View Information Collection Request (ICR) Package

OMB Control No: 0960-0777	ICR Reference No: 201906-0960-007
Status: Historical Active	Previous ICR Reference No: 201607-0960-009
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Accommodation in Communication Method
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: 12/03/2019
	Date Received in OIRA: 09/20/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2022	36 Months From Approved	12/31/2019
Responses	5,000	0	5,000
Time Burden (Hours)	1,667	0	1,667
Cost Burden (Dollars)	0	0	0

Abstract: SSA supplies a designated telephone number allowing Social Security applicants, beneficiaries, recipients, and representative payees who are blind or visually-impaired to tell SSA which of the following seven methods of communication they want SSA to use when it sends them benefit notices and other related communications: (1) standard print notice by first class mail, (2) standard print mail with a follow-up telephone call, (3) certified mail, (4) Braille, (5) Microsoft Word file on data compact disk (CD), (6) large print (18-point font) or (7) audio CD. However, respondents who want to receive notices from SSA through a communication method other than the seven methods listed above use Form SSA-9000 to: (1) describe the type of accommodation they want, (2) disclose their condition necessitating the need for a different type of accommodation, and (3) explain why none of the seven methods described above are sufficient for their needs. SSA uses Form SSA-9000 to determine, based on applicable law and regulation, whether to grant an individual's request for an accommodation based on their blindness, other visual impairment, and as applicable, another disabling condition. SSA collects this information electronically through either an in-person interview or a telephone interview during which the SSA employee keys in the information on Intranet screens. The respondents are Social Security applicants, beneficiaries, recipients, and representative payees who are blind or visually impaired and who ask SSA to send notices and other communications in an alternative method besides the seven modalities we described above.

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:
	84 FR 31972	07/03/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 48694	09/16/2019
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Request for Accommodation in Communication Method	SSA-9000-F6

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	5,000	5,000
Annual Time Burden (Hours)	1,667	1,667
Annual Cost Burden (Dollars)	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:

Annual Cost to Federal Government: $60,000

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? Uncollected

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

View ICR - OIRA Conclusion