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:
0960-0555
ICR Reference No:
202004-0960-001
Status:
Historical Active
Previous ICR Reference No:
201703-0960-008
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Disability Case Development Information Collections
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:
04/03/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/02/2020
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2020
12/31/2020
12/31/2020
Responses
17,740,000
0
17,730,000
Time Burden (Hours)
4,501,999
0
4,501,166
Cost Burden (Dollars)
0
0
0
Abstract:
State disability determinations services collect the information SSA needs to administer our disability program. For the purposes of this ICR, we divide this information into three categories: 1) consultative examinations (a/b/c); 2) medical evidence of record; and 3) pain/other symptoms/impairment. Respondents are individuals, private sector, and State and local governments. We are submitting a non-substantive Change Request to request a new call script for use for CE video teleconferences specifically for the current COVID-19 emergency.
Authorizing Statute(s):
US Code:
42 USC 1383
Name of Law: Social Security Act
US Code:
42 USC 423
Name of Law: Social Security Act
US Code:
42 USC 421
Name of Law: Social Security Act
US Code:
42 USC 1382c
Name of Law: Social Security Act
US Code:
42 USC 405
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:
82 FR 17494
04/11/2017
30-day Notice:
Federal Register Citation:
Citation Date:
82 FR 29136
06/27/2017
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
9
IC Title
Form No.
Form Name
Category I , CE a) Medical Evidence from CE Providers (Paper Forms; subset of "CE Forms Samples" category)
Category I, CE a) Source Credentialing Information (Subset of "CE Sample Forms")
N/A
Sample CE Forms
Category I, CE a) Medical Evidence from CE Providers (Electronic Transmission through ERE; subset of "CE Forms Samples" category)
Category I, CE b) Claimant/Appointment Letter Information (subset of "CE Forms Samples" category)
Category I, CE c) Claimants re Report to Medical Provider (subset of "CE Forms Samples" category)
Category I, CE d) One-Time CE Claimant Telehealth Call Script (subset of "CE Forms Samples" category)
Category II - MER Paper Submissions (subset of "MER Samples") category
Category II - MER, ERE & Connect Direct transmission of MER forms (subset of "MER Samples" category)
Category III - Pain/Other Symptoms/Impairment Information
Pain Questionnaire
Pain Questionnaire
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
17,740,000
17,730,000
0
10,000
0
0
Annual Time Burden (Hours)
4,501,999
4,501,166
0
833
0
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:
Due to the COVID-19 situation, we cannot schedule our current in person psychiatric and psychological examinations, nor do all of our CE providers have access to HIPAA-compliant video technology for remote exams. To ensure we can still hold necessary examinations for claimants, we are implementing a new call script to allow for the use of non-secure technologies during an emergency period when HHS has relaxed enforcement of the HIPAA privacy rule. We expect to use this call script only once per claimant, as needed, for psychological CE examinations, and only during the COVID-19 emergency. This new call script increases the total public reporting burden for this ICR from 4,501,166 hours to 4,501,999 hours.
Annual Cost to Federal Government:
$574,000,000
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?
Yes
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:
04/02/2020
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