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:
0960-0777
ICR Reference No:
201012-0960-003
Status:
Historical Active
Previous ICR Reference No:
201006-0960-003
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Request for Accommodation in Communication Method
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
02/14/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/24/2010
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2013
09/30/2013
09/30/2013
Responses
2,500
0
2,500
Time Burden (Hours)
438
0
438
Cost Burden (Dollars)
0
0
0
Abstract:
In a recent legal action, American Council of the Blind, et al v. Michael Astrue and Social Security Administration (No. C 05-04696 WHA (N.D. Cal.), the district court ordered SSA to offer two additional modalities(besides the three already available) for sending notices and other communications to blind or visually impaired applicants, beneficiaries, recipients, and representative payees. If members of these groups want to request another communication method besides the five ordered by the court, they will complete Form SSA-9000, the Request for Accommodation in Communication Method. The SSA-9000 asks respondents to describe the type of accommodation they want, to disclose the condition they have that necessitates the need for a different type of accommodation, and to explain why none of the five methods already offered by the agency is sufficient. In this nonsubstantive change request, we are submitting wording changes that we believe will help clarify the application for respondents.
Authorizing Statute(s):
US Code:
29 USC 794
Name of Law: Section 504 of the Rehabilitation 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 30897
06/02/2010
30-day Notice:
Federal Register Citation:
Citation Date:
75 FR 49013
08/12/2010
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Request for Accommodation in Communication Method (Intranet screens/field office interview)
Request for Accommodation in Communication Method (paper form)
SSA-9000
Request for Accommodation in Communication Method
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
2,500
2,500
0
0
0
0
Annual Time Burden (Hours)
438
438
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:
Since OMB approved the emergency clearance for this new ICR in February 2010, we have revised the burden estimate based on actual requests and the method of response used by the public. Where we estimated 20 percent of the respondents would use the paper form, we found, based on actual data, only 10 percent of the respondents are using the paper form. We have adjusted the total burden accordingly to account for the difference in response time between the two collection methods.
Annual Cost to Federal Government:
$188,387
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:
12/24/2010
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