Supporting Statement for Form SSA-887
Summary of Evidence
A. Justification
When claimants for Social Security disability benefits receive an initial or revised determination that their disability does not exist or has ceased, they are entitled to an evidentiary hearing at the reconsideration level from the Social Security Administration (SSA), according to Section 205(b) of the Social Security Act and 20 CFR 404.913(b), 404.914(a), 416.1413(b), and 416.1414(a) of the Code of Federal Regulations. 20 CFR Section 416.1407 extends this hearings process to comparable cases under Title XVI of the Act. Form SSA-887 documents information that will be used for these evidentiary hearings.
Form SSA-887 is completed by a Disability Hearing Officer (DHO) from the claimant’s State Disability Determination Service (DDS). The DHO summarizes all medical and vocational reports that were used to make the no-disability determination. This form, which is used to prepare for and conduct the disability hearing, is also made available to claimants so that they are aware of the basis for the no-disability decision and they can prepare for the reconsideration hearing accordingly.
The form is not currently scheduled for complete electronic implementation since (a) it is completed internally and (b) paper copies must still be sent to claimants.
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 form SSA-887 were not used, DHOs would have no way of organizing and summarizing the evidence relevant to a no-disability decision. This would make the evidentiary hearing process difficult to conduct. Additionally, not using the form would deprive claimants of the right to have the most recent information pertaining to their case made available to them. Since the form is only completed when an evidentiary reconsideration hearing is scheduled, it cannot be used 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 inconsistent with 5 CFR 1320.5.
The 60-day advance Federal Register Notice was published on March 23, 2007 at 72 FR 13851, and SSA has received no public comments. The second Notice was published on June 13, 2007, at 72 FR 32697. There have been 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 may contain questions that could be considered of a sensitive nature, since the form summarizes medical evaluation results. However, the form is only seen by the DHOs, the claimants themselves, and the SSA employees involved in conducting the reconsideration, and the information contained within the form is held in complete confidentiality.
12. Each year, an estimated 49,000 respondents take 15 minutes each to complete form SSA‑887. Therefore, the total burden is 12,250 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 $75,460. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
15. There are no changes 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 at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
B. Collections of Information Employing Statistical Methods
Statistical methods are not used for this information collection.
SSA-887
| File Type | application/msword |
| File Title | Supporting Statement for Form SSA-773-U4 |
| Author | 133030 |
| Last Modified By | 177717 |
| File Modified | 2007-06-14 |
| File Created | 2007-06-01 |