Medical Consultant's Review of Psychiatric Review Technique Form

Medical Consultant's Review of Psychiatric Review Technique Form, 20 CFR 404.1520a, 1640, 1645

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0677 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-3023 Medical Consultant's Review of Psychiatric Review Technique Form Form and Instruction
SSA-3023 Medical Consultant's Review of Psychiatric Review Techni S3023.pdf Form and Instruction
SSA-3020 (AeDib Fo Medical Consultant's Review of Psychiatric Review Techni MC_Rev_f.pdf Form

Information Collection (IC) Details

IC Title:	Medical Consultant's Review of Psychiatric Review Technique Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 404.1640 20 CFR 404.1643 20 CFR 404.1645 20 CFR 416.920a 20 CFR 404.1520a

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-3023	Medical Consultant's Review of Psychiatric Review Technique Form	S3023.pdf		No		Paper Only
Form	SSA-3020 (AeDib Form)	Medical Consultant's Review of Psychiatric Review Technique Form	MC_Rev_f.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 344	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	66,736	-1,264	68,000
Annual IC Time Burden (Hours)	13,347	-253	13,600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.