Supporting Statement for Form SSA-3023,
Medical Consultant’s Review of Psychiatric Review Technique Form
20 CFR 404.1520a, 404.1640, 404.1643, 404.1645, 416.920(a)
OMB No. 0960-0677
A. Justification
In accordance with 20 CFR 404.1640, 404.1643 and 404.1645 of the Code of Federal Regulations, the Social Security Administration (SSA) measures the performance of Disability Determination Services (DDSs) in the area of quality of documentation and determinations on claims. Section 221(c) of the Social Security Act requires that SSA review state agency performance in individual cases and classes of cases. Standards are applied to help assure effective and uniform administration of SSA’s disability program. In accordance with 20 CFR 404.1520a and 416.920a, DDS’s administering the Title II (Disability Insurance) and Title XVI (Supplemental Security Income) programs are required to evaluate the severity of mental impairments using form SSA-2506-BK, Psychiatric Review Technique (OMB No. 0960-0413). Section 1633(a) of the Social Security Act provides that the Commissioner of Social Security may make arrangements as appropriate to carry out any administrative functions as necessary.
Form SSA-3023 is used by SSA’s regional review component to facilitate the contract medical/psychological consultant’s review of the Psychiatric Review Technique Form. The form records the reviewing medical/psychological consultant’s assessment of the Psychiatric Review Technique prepared by the adjudicating component. The medical/psychological consultant completes an SSA-3023 only when an adjudicating component’s Psychiatric Review Technique is in the file. The SSA-3023 is required for each Psychiatric Review Technique form completed. The respondents are medical/psychological consultants who review the Psychiatric Review Technique Form for quality purposes.
80% of the forms are collected electronically through the Accelerated Electronic Disability Insurance Benefits (AeDib) process. Electronic versions of the SSA-3023 were implemented under the AeDib initiative in June 2003.
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.
This collection does not have a significant impact on a substantial number of small businesses or other small entities.
If the information were not collected, reviewing medical/psychological consultants would have an increased burden of recording the review in free form narrative. Consequently, Categories of Disorders, Ratings of Functional Limitations, various listings and Medical Disposition agreements/disagreements would need to be written in long hand, as opposed to using a check sheet. Collection of this information is mandatory and cannot be conducted less frequently.
Generally, the medical/psychological consultant completes the form only once. However, on occasion, there may be more than one Psychiatric Review Technique form in file. In that case, an SSA-3023 must be filled out for each Psychiatric Review Technique form. 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.
The 60-day advance Federal Register Notice was published on June 13, 2006 at 71 FR 34181, and SSA has received no public comments. The second Notice was published on September 11, 2006, at 71 FR 53485. There have been no outside consultations with members of the public.
SSA provides no payment or gifts to the respondents.
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.
The information collection does not contain any questions of a sensitive nature.
Approximately 344 medical/psychological consultants will respond 194 times each, which generates approximately 66,736 total annual responses to this form. Since SSA estimates that a respondent will take 12 minutes to complete this form, the estimated total hours are 13,347. The total burden is reflected as burden hours, and no separate cost burden has been calculated.
There is no known cost burden to the respondents.
The annual cost to the Federal Government is approximately $1,198,396.48.
This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
The decrease in burden hours was a result of recalculating the incidence of mental disability claims based on current 2005 fiscal year statistical data.
The results of the information collection will not be published.
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 date had been reached. In addition, Government waste has been avoided because stocks of forms will not have to be destroyed and reprinted.
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).
B. Collection of Information Employing Statistical Methods
Statistical methods are not used for this information collection.
| File Type | application/msword |
| File Title | Supporting Statement for Form SSA-3023, |
| Author | 498040 |
| Last Modified By | Davidson, Liz |
| File Modified | 2006-09-13 |
| File Created | 2006-09-13 |