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:
0960-0671
ICR Reference No:
202410-0960-009
Status:
Active
Previous ICR Reference No:
202410-0960-008
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:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
10/16/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/16/2024
Terms of Clearance:
In accordance with 5 CFR 1320, this information collection is approved.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2027
36 Months From Approved
01/31/2026
Responses
2,567,690
0
3,827,490
Time Burden (Hours)
871,229
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.
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
Number of Information Collection (IC) in this ICR:
10
IC Title
Form No.
Form Name
Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing)
HA-504-OP1
Acknowledgement of Receipt (Notice of Hearing)
Claimant Enhanced Outreach - Follow Up Call – No Representative (Unrepresented Claimant/ProSe)
Claimant Enhanced Outreach - Follow up Call – With Representative
Claimant Enhanced Outreach - Initial Call No Representative (Unrepresented Claimant/ProSe)
Claimant Enhanced Outreach - Initial Call With Representative
Claimant Enhanced Outreach Call
Courtesy Copy of Remote Hearings Options Letter to Claimant
HA-504 - Acknowledgement of Receipt (Notice of Hearing)
HA-504-OP2, HA-504, HA-504-OP1
Acknowledgement of Receipt (Notice of Hearing)
,
Acknowledgement of Receipt (Notice of Hearing)
,
Acknowledgement of Receipt (Notice of Hearing)
HA-510 - Waiver of Timely Written Notice of Hearing
HA-510
Waiver of Timely Written Notice of Hearing
HA-55 (Objection to Appearing by Audio or Agency video); HA-56 (Agreement to Appearing by Online Video); HA-L54 (Notice of Ways to Attend a Hearing)
HA-56, HA-55
Objection to Appearing by Video Teleconferencing
,
Agreement to Appearing by Online Video
HA-L2 - Acknowledgement Letter
HA-L2 - Verification of New Residence
HA-L54 - Notification of objection to audio and agency video and agreement to online video more than 30-days after receipt of notice showing good cause
HA-L83 - Good Cause for Missing Deadline
HA-L83 - Notice of Hearing Cover Letter
HA-L83 - Objection Stating Issues in Notice are Incorrect
Microsoft Teams Video Hearing Call Script - Claimant Outreach
Microsoft Teams Video Hearing Call Script - Representative Payee Outreach
Remote Hearing Options Letter and Form Mailed to Representative
N/A
Remote Hearing Notice and Agreement Form
Remote Hearings Options Follow up Call with Representative – no form
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
2,567,690
3,827,490
0
-978,300
-281,500
0
Annual Time Burden (Hours)
871,229
1,186,999
0
-154,521
-161,249
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:
Yes
Burden Reduction Due to:
Changing Regulations
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
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:
10/16/2024
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