Form
Revised PA & PRA Statements.pdf	Other-Revised PA & PRA Statements
Revised PA & PRA Statements.pdf	Other-Revised PA & PRA Statements
SSA-789 Request for Reconsideration--Disability Cessation SSA-789 - Revised.pdf	Form
SSA-789 Request for Reconsideration--Disability Cessation SSA-789 - Revised Version (Signature Removal).pdf	Form
SSA-789 - Current.pdf SSA-789 - Current	IC Document
SSA-789 - Current.pdf SSA-789 - Current	IC Document

IC Title:

Request for Reconsideration--Disability Cessation

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 404.909 20 CFR 416.1409

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	SSA-789			www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Revised PA & PRA Statements				www.ssa.gov	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: 49,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	49,000	19,000	30,000
Annual IC Time Burden (Hours)	54,717	48,217	6,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-789 - Current		06/23/2021

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

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