Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Workers Compensation Public Disability Benefit Questionnaire Modified 2000 500 0 Form SSA-546
Workers' Compensation/Public Disability Benefit Questionnaire Modified 248000 62000 0 Form SSA-546
Other-MCS screens
Total burden requested under this ICR: 250000 62500 0  
To view an IC, click on IC Title