Disability Perception Survey (DPS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0960-NEW- Supporting Statements Part B for Disability Perception Survey (DPS) (final).docx	Supporting Statement B	Uploaded 2022-06-03	Repair queued
0960-NEW -Supporting Statement Part A for Disability Perception Survey (DPS) (final).docx	Supporting Statement A	Uploaded 2022-06-03	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
251928	Disability Perception Survey (DPS) - Web version	Other-DPS Survey	New
251927	Disability Perception Survey (DPS) - Phone Version	Other-Telephone Inviewer FAQ	New

ICR Details

OMB Control No:	ICR Reference No: 202203-0960-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Disability Perception Survey (DPS)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/03/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	5,011	0
Time Burden (Hours)	1,420	0
Cost Burden (Dollars)	0	0

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Abstract: The Social Security Administration’s (SSA’s) Social Security Disability Insurance (SSDI) program provides crucial financial support to individuals unable to work due to a medical condition. Having access to and understanding information about SSDI among working adults is an important factor in connecting people with benefits. The purpose of the survey to is understand information working adults currently have about the SSDI program to improve projections of disability applications and incidence. SSA is requesting clearance to administer the Disability Perception Survey (DPS) to a sample of working age adult SSDI program recipients, and those who qualify for this benefit, to capture attitudes and perceptions about SSDI among working-age adults in the general population, and to determine what roles those factors ultimately play in an individual’s decision to apply to the program. The DPS evaluation will consist of two parts: (1) the DPS survey administered to working-age adults (18 to 64 years of age) who are either SSDI recipients or those who qualify for SSDI; and (2) links of the survey data, including the individuals’ social security numbers, to individuals’ administrative records for research purpose. SSA will use the data the DPS collects to learn about the average American SSDI adult recipient’s knowledge and understanding of the SSDI program and about who qualifies for these benefits. SSA contracted with NORC at the University of Chicago to conduct the DPS data collection. The respondents are working adults (age 18-64) SSDI program recipients, and those who may qualify for SSDI benefits for SSDI benefits.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 18453	03/10/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 33282	06/01/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Disability Perception Survey (DPS) - Phone Version
Disability Perception Survey (DPS) - Web version

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	5,011	0	0	5,011	0	0
Annual Time Burden (Hours)	1,420	0	0	1,420	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection that increases the public reporting burden. See the chart above for burden figures.

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Annual Cost to Federal Government: $1,146,500

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/03/2022

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