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View ICR - OIRA Conclusion

OMB Control No: 0960-0534	ICR Reference No: 202412-0960-008
Status: Active	Previous ICR Reference No: 202410-0960-020
Agency/Subagency: SSA	Agency Tracking No:
Title: Waiver of Right to Appear--Disability 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: 07/24/2025
	Date Received in OIRA: 12/20/2024
Terms of Clearance: Prior to the next submission, the agency will further clarify how it developed the management information informing the estimate of total annual responses.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2028	36 Months From Approved	07/31/2025
Responses	4,356	0	200
Time Burden (Hours)	1,328	0	110
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	4,356	200	4,156
Annual Time Burden (Hours)	1,328	110	1,218
Annual Cost Burden (Dollars)	0	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: When we last cleared this IC in 2021, the burden was 10 hours. However, we are currently reporting a burden of 218 hours. This change stems an increase in the number of responses from 200 to 4,356. This change also stems from COVID operations suspension hearings in 2020 and then limited the manners of appearance in 2020 and 2021, resuming normal processing in 2022. In addition, an Emergency Message was issued during COVID that contained reminders and instructions for completion of the SSA-773-U4. These figures represent current Management Information data. * Note: The total burden reflected in ROCIS is 1,328, while the burden cited in #12 of the Supporting Statement is 217. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30-minute, one-way, drive burden. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

Annual Cost to Federal Government: $10,255

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? No

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

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