Application for Widow's or Widower's Insurance Benefits
Revision of a currently approved collection
No
Regular
Approved without change
06/23/2023
06/01/2022
Prior to tri-annual renewal of this information collection request, the agency will substantially expand the description and justification for this information collection in the Supporting Statement A. Consistent with M-22-10, this expanded discussion (in Question Prompt #2) should address the following aspects of the collection:
(1) Provide a discussion about the common pathways a widow or widower would learn about how to apply for benefits (e.g. being informed by the funeral home, being informed through direct outreach from SSA, such as a notice, or independently researching the matter);
(2) Explain the common circumstances in which the agency requires documentation from the respondent (or whether it is source from other entities) regarding proof of death, proof of marriage, proof of income of the deceased or respondent, and any other common documentation requirements;
(3) Explain if there are any circumstances in which the agency proactively contacts a known spouse or survivor after receiving indication from the funeral home or state vital services that the number holder had deceased;
(4) Explain in additional detail whether or not, during an interview application, the agency is able to use information already on file about the deceased to support or facilitate the respondentâs answers to questions 7 and 8 (regarding the deceasedâs income); question 10 (regarding the deceasedâs former marriages); and questions 21 and 22 (regarding the surviving spouseâs recent income);
(5) Provide any relevant management information that can demonstrate the amount of SSA-10s that are successfully filed and adjudicated in a single touchpoint (i.e. the phone call in which the application interview is conducted) vs. SSA-10s that require multiple touchpoints, such as through the need to provision additional evidence or because the respondent lacks sufficient information during the initial interview with SSA;
(6) Provide management information on the number of SSA-10s that are denied each year.
No later than 18 months after approval of this information collection, the agency will update the âSurviving Spouseâ page of SSAâs website to:
(1) For each âsubsection,â make more prominent the specific methods for âtaking actionâ (e.g. filing a claim) through ensuring better placement at the top of the section and improved visual presentation of phone numbers or the use of buttons to link prospective respondents to the necessary modality for completing the information collection.
(2) To update the language of âFor example, if the person died in July, you must return the benefits paid in Augustâ to more clearly explain that benefits paid in August would be from the payment owed the number holder for July (e.g. by adding a parenthetical to the end of the sentence with verbiage like â(because the benefit they receive in August is for the month of July)â.
(3) Make any necessary changes to improve greater consistency between the use of âSurviving spouseâ vs. âWidow/Widowerâ among the form and any information materials, if appropriate.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
06/30/2026
36 Months From Approved
06/30/2023
572,656
0
521,039
286,328
0
121,614
0
0
0
SSA needs information to make a formal determination for entitlement to widowâs or widowerâs benefits. We use Form SSA-10-BK to determine whether an applicant meets the statutory and regulatory conditions for entitlement to widowâs or widowerâs under the Old Age, Survivors, and Disability Insurance (OASDI) program. SSA employees interview individuals applying for benefits either face to-face or via telephone and enter the information into the Modernized Claims System (MCS). When MCS is temporary unavailable, technicians use the paper form to record the information. The respondents are applicants for widowâs or widowerâs benefits.
US Code:
42 USC 402
Name of Law: Social Security Act
When we last cleared this IC in 2019, the burden was 121,614 hours. However, we are currently reporting a burden of 286,328 hours. This change stems from an increase in the number of responses from 521,039 to 572,656. In addition, we updated the completion time from 14 & 15 to 30 minutes. We made the correction to the average burden per response per our current management information data. We believe that 30 minutes is a better estimate for respondents to gather information, read the instructions, and to complete the form.
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.
Form SSA-10 Application for Social Security Benefits
Supporting Statement - 0004 (Final).docx
Application for Widow's or Widower's Insurance Benefits - Paper Version