Work Incentives Planning and Assistance (WIPA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-4566 WIPA CASE NOTES	Form	Unchanged	Available
Form SSA-4565 WIPA Intake Information	Form	Unchanged	Available
Form SSA-4565 Help Line Work Incentives Planning and Assistance (WIPA) Referral and WIPA Intake (SSA-4565)	Form	Unchanged	Available
Form SSA-4565 Wipa Case Notes	Form	Unchanged	Available
Supporting Statement 0960-0629 (Final).docx	Supporting Statement A	Uploaded 2022-06-02	Available
Justification for Non-Substantive Changes - 0960-0629.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-04-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
253857	WIPA STAR System	Other-WIPA Star Screens	Modified
238019	Work Incentives Planning and Assistance Program (WIPA)-- SSI & SSI Beneficiaries (SSA-4565)	Form	Unchanged	WIPA CASE NOTES
238019	Work Incentives Planning and Assistance Program (WIPA)-- SSI & SSI Beneficiaries (SSA-4565)	Form	Unchanged	WIPA Intake Information
178887	WIPA Case Notes (SSA-4566)	Form	Unchanged	Help Line Work Incentives Planning and Assistance (WIPA) Referral and WIPA Intake (SSA-4565)
178887	WIPA Case Notes (SSA-4566)	Form	Unchanged	Wipa Case Notes

ICR Details

OMB Control No: 0960-0629	ICR Reference No: 202604-0960-007
Status: Received in OIRA	Previous ICR Reference No: 202203-0960-011
Agency/Subagency: SSA	Agency Tracking No:
Title: Work Incentives Planning and Assistance (WIPA)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/22/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	10/31/2026	10/31/2026
Responses	1,698,080	1,698,080
Time Burden (Hours)	472,573	472,573
Cost Burden (Dollars)	0	0

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Abstract: As part of SSA’s strategy to assist SSDI) beneficiaries and SSI recipients who wish to return to work and achieve self-sufficiency, SSA established the Work Incentives Planning and Assistance (WIPA) program. This community based, work incentive, planning and assistance project collects identifying claimant information via project sites and community work incentives coordinators (CWIC). SSA uses this information to ensure proper management of the project, with particular emphasis on administration, budgeting, and training. In addition, project sites and CWIC’s collect data from SSDI beneficiaries and SSI recipients on background employment, training, benefits, and work incentives. SSA is interested in identifying SSDI beneficiary and SSI recipient outcomes under the WIPA program, to determine the extent to which beneficiaries with disabilities and SSI recipients achieve their employment, financial, and healthcare goals. SSA will also use the data in its analysis and future planning for SSDI and SSI programs. Respondents are SSDI beneficiaries, SSI recipients, community project sites, and employment advisors. We are making a non-substantive change request to the WIPA Case notes to enhance task tracking for users and to strengthen the oversight and management capabilities for WIPA.

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Authorizing Statute(s): US Code: 42 USC 1320b-20 Name of Law: Social Security Act
  

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 13783	03/10/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 31598	05/24/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
WIPA Case Notes (SSA-4566)	SSA-4565, SSA-4565	Wipa Case Notes ,   Help Line Work Incentives Planning and Assistance (WIPA) Referral and WIPA Intake (SSA-4565)
WIPA STAR System
Work Incentives Planning and Assistance Program (WIPA)-- SSI & SSI Beneficiaries (SSA-4565)	SSA-4566, SSA-4565	WIPA Intake Information ,   WIPA CASE NOTES

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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	1,698,080	1,698,080	0	0	0	0
Annual Time Burden (Hours)	472,573	472,573	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: When we last cleared this IC in 2020, the burden was 25,000 hours. However, we are currently reporting a burden of 472,573 hours. This change stems from an increase in the number of responses from 90,000 to 330,80 from adding the WIPA Star System. The new WIPA Star System is a new data system that increases the public reporting burden. See question #12 for burden estimates. 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.

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Annual Cost to Federal Government: $23,003,420

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.     Yes

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.     Yes

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: 07/22/2026

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