SSA-1207 Supporting Statement

3

Supporting Statement for Forms SSA-1207, SSA-1207 SUP-1,

SSA-1207 SUP-3

Disability Hearing Officer’s Decision

20 CFR 404.917 and 416.1417

OMB No. 0960-0441

A. Justification

1. Section 205(b) of the Social Security Act requires that the Social Security Administration (SSA) provide an evidentiary hearing at the reconsideration level of appeal for claimants who have received an initial or revised determination that a disability did not exist or has ceased. Title 20 CFR Sections 404.917 and 416.1417 state, in part, “The disability hearing officer who conducts your disability hearing will prepare and will also issue a written reconsidered determination….”

2. Form SSA-1207 (and the supplement which applies to the type of claim involved) will be used by the State and federal Disability Hearing Officer (DHO) in preparing the disability decision. The form will aid the DHO in addressing the crucial elements of the case in a sequential and logical fashion. The completed form will be the official document of the decision, and a copy will be forwarded to the claimant/representative.

3. Electronic versions of the forms are housed in SSA's IWS LAN. The majority of DHOs has access to SSA’s IWS LAN and has the option of completing the forms electronically. The electronic forms have to be printed and a paper version placed in the claim folder. At this time, the CDR process is not electronic, it is a paper process. A paper folder is the official record. The SSA-1207 is completed by hand and placed in the official folder. There is no electronic submission of the information. In the future, as scarce resources permit, the CDR process will become electronic.

4. There are no other forms used by SSA that collect information similar to that collected on Form SSA-1207, and there is no duplication of the information collected.

5. The collection of information does not involve small businesses or other small entities.

6. This information collection cannot be conducted less frequently because there would be no record of the disability decision, and claimants would be deprived of the right to have the most recent information included in their reconsideration evaluations. 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 inconsistent with 5 CFR 1320.5.

8. The 60-day advance Federal Register (FR) notice was published on January 4, 2007 at 72 FR 357. There were no public comments. The second notice will be published on March 15, 2007 at 72 FR 12244. There were no outside consultations with members of the public.

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

10. The information provided on this form 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. The total estimated number of claimants who will use Form SSA-1207 is 65,000 annually. The estimated average response time is 45 minutes, for a total of 48,750 burden hours. The total burden is reflected as burden hours, and no separate cost burden has been calculated. This form is completed by state officials 90% of the time and by federal employees 10%.

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

14. The annual cost to the Federal Government is approximately $585,000.

15. There have been no program changes or adjustments for this form, and there is no change in 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 clearance. SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis). This exemption was granted so that otherwise usable editions of forms would not be taken out of circulation because the expiration date had 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.

B. Collections of Information Employing Statistical Methods

Statistical methods are not used for this information collection.