Supporting Statement--SSA-372

Supporting Statement for the SSA-372

Request for Reinstatement (Title XVI)

20 CFR 416.999 - 416.999d

OMB #0960-NEW

1. Justification

1. Section 112 of Public Law 106-170, the Ticket to Work and Work Incentives Improvement Act of 1999, added section 1631(p) to the Social Security Act to allow certain previously entitled individuals to request expedited reinstatement (EXR) of those disability benefits under Title XVI when their medical condition no longer permits them to perform substantial gainful activity (SGA). The rules for EXR are further described in 20 CFR 416.999 through 20 CFR 416.999d in the Code of Federal Regulations.

2. This information will be used by the Social Security Administration (SSA) to inform previously entitled individuals of the EXR requirements and to document that the individual wishes to request EXR. The paper form is either given to the individual by an SSA claims representative or mailed to an individual who indicates his/her intent to request EXR over the phone. Because the EXR process is a paper process, the signed form is maintained in the paper disability folder as documentation that the individual is aware of the EXR requirements and that are requesting EXR. There is no copy of the form saved in the electronic disability folder at this time. Respondents are individuals requesting expedited reinstatement of Title XVI disability benefits.

3. At this time this information is not collected electronically and must be completed manually. There is no current plan to collect this information over the internet. This is due to the fact that EXR is a relatively small workload and it is not automated within SSA systems. This information is not collected through another electronic system collection.

4. The nature of the information being collected and the manner in which it is collected preclude duplication. There is no other collection instrument used by SSA that collects data similar to that collected here.

5. This collection does not have a significant impact on a substantial number of small businesses or other small entities.

6. If this information were not collected SSA could not ensure that individuals requesting EXR are aware of the requirements and that they have made the choice to request EXR. Also, because this information is only collected on an as needed basis, it cannot be collected less frequently. There are no technical or legal obstacles that prevent burden reduction.

7. There are no special circumstances that would cause this information collection to be conducted in a manner that is not consistent with 5 CFR 1320.5.

8. The 60-day advance Federal Register Notice was published on November 1, 2006 at 71 FR 64327, and SSA has received no public comments. The second Notice was published on February 14, 2007, at 72 FR 7107. There have been no outside consultations with members of the public.

9. SSA provides no payment or gifts to the respondents.

10. The information requested is protected and held confidential in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974) and OMB Circular No. A-130.

11. The information collection does not contain any questions of a sensitive nature.

12. SSA estimates that approximately 2,000 respondents will make EXR requests (Title XVI only) annually. It is expected that it will take respondents two minutes to complete the form, for a total of 67 burden hours. The total burden is reflected as burden hours, and no separate cost burden has been calculated.

13. There is no known cost burden to the respondents.

14. The annual cost to the Federal Government is $4,620. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.

15. This is an existing collection in use without OMB approval that will increase the public reporting burden.

16. The results of the information collection will not be published.

17. OMB has granted SSA an exemption from the requirement that the expiration date for OMB approval be printed on its program forms. SSA produces millions of public-use forms, many of which have a life cycle longer than that of an OMB approval. SSA does not periodically revise and reprint its public-use forms, (e.g. on an annual basis). This exemption was granted so that otherwise useable editions of forms would not be taken out of circulation because the expiration data has been reached. In addition, Government Waste has been avoided because stocks of forms will not have to be destroyed and reprinted.

18. SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

2. Collections of Information Employing Statistical Methods

Statistical methods are not used for this information collection.