Information Collection

Disability Update Report (Submittable online process)

IC 258863 under ICR 202603-0960-001 · OMB 0960-0511.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-455 Disability Update Report Disability Update Report (Submittable online process)	Form and Instruction
SSA-455 Privacy Act Statement (revised).docx	Other-SSA-455 Privacy Act Statement
SSA-455 Disability Update Report SSA-455 (revised).pdf www.ssa.gov	Form and Instruction
SSA-455 (current).pdf SSA-455 (current)	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 404.1589-404.1595 20 CFR 416.988-416.996

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 and Instruction	SSA-455			www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-SSA-455 Privacy Act Statement (revised)					No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 89,104

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	89,104	44,104	45,000
Annual IC Time Burden (Hours)	22,276	11,026	11,250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA-455 (current)		03/23/2026

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

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