Addendum - 0579

Addendum - 0579 (Final).docx

Disability Report - Adult

Addendum - 0579

OMB: 0960-0579

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Addendum to the Supporting Statement for Form SSA-3368

Disability Report – Adult

20 CFR 404.1512 and 416.912

OMB No. 0960-0579


Minor Revisions to Form SSA-3368-BK


SSA is making the following revisions:


  • Change 1: We are revising the dollar amount in sections 4.E and 4.G to $1,310.


Justification 1: We made this change to reflect the 2021 Non-Blind Disabled Substantial Gainful Activity (SGA) amount as contained within 20 CFR 404.1571 through 404.1576 and 416.971 through 416.976.


  • Change #2: We are revising the PRA statement on this form.


Justification #2: We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.


  • Change #3: We are revising the Privacy Act Statement on this form.


Justification #3: SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on this form.



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