This information
collection is approved through 1-94 under the following condition:
SSA will update this form to reflect the changes in the evaluation
of mental illness outlined in SSA's proposed Adult Mental Disorders
regulation.
Inventory as of this Action
Requested
Previously Approved
01/31/1994
01/31/1994
07/31/1992
458,568
0
460,625
114,642
0
115,156
0
0
0
THE INFORMATION COLLECTED BY USE OF
THIS FORM IS USED BY THE SOCIAL SECURITY ADMINISTRATION TO EVALUATE
THE SEVERITY OF MENTAL IMPAIRMENTS IN ADULTS WHO HAVE FILED A CLAIM
FOR DISABILITY BENEFITS. THE AFFECTE PUBLIC CONSISTS OF STATE
DISABILITY DETERMINATION AGENCIES WHO ARE RESPONSIBLE FOR REVIEWING
THE CLAIM FROM BENEFICIARIES/RECIPIENTS AND
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:
(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;
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.