Addendum to Supporting Statement

Addendum 0247 (revised).doc

Workers' Compensation/Public Disability Benefit Questionnaire

Addendum to Supporting Statement

OMB: 0960-0247

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Addendum for SSA-546

Workers' Compensation/Public Disability Benefit Questionnaire

20 CFR 404.408

OMB No. 0960-0247




Minor Revisions to the Collection Instrument


We are removing the paper version of Form SSA-546. Field Office technicians no longer use the paper Form SSA-546, because the electronic WC/PDB screens in the Modernized Claims System (MCS) application collects the same information. In the rare occasion that MCS is unavailable to process the WC/PDB allegations, the technician is able to use Interactive Computations Facility (ICF) pre-adjudicate screen. The functionality is similar to the WC/PDB screens in MCS. The screens are COMMON screens and therefore alleviate the need for the paper Form SSA-546.

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AuthorSue Shinsky
Last Modified By889123
File Modified2014-09-02
File Created2014-09-02

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