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OMB Control No: 0960-0671	ICR Reference No: 202404-0960-001
Status: Historical Inactive	Previous ICR Reference No: 202304-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: Acknowledgement of Receipt (Notice of Hearing)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 09/30/2024
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 10/16/2024
	Date Received in OIRA: 08/26/2024
Terms of Clearance: Withdrawn at SSA's request to correct submission.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2026	6 Months From Approved	01/31/2026
Responses	3,827,490	0	3,827,490
Time Burden (Hours)	1,186,999	0	1,186,999
Cost Burden (Dollars)	0	0	0

Abstract: SSA uses the information we obtain on Forms HA-55, HA-504, HA 504 OP1, HA-510, and HA-510-OP1 to manage the means by which we conduct hearings before an administrative law judge (judge) or administrative appeals judges (judge), and the scheduling of hearings with an judge. We use the HA-55, Objection to Appearing by Video Teleconferencing, and its accompanying cover letter, HA-L2, to allow claimants to opt-out of an appearance via video teleconferencing (VTC) for their hearing with a judge. The HA-L2 explains the good cause stipulation for opting out of VTC if the claimant misses the window to submit the HA-55, and for verifying a new residence address if the claimant moved since submitting their initial hearing request. SSA uses the HA-504 and HA-504-OP1, Acknowledgement of Receipt (Notice of Hearing), and accompanying cover letter, HA-L83, to: (1) acknowledge the claimants will appear for their hearing with a judge; (2) establish the time and place of the hearing; and (3) remind claimants to gather evidence in support of their claims. The only difference between the two versions of the HA-504 is the language used for the selection check boxes as determined by the type of appearance for the hearing (in person, phone teleconference, or VTC). In addition, the cover letter, HA-L83, explains: (1) the claimants’ need to notify SSA of their wish to object to the time and place set for the hearing; (2) the good cause stipulation for missing the deadline for objecting to the time and place of the hearing; and (3) how the claimants can submit, in writing, any additional evidence they would like the judge to consider, or any objections they have on their claims. The HA-510 and HA-510-OP1, Waiver of Written Notice of Hearing, allow the claimants to waive their right to receive the Notice of Hearing as specified in the HA-L83. We typically use these forms when there is a last minute available opening on an judge’s schedule, so the claimants can fill in the available time slot. If the claimants agree to fill the time slot, we ask them to waive their right to receive the Notice of Hearing. We use the HA-510-OP1 at the beginning of our process for representatives and claimants who wish to waive the 20 day (for amended or continued hearing notices) or 75 day (for all other hearing notices) requirement earlier in the process, and the HA-510 later in the process for those representatives and claimants who want the full 20 or 75 days before the scheduled hearing. The respondents are applicants for Social Security disability payments who request a hearing to appeal an unfavorable entitlement or eligibility determination or their representative payees. We are revising this Information Collection due to our Final Rule for Setting the Manner of Appearance of Parties and Witnesses at Hearings, RIN 0960-AI71.

Emergency Justfication: We published the Final Rule associated with this ICR. The effective date of the Final Rule is November 23, 2024; however, the system would not allow us to submit this as a regular revision, as it is associated with a final rule (and we did not submit the ICR documents at the NPRM stage, since, at that point, we did not have revisions to the associated information collections). We hope that we can resolve this issue and have this corrected to a submission as a regular revision (not an Emergency).

Authorizing Statute(s): US Code: 42 USC 405 Name of Law: Social Security Act
US Code: 42 USC 1383 Name of Law: Social Security Act

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0960-AI71	Final or interim final rulemaking	89 FR 68341	08/26/2024

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: When we last cleared this IC in 2023, the burden was 1,186,999 hours. However, we are currently reporting a burden of 833,634 hours. This change is a result of a decrease in the number of responses from 2,762,500 to 2,492,500, as well as the removal of the Enhanced Outreach Notices and the combination of the Enhanced Outreach Calls to one call total. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data. In addition, we are including the new notice, Form HA-L54, Notice of Ways to Attend a Hearing; and the new form, Form HA-56, Agreement to Appearing by Online Video, both of which increase the overall burden for this information collection. We note that the minor burden increase for adding these two new information collections does not affect the overall decrease for this ICR due to the decrease in the number of respondents.

Annual Cost to Federal Government: $2,705,717

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. No

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. 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? No

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

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