Internet Social Security Disability Report (ISSDR)

ICR 200205-0960-004

OMB: 0960-0650

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
9689
Migrated
ICR Details
0960-0650 200205-0960-004
Historical Active
SSA
Internet Social Security Disability Report (ISSDR)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/29/2002
Retrieve Notice of Action (NOA) 05/28/2002
The pilot of this system is approved for use through 4/2003 under the conditions that in the next submission SSA: 1)presents as background a description of the results of its cognitive test under OMB #0960-0526; 2) evaluates the pilot as well as the new systems' impact on the functionality of SSA's disability operation from both SSA's and the respondents' perspective throughout the entire disability determination process. This internet application should make the determination process more cost-effective for SSA and less burdensome on respondents; 3)no later than 8/2002 adjusts other relevant paperwork burden estimates to reflect substitution of this technology for existing application modes. Prior to full national implementa- tion, SSA must submit directly to OMB the new package including the above analyses. OMB expects to expeditiously review this submission upon receipt (i.e. within 30 days.)
  Inventory as of this Action Requested Previously Approved
05/31/2003 05/31/2003
66,000 0 0
132,000 0 0
0 0 0

The ISSD Report will collect allegations of disability and gather information about the disabling condition and sources of medical evidence. Collecting this information is critical to case development and adjudication. The information on the Disability Report, together with other evidence and information, will be used by State Disability Determination Services to develop medical evidence, assess the alleged disability, and make a determination on whether or not the applicant is disabled under the Act.

None
None


No

1
IC Title Form No. Form Name
Internet Social Security Disability Report (ISSDR)

  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 66,000 0 0 66,000 0 0
Annual Time Burden (Hours) 132,000 0 0 132,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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.
05/28/2002


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