View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0960-0189
ICR Reference No:
201011-0960-005
Status:
Historical Active
Previous ICR Reference No:
201005-0960-004
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Quality Review Case Analysis: Sample Number Holder; Auxiliaries/Survivors; Parent; Stewardship Annual Earnings Test Workbook
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
06/08/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/24/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2014
36 Months From Approved
06/30/2011
Responses
18,424
0
13,499
Time Burden (Hours)
2,619
0
2,268
Cost Burden (Dollars)
0
0
0
Abstract:
SSA collects information on Forms SSA-2930, SSA-2931, and SSA-2932 to establish a national payment accuracy rate for all cases in payment status, and to serve as a source of information regarding problem areas in the Retirement and Survivors Insurance (RSI) and Disability Insurance (DI) programs. SSA also uses the information to measure the accuracy rate for newly adjudicated RSI/DI cases. SSA collects information on Form SSA-4659 to evaluate and determine the effectiveness of the annual earnings test, and uses the results in developing ongoing improvements in the process. SSA sends each beneficiary an appointment letter for the interview. About 25 percent of respondents will have face-to-face contact reviews and receive one of the following letters for an appointment: SSA-L8550-U3 (Appointment Letter- Sample Individual), SSA-L8551-U3 (Appointment Letter- Sample Family), or the SSA-L8552-U3 (Appointment Letter-Rep Payee). The other 75 percent of respondents will receive a notice for a telephone contact review: either the SSA-L8553-U3 (Beneficiary Telephone Contact), or the SSA-L8554-U3 (Rep Payee Telephone Contact) notice. To help the beneficiary prepare for the interview, we include three forms with each notice: 1) SSA-85 (Information Needed to Review Your Social Security Claim) that lists the information the respondents will need to gather to prepare for the interview. 2) SSA-2935 (Authorization to the Social Security Administration to Obtain Personal Information) so SSA can obtain information to verify the correctness of the payment to the beneficiary. 3) SSA-8552 (Interview Confirmation) to confirm or reschedule the interview if necessary. The respondents are a statistically valid sample of all RSI/DI beneficiaries in current pay status or their representative payees. The respondents are a statistically valid sample of all RSI/DI beneficiaries in current pay status or their representative payees.
Authorizing Statute(s):
US Code:
42 USC 1382c
Name of Law: Social Security Act
US Code:
42 USC 1395o
Name of Law: Social Security Act
US Code:
42 USC 405
Name of Law: Social Security Act
US Code:
42 USC 428
Name of Law: Social Security Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 80563
12/22/2010
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 14441
03/16/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
15
IC Title
Form No.
Form Name
SSA-2930
SSA-2930(revised)
RSI/DI Quality Review Case Analysis - Sampled Number Holder
SSA-2931
SSA-2931(revised)
RSI/DI Quality Review Case Analysis - Auxiliaries/Survivors
SSA-2932
SSA-2932 (revised)
RSI/DI Quality Review Case Analysis ? Parent
SSA-2935
SSA-2935
Authorization to the Social Security Administration to Obtain Personal Informaition
SSA-4659
SSA-4659
Stewardship Annual Earnings Test Workbook
SSA-820 and SSA-821
SSA-820-F4, SSA-821-BK
Work Activity Report (Self-Employed Person)
,
Work Activity Report-Employee
SSA-85
SSA-85
Information Needed to Review Your Social Security Claim
SSA-8510
SSA-8510
Authorization For The Social Security Administration To Obtain Personal Information
SSA-8552
SSA-8552
Interview Confirmation
SSA-L8550-U3
SSA-L8551-U3
SSA-L8552-U3
SSA-L8553-U3
SSA-L8554-U3
iClaim Stewardship Questions
ICR Summary of Burden
Total Approved
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
18,424
13,499
0
1,220
3,705
0
Annual Time Burden (Hours)
2,619
2,268
0
169
182
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
There is an increase in burden for this ICR, because we have begun using other forms as part of our quality reviews. Although these we clear these forms under separate OMB numbers, the burden we report here is only for their use in this ICR. The burden chart in question #12 indicates these forms and their OMB numbers.
Annual Cost to Federal Government:
$3,317
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
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?
Uncollected
Agency Contact:
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov
Common Form ICR:
No
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:
03/24/2011
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