Addendum to Supporting Statement

Addendum to the Supporting Statement for the SSA-787

Physician’s/Medical Officer’s Statement of Patient’s Capability to Mange Benefits

20 CFR 404.2015 and 416.615

OMB No. 0960-0024

Revisions to the Collection Instrument

• We are revising the PRA Statement to reflect our current boilerplate language. The current language, which dates back to the last reprint of the form, is now outdated.

• SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statement on agency forms. As a result, SSA is adding a Privacy Act Statement to this form.