Explanation of Changes (survey) -- 0960-0444

OMB No. 0960-0444

Form SSA-8001; Application for Supplemental Security Income

Description of Non-Substantive Change

Change:

Insurance companies and other agencies (including other government agencies) sometimes refer potential Title XVI disability applicants to the Social Security Administration (SSA), serving a valuable role in directing people to us. However, we only have anecdotal evidence about the frequency of these referrals.

To obtain an estimate of how often people file for disability payments at the request/suggestion of an organization or company, SSA will conduct a brief two-week survey of Title XVI disability applicants. The survey will cover those applicants who filed a paper application (Form SSA-8001) or completed a field office interview to file an application. We will ask two brief questions (listed below and attached as a separate IC).

Justification:

SSA is conducting this brief survey to assess the frequency of disability applicant referrals from insurance companies or other organizations. As SSA continues to work on improving our claims processes, this information will inform our planning for third-party claims development.

Survey Questions:

1. Did any organization or company refer you to SSA to file for disability benefits? (Yes/No)

What type of organization referred you:

• Private disability company

• Public (state/local) disability program

• Worker’s compensation agency

• Department of Veteran’s Affairs

• State/local public assistance office (TANF, food stamps, general assistance programs)

• Unemployment office

• Other (please specify):

2. If yes, were you required to file for Social Security disability benefits as a condition of receiving cash benefits from the referring organization?

• Yes

• No

• Do not receive or expect to receive cash benefits from the organization that referred me.