OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Request to Withdraw a Hearing Request; Request to Withdraw an Appeals Council Request for Review; and Administrative Review Process for Adjudicating Initial Disability Claims

OMB 0960-0710 · SSA.

OMB 0960-0710

Claimants have a statutory right under the Act and current regulations to apply for Social Security DIB or SSI payments. SSA must collect information from each step of the administrative review process to adjudicate claims fairly and efficiently. SSA collects this information to establish a claimant’s right to administrative review, and the severity of the claimant’s alleged impairments. SSA uses the information to determine entitlement or continuing eligibility to DIB or SSI payments, and to enable appeals of these determinations. The respondents are applicants for Title II DIB or Title XVI SSI benefits; their appointed representatives; legal advocates; medical sources; and schools.

The latest form for Request to Withdraw a Hearing Request; Request to Withdraw an Appeals Council Request for Review; and Administrative Review Process for Adjudicating Initial Disability Claims expires 2027-11-30 and is listed under ICR 202206-0960-008.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form e86 (Submittable P Request to Withdraw an Appeals Council Request for ReviewForm and Instruction
Form e85 (Submittable P Request to Withdraw a Hearing RequestForm and Instruction
Form HA-86 Request to Withdraw an Appeals Council Request for ReviewForm
Form HA-85 Request to Withdraw a Hearing RequestForm
Form HA-85 20 CFR 404.971 and 416.1471 (HA-85, Request to Withdraw a Hearing Request; HA-86, Request to Withdraw an Appeals Council Request for Review)Form
Addendum - 0710 (Final).docx Supplementary Document
Supporting Statement - 0710 (Final).docxSupporting Statement A
20 CFR 404.961, 416.1461, 405.330, 405.366 Information collection
20 CFR 404.1512, 404.1740(c)(4), 416.912, and 416.1540(c)(4) Information collection
20 CFR 1540(b)(1) Information collection
20 CFR 404.1740(b)(1) Information collection
20 CFR 404.971 and 416.1471 (HA-85, Request to Withdraw a Hearing Request; HA-86, Request to Withdraw an Appeals Council Request for Review) Form and Instruction
20 CFR 404.971 and 416.1471 (HA-85, Request to Withdraw a Hearing Request; HA-86, Request to Withdraw an Appeals Council Request for Review) Form and Instruction
20 CFR 404.971 and 416.1471 (HA-85, Request to Withdraw a Hearing Request; HA-86, Request to Withdraw an Appeals Council Request for Review) Form
20 CFR 404.971 and 416.1471 (HA-85, Request to Withdraw a Hearing Request; HA-86, Request to Withdraw an Appeals Council Request for Review) Form
20 CFR 404.971 and 416.1471 (HA-85, Request to Withdraw a Hearing Request; HA-86, Request to Withdraw an Appeals Council Request for Review) Form
20 CFR 405.20 Information collection
20 CFR 405.1(c)(2) Information collection
20 CFR 405.505 Information collection
20 CFR 405.1(b)(5) and 405.372(b) Information collection
20 CFR 405.372(c) Information collection
20 CFR 405.401 Information collection
20 CFR 404.987 & 404.988, 416.1487 & 4161488, and 405.601 Information collection
20 CFR 404.982 & 416.1482 Information collection
20 CFR 405.381 Information collection
20 CFR 404.957, 416.1457, 405.380 Information collection
20 CFR 405.334 Information collection
20 CFR 404.949 and 416.1449 Information collection
20 CFR 404.950, 416.1450, 405.332 Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202206-0960-008 Revision of a currently approved collection 2022-10-19
202108-0960-009 No material or nonsubstantive change to a currently approved collection 2021-08-20 Approved without change
202108-0960-005 No material or nonsubstantive change to a currently approved collection 2021-08-10 Approved without change
202106-0960-002 No material or nonsubstantive change to a currently approved collection 2021-06-17 Approved without change
202011-0960-009 No material or nonsubstantive change to a currently approved collection 2020-11-17 Approved without change
201905-0960-009 Revision of a currently approved collection 2019-09-27 Approved without change
201611-0960-003 No material or nonsubstantive change to a currently approved collection 2016-11-23 Approved without change
201606-0960-005 Revision of a currently approved collection 2016-09-19 Approved without change
201304-0960-007 Revision of a currently approved collection 2013-08-07 Approved without change
201101-0960-007 Revision of a currently approved collection 2011-05-03 Approved without change
200812-0960-009 Revision of a currently approved collection 2009-03-19 Approved without change
200602-0960-005 New collection (Request for a new OMB Control Number) 2006-02-07 Approved without change

OMB Details

20 CFR 404.961, 416.1461, 405.330, 405.366

Federal Enterprise Architecture: Income Security - General Retirement and Disability