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OMB Control No: 0960-0277	ICR Reference No: 202603-0960-006
Status: Received in OIRA	Previous ICR Reference No: 202310-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Review of Hearing Decision/Order
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 08/27/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2026
Responses	81,855	151,600
Time Burden (Hours)	48,730	123,175
Cost Burden (Dollars)	0	0

Abstract: Claimants who disagree with a judge’s hearing decision, or dismissal of a hearing request on Title II and Title XVI claims have the right under current SSA regulations to request Appeals Council (AC) review. Claimants may request Appeals Council review by filing a written request using paper Form HA-520; uploading the fillable static PDF of Form HA-520 through SSA’s Upload Documents portal (OMB No. 0960-0830), or submitting the Internet application, i520. In addition, they may submit additional evidence or arguments to support their request for review at the same time. SSA uses the information gathered on Form HA-520 to establish that the claimant filed the request for review within the prescribed time and to ensure the claimant completed the requisite steps permitting the AC review. The AC uses the information to: (1) document the claimant’s reason(s) for disagreeing with the hearing decision or dismissal order; (2) determine whether the claimant has additional evidence to submit; (3) determine whether the claimant is requesting an extension of time, and (4) help determine whether the claimant has a representative or wants to appoint one, regardless of if they had a representative for their hearing request. In situations where the respondent submits the HA-520 or i520 without providing additional evidence or argument, or requesting an EOT, the AC reviews the request based on the existing file. The respondents are claimants, or their appointed representative, guardian, parent of a minor claimant, or representative payee, requesting review of a hearing decision or order of dismissal.

Authorizing Statute(s): US Code: 42 USC 1383 Name of Law: The Public Health and Welfare
   US Code: 42 USC 405 Name of Law: The Public Health and Welfare
   PL: Pub.L. 106 - 169 251 Name of Law: Foster Care Independence Act of 1999
   PL: Pub.L. 106 - 169 809 Name of Law: Foster Care Independence Act of 1999

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:
	91 FR 38753	06/26/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 55418	08/27/2026
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	81,855	151,600	-69,745
Annual Time Burden (Hours)	48,730	123,175	-74,445
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 2023, the burden was 34,742 hours. However, we are currently reporting a burden of 20,464 hours. This change stems from a decrease in the number of responses from 151,600 to 81,855, caused by normal fluctuations in respondents requesting AC level review. Although the number of responses changed, SSA did not take any action to cause this change. In addition, we decreased our burden per response for this form, which decreased the overall burden for the ICR. These figures represent current Management Information data. Note: The total burden reflected in ROCIS is 48,730, while the burden cited in #12 of the Supporting Statement is 20,464. 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 + learning costs. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

Annual Cost to Federal Government: $246,150

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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