0960-0444 - SSA-8001 Internet Claim Systems (iSSI) - First Party

First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #1
Applicants who entered the internet disability application and indicated they want to file for SSI
will receive the following questions as part of their path.

We ask applicants to let us know if they are students to evaluate if some of the income reported
can be excluded (when applicable). We only collect their “yes” or “no” response.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #2
We are requesting the lawful presence information as we are expanding the online services to
non-US citizen claimants. This information is part of the SSI eligibility requirements.

This information is propagated
from the response they provided
on the Identification screen.

We added this question
for Operational purposes
as a short-term solution
until backend systems’
modifications are
completed

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First-Party Internet Claim (iClaim) Screens for SSI Application

Screen #3

Their address is propagated from
the contact information they
entered in the identification
section

We added this question to determine their living arrangement as it is part of the SSI eligibility
factors which technicians can review, and process as needed e.g., send claim for medical
determination, or seek further clarification when applicable.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #4

We added this informational page to explain what is considered income and provide guidance to
individuals about what information may be needed.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #5

The month of filing is
propagated so applicants
can provide information
only one month

We leverage the disability application
responses about employment, collected in the
“General” section, by populating all
employers associated with the month in
question.

Screen #6
We added questions
about wages and sick
page to determine if
they meet the basic
eligibility requirements
for SSI.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen # 7

This screen is a continuation of the income resources information to determine basic eligibility
requirements for SSI.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen# 8

We added this informational page to explain what is considered resources and provide guidance
to individuals about what information may be needed.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #9
We added questions on screens #9 and #10 about resources to determine if the individual meets
the basic eligibility requirements for SSI.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #10

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #11
We added language to the “Review Information” page which will display the answers to the SSI
questions*. The language informs applicants that the information will be used for both
applications (DIB and SSI). Under the same page, we also updated the section about electronic
signatures to provide relevant information about the signature for the SSI application.

* Please note this is just an example, the length of the summary depends on the number of
questions applicants answer depending on their unique situation (e.g., married or not, number of
employers, etc.,)

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #11 Continuation

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #11 Continuation

We updated the “Electronic Signature Agreement” section to include language about the SSI application

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #12

We moved the OMB
No. 0960-0444 from
this page to the
Welcome Page.

We removed the question “Is
everyone in your household
receiving or applying for
Supplemental Security
Income?”

We updated the information about
SNAP to provide one message that
applies to all SSI applicants.

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First-Party Internet Claim (iClaim) Screens for SSI Application
Screen #13

We updated this message to eliminate language
regarding the number of attempts that can be made
before an error stops the online process and
requires contact with SSA.

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