View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0960-0618
ICR Reference No:
202005-0960-001
Status:
Historical Active
Previous ICR Reference No:
201902-0960-011
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Social Security Benefits Application
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 with change
Conclusion Date:
05/11/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/07/2020
Terms of Clearance:
Within two weeks of approval of this change request, the agency will brief OMB on the technical operation of the new electronic collection. OMB affirms that potential future revisions to this collection that reduce the available modalities for responding to the collection will be treated as substantive and require appropriate Federal Register notice.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2021
04/30/2021
04/30/2021
Responses
7,113,513
0
7,103,513
Time Burden (Hours)
1,581,027
0
1,576,027
Cost Burden (Dollars)
0
0
0
Abstract:
Title II of the Social Security Act provides retirement, survivors, and disability benefits to members of the public who meet the required eligibility criteria and file the appropriate application. This collection comprises the various application methods for the retirement, survivors, and disability benefits. These methods include the following modalities: paper forms (Forms SSA–1, SSA–2, and SSA–16), Modernized Claims System (MCS) screens for in-person interview applications, as well as the Internet-based iClaim and iAppointment applications allowing the public to apply electronically. SSA uses the information collected using these modalities to determine: (1) the applicants' eligibility for the above-mentioned Social Security benefits, and (2) the amount of the benefits. The respondents are applicants for retirement, survivors, and disability benefits under Title II of the Act, their representatives, and in some instances, applicants for SSI payments or their representatives who are requesting to file for SSI through iClaim. This is a non-substantive Change Request to include the new Medicare Part B Online screens for use during a COVID-related special enrollment period for Medicare Part B.
Authorizing Statute(s):
US Code:
42 USC 426
Name of Law: Social Security Act
US Code:
42 USC 1395j
Name of Law: Social Security Act
US Code:
42 USC 1395o
Name of Law: Social Security Act
US Code:
42 USC 402
Name of Law: Social Security Act
US Code:
42 USC 423
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 22175
05/12/2017
30-day Notice:
Federal Register Citation:
Citation Date:
82 FR 35022
07/27/2017
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
1st Party Internet Social Security Benefits Application (iClaim) - Domestic Applicants
1st Party Internet Social Security Benefits Application (iClaim) - Foreign Applicants
3rd Party iClaim
Medicare Part B Online Application - COVID-related
Medicare-only MCS SSA-1 screens
Medicare-only Paper Form SSA-1
SSA-1
Application for Retirement Insurance Benefits
Medicare-only iClaim
Paper Form SSA-1 (Application for Retirement Insurance Benefits)
SSA-1
Application for Retirement Insurance Benefits
Paper Form SSA-16 (Application for Disability Insurance Benefits )
SSA-16
Application for Disability Insurance Benefits
Paper Form SSA-2 (Application for Wife's or Husband's Insurance Benefits)
SSA-2
Application for Wife's or Husband's Insurance Benefits
SSA-1 MCS Signature Proxy
SSA-16 MCS Signature Proxy
SSA-2 MCS Signature Proxy
iAppointment
iClaim Applicant After 3rd Party Completion
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
7,113,513
7,103,513
0
10,000
0
0
Annual Time Burden (Hours)
1,581,027
1,576,027
0
5,000
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:
We are including the new, temporary, Medicare Part B Online screens under 0960-0618 for CMS to use during a COVID-related special enrollment period. Once we obtain approval for these screens, we will transfer them back to CMS. Therefore, there is a temporary increase in burden of 5,000 hours, but that increase will last only for as long as necessary.
Annual Cost to Federal Government:
$66,625,863
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:
05/07/2020
An official website of the United States government
The .gov means it's official.
The site is secure.
