Supporting Statement 0960-0349

Supporting Statement for Form SSA-789

Request for Reconsideration – Disability Cessation

20 CFR 404.909, 404.1597(b), 416.995, & 416.1409

OMB No. 0960-0349

1. Justification

1. Introduction/Authoring Laws and Regulations

Section 205(b) of the Social Security Act (Act) requires SSA to offer a disability hearing at the continuing disability review level of appeal for claimants who received an initial continuing disability review (CDR) cessation, reconsideration pre-hearing cessation determination, or for claimants who appeal an adverse medical reopening EXCEPT in cases of change of onset. The regulatory requirements for implementing Section 205(b) of the Act are set forth in Sections 20 CFR 404.909, 404.1597(b), 416.995, & 416.1409 of the Code of Federal Regulations.

2. Description of Collection

SSA conducts periodic reviews of beneficiaries to confirm that they continue to be disabled to continue qualifying for disability benefits. The primary information collection associated with that process is the Continuing Disability Review (CDR, OMB Control 0960-0072). In addition to CDRs, SSA has the authority to adversely reopen claims, and based on medical factors, revise the determination to a denial, later onset, or closed period determination. When SSA determines through these processes that the claimants’ disabilities ceased, did not exist, or are no longer disabling, the claimant will receive a written notice from SSA regarding the determination and their benefits will be ceased. The notice includes a discussion of the claimant’s appeal rights, including the right to continue benefits during appeal, referred to as statutory benefits continuation (SBC). The notice does not include a copy of the SSA-789, nor does it include a self-addressed envelope to allow potential respondents to mail the SSA-789 back to SSA. Claimants must either independently download a copy of the SSA-789 from ssa.gov, complete the document via the Upload Documents portal, or independently request that SSA send them a copy of the SSA-789.

If the claimant disagrees with the determination to cease benefits, they may request an appeal. A written appeal request is the first step in the reconsideration process. During the reconsideration process, the claimant’s file will be reviewed by an adjudicative team or designated person that was not involved in the determination under appeal, and in most cases a Disability Hearing Officer (DHO) with Disability Determination Services (DDS) will hold an evidentiary hearing where the claimant has an opportunity to review the evidence, introduce new evidence, and present their objections to an unfavorable medical determination before a DHO.

The claimant has 60 days after the date of the cessation notice to request a reconsideration (plus 5 days to account for mailing time). SSA uses Form SSA-789 as the primary means of collecting the information associated with requesting a reconsideration of a CDR or an adverse medical reopening (except in cases for change of onset only). Claimants can submit this request via a mailed submission to the field office, through visiting a field office and physically completing a request on site, or through the web-based option of Upload Documents. SSA only accepts written requests (both electronic and paper) for reconsideration and will not accept phone-based interviews as a means of submitting the request. This is due to a requirement under 20 CFR 404.909(a), which states “[w]e shall reconsider an initial determination if you or any other party to the reconsideration files a written request.”

SSA uses the information collected on Form SSA-789 to arrange for a hearing or to prepare a determination based on the evidence of record. Specifically, claimants or their representatives use Form SSA-789 to: (1) ask SSA to reconsider a determination; (2) indicate if they wish to appear at a disability hearing; (3) submit any additional information or evidence for use in the reconsidered determination (the claimant can also choose to submit this information at a later point in the reconsideration process); and (4) indicate if they will need an interpreter for the hearing. For individuals who indicate that they do not wish to appear at a disability hearing, SSA will follow-up with them to confirm their decision by having them complete and sign an SSA-773 (“Waiver of Right to Appear – Disability Hearing,” OMB Control 0960-0534). SSA does not have data on how much additional information or evidence supporting the claimant’s request for reconsideration is provided via the SSA-789 (as opposed to being provided later in the reconsideration process).

In asking to reconsider a determination, the claimant must explain their reason for submitting the request. SSA encourages claimants to briefly describe why the individual believes he or she is still disabled, or what part of the notice he or she thinks is inaccurate, but to avoid writing, “I am still disabled and cannot work,” as this statement does not provide specific information about the individual’s reason for requesting reconsideration. Additionally, if the claimant is filing the SSA-789 late (i.e. more than 65 days after the date of the original notice ceasing benefits), then this section can also be used to explain the reason for the lateness.

While the SSA-789 requests claimants provide any additional information or evidence available to use in the reconsideration determination, claimants do not need to provide this information as a part of submitting the SSA-789. Evidence to support the reconsideration determination may always be submitted up until the hearing. Additionally, at the claimant’s request, the DHO has the discretion to accept evidence up to 15 days after the hearing if the evidence was not available prior to the hearing and the DHO determines the evidence has bearing on the determination.

Note that the SSA-789 is exclusively for reconsideration appeals for claimants whose benefits have ceased via CDRs or adverse medical reopening’s. For claimants who received denials through the initial benefits application process or unfavorable reopening’s due to a change of onset, the request for reconsideration is made via the SSA-561 or the i561 web application (under the iAppeals web application), both of which are under OMB Control 0960-0622.

We identified the following psychological costs based on the requirements for this information collection:

• Psychological Cost #1:

  • Requirement for the Program: The SSA-789 asks individuals to provide some personal information about themselves so SSA can accurately process the request and apply it to the correct case.

• Psychological Cost: The personal information required to complete the form is minimal and asks for the same information requested at the initial filing request.

• Psychological Cost #2:

  • Requirement for the Program: The SSA-789 asks the individual to supply any new evidence to SSA which may support their need for this benefit.

• Psychological Cost: The respondent might perceive that the agency distrusts them and their claim for benefits. Because of this, some may find the entire process stressful to the point that it may take them longer to complete the form, or they may postpone it, or stop completion of the form entirely.

We understand these psychological costs may cause respondents to delay their completion of the information collection or cause them to abandon the information collection entirely. However, we require full completion of this collection to process the proceed with the reconsideration of their claim. Therefore, we have taken this potential psychological cost into account when calculating our burden in #12 below.

The respondents are disability claimants for Social Security benefits or Supplemental Security Income (SSI) payments who wish to appeal an unfavorable medical cessation determination.

3. Use of Information Technology to Collect the Information

The SSA-789 is available as a fillable PDF on SSA’s website and via the Upload Documents application. The Upload Documents application allows for the electronic submission of the form. If using the fillable PDF, respondents can complete the form electronically, download it, and either send in or bring it to a field office for processing. Paper submissions could be either dropped off at the FO or mailed in, and unfortunately there is no data to breakdown how those paper submissions were submitted. In addition, it is possible that respondents submitted a paper version which was then uploaded to the system by an FO technician using Upload Documents; however, there is no data to capture this. We estimate that approximately 60% of respondents visited the FO to complete the SSA-789, with this number likely decreasing in the coming years due to increased usage of Upload Documents.

4. Why We Cannot Use Duplicate Information

The nature of the information we collect and the way we collect it preclude duplication. SSA does not use another collection instrument to obtain similar data.

5. Minimizing Burden on Small Respondents

This collection does not significantly affect small businesses or other small entities.

6. Consequence of Not Collecting Information or Collecting it Less Frequently

If we did not use Form SSA-789, we would deprive claimants of their due process right to appeal a determination to cease Social Security disability benefits. The information we collect using Form SSA-789 also provides the claimant with the opportunity to state the need for an interpreter at an administrative hearing with a DHO. Because we collect the information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.

7. Special Circumstances

There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.

8. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on February 12, 2025, at

90 FR 9488, and we received 10 public comments. The 30-day FRN published on April 16, 2025, at 90 FR 16050 . If we receive any comments in response to this Notice, we will forward them to OMB. We did not consult with the public in the revision of this form.

9. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.

10. Assurances of Confidentiality

SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.

11. Justification for Sensitive Questions

The information collection does not contain any questions of a sensitive nature.

12. Estimates of Public Reporting Burden

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Total Annual Burden (hours)	Average Theoretical Hourly Cost Amount (dollars)*	Average Wait Time in Field Office (minutes)**	Total Annual Opportunity Cost (dollars)***
SSA-789	72,796	1	10	12,133	$13.30*	23**	$161,369***

* We based this figure on the combined average DI payments based on SSA's current FY 2025 data (https://www.ssa.gov/legislation/2024FactSheet.pdf).

** We based this figure on the average FY 2025 wait times for field offices, based on SSA’s current management information data.

*** This figure does not represent actual costs that we are imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application.

In addition, OMB’s Office of Information and Regulatory Affairs (OIRA) is requiring SSA to use a rough estimate of a 30-minute, one-way, drive time in our calculations of the time burden for this collection. OIRA based their estimation on a spatial analysis of SSA’s current field office locations and the location of the average population centers based on census tract information, which likely represents a 13.97-mile driving distance for one-way travel. We depict this on the chart below:

Total Number of Respondents Who Visit a Field Office	Frequency of Response	Average One-Way Travel Time to a Field Office (minutes)	Estimated Total Travel Time to a Field Office (hours)	Total Annual Opportunity Cost for Travel Time (dollars)****
43,677	1	30	21,839	$290,458.70****

**** We based this dollar amount on the Average Theoretical Hourly Cost Amount in dollars shown on the burden chart above.

Per OIRA, we include this travel time burden estimate under the 5 CFR 1320.8(a)(4), which requires us to provide “time, effort, or financial resources expended by persons [for]…transmitting, or otherwise disclosing the information,” as well as 5 CFR 1320.8(b)(3)(iii) which requires us to estimate “the average burden collection…to the extent practicable.” SSA notes that we do not obtain or maintain any data on travel times to a field office, nor do we have any data which shows that the average respondent drives to a field office, rather than using any other mode of transport. SSA also acknowledges that respondents’ mode of travel and, therefore, travel times vary widely dependent on region, mode of travel, and actual proximity to a field office.

NOTE: We included the total opportunity cost estimate from this chart in our calculations when showing the total time and opportunity cost estimates in the paragraph below.

NOTE: SSA is unable to breakdown the method by which the respondents complete the SSA-789, whether it was completed electronically via the Intranet; through an in-office or telephone appointment; or if it was a paper version submitted to the FO upon completion, which was then scanned into the electronic file or completed through the Upload Documents application. Therefore, unlike the information collection in 2021, we are not able to precisely predict how many respondents physically traveled to the FO.  

We calculated the following Learning Cost time burden based on the estimated time and effort we expect respondents will take to learn about this program, its applicability to their circumstances, and to cover any additional research we believe respondents may need to take to understand how to comply with the program requirements (beyond reading the instructions on the collection instrument):

NOTE: Since respondents learn about these forms in several ways (via SSA, FO, or through our website), we need to come up with a combined learning cost for this information collection. As most of the respondents learn about it through SSA, we will lean toward that as the main way they learn about it.

Total Number of Respondents	Frequency of Response	Estimate Learning Cost (minutes)	Estimated Total Annual Burden (hours)	Total Annual Learning Cost (dollars)**
72,796	1	20	24,265	$322,724.50****

*****We based this dollar amount on the Average Theoretical Hourly Cost Amount in dollars shown on the burden chart above.

NOTE: We included the total opportunity cost estimate from this chart in our calculations when showing the total time and opportunity cost estimates in the paragraph below.

We base our burden estimates on current management information data, which includes data from actual interviews, as well as from years of conducting this information collection. Per our management information data, we believe that 20 minutes accurately shows the average burden per response for learning about the program; receiving notices as needed; reading and understanding instructions; gathering the data and documents needed; answering the questions and completing the information collection instrument; scheduling any necessary appointment or required phone call; consulting with any third parties (as needed); and waiting to speak with SSA employees (as needed). Based on our current management information data, the current burden information we provided is accurate. The total burden for this ICR is 24,265 burden hours (reflecting SSA management information data), which results in an associated theoretical (not actual) opportunity cost financial burden of $322,724.50. SSA does not charge respondents to complete our applications.

13. Annual Cost to the Respondents (Other)

This collection does not impose a known cost burden on the respondents.

14. Annual Cost to Federal Government

The annual cost to the Federal Government is approximately $65,025. This estimate accounts for costs from the following areas:

Description of Cost Factor	Methodology for Estimating Cost	Cost in Dollars*
Designing and Printing the Form	Design Cost + Printing Cost	$2,601
Distributing, Shipping, and Material Costs for the Form	Distribution + Shipping + Material Cost	$0*
SSA Employee (e.g., field office, 800 number, DDS staff) Information Collection and Processing Time	GS-9 employee x # of responses x processing time	$584,734
Full-Time Equivalent Costs	Out of pocket costs + Other expenses for providing this service	$0*
Systems Development, Updating, and Maintenance	GS-9 employee x man hours for development, updating, maintenance	$4,277
Quantifiable IT Costs	Any additional IT costs	$0*
Total		$591,611

* We have inserted a $0 amount for cost factors that do not apply to this collection.

SSA is unable to break down the costs to the Federal government further than we already have.  It is difficult for us to break down the cost for processing a single form, as field office staff often help respondents fill out several forms at once, and the time it takes to do so can vary greatly per respondent.  As well, because so many employees have a hand in each aspect of our forms, we use an estimated average hourly wage, based on the wage of our average field office employee (GS-9, step 1) for these calculations.  However, we have calculated these costs as accurately as possible based on the information we collect for creating, updating, and maintaining these information collections.

15. Program Changes or Adjustments to the Information Collection Request

When we last cleared this IC in 2022, the burden was 10,617 hours. However, we are currently reporting a burden of 24,265 hours. This change stems from an increase in the number of responses from 49,000 to 72,796. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data.

* Note: The total burden reflected in ROCIS is 67,783, while the burden cited in #12 of the Supporting Statement is 12,133. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden + learning costs. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

17. Displaying the OMB Approval Expiration Date

OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.

18. Exceptions to Certification Statement

SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

2. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.