Information Collection

SSA-454-BK, Continuing Disability Review Report - Full Paper Version

IC 9017 under ICR 202506-0960-004 · OMB 0960-0072.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-454-BK SSA-454-BK, Continuing Disability Review Report - Full Paper Version	Form
Form SSA-454-BK Continuing Disability Review Report SSA-454-BK, Continuing Disability Review Report - Full Paper Version	Form
SSA-454-BK Continuing Disability Review Report SSA-454-BK (Revised Version).pdf www.socialsecurity.gov	Form
SSA-454-BK Continuing Disability Review Report SSA-454-BK (Revised Version).pdf www.socialsecurity.gov	Form
SSA-454-BK - Current Version.pdf Currently Approved SSA-454-BK	IC Document
SSA-454-BK - Current Version.pdf Currently Approved SSA-454-BK	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.989 20 CFR 404.1589

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-454-BK			www.socialsecurity.gov	No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 249,194

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	249,194	59,844	189,350
Annual IC Time Burden (Hours)	2,707,908	1,022,693	1,685,215
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Currently Approved SSA-454-BK		01/09/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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