Addendum to the Supporting Statement for 0960-0229

Addendum to the Supporting Statement for

Form SSA-8000-BK

Application for Supplemental Security Income

20 CFR, 416.207 & 416.305- 335, Subpart C

OMB No. 0960-0229

Revisions to the Collection Instrument

Below is a summary of changes for SSA-8000-BK. These revisions are to update minor changes in policy. There are no required changes for the Modernized Supplemental Security Income Claims System (MSSICS).

• Change 1: Pages 5-6; Question #19 – We are removing the Probation and Parole Violation (PPV) questions. We deleted the questions 19(a), 19(b), 19(c) and 19(d).

Justification 1: The Clark v. Astrue Court Order prohibits the Social Security Administration (agency) from using probation or parole violation warrants to suspend or deny payments. Therefore, we are removing these questions to remain in compliance with the Clark Court Order.

• Change 2: Page 23; We are revising the fugitive felon (FF) warrant bullets.

From:

IF A WARRANT HAS BEEN ISSUED FOR YOUR ARREST -You must report to Social Security if:

• Your warrant is for a crime or an attempted crime that is a felony (or, in jurisdictions that do not define crimes as felonies, a crime that is punishable by deathor imprisonment for a term exceeding 1 year); or

• Your warrant is for a violation of probation or parole under Federal or State law.

To:

FELONY OR ARREST WARRANT – You must report to Social Security if you have a felony or arrest warrant for:

• Escape from custody,

• Flight to avoid prosecution or confinement, or

• Flight- Escape.

Justification 2: The Martinez v. Astrue Settlement only allows the agency to suspend or deny payments based on three warrants; escape from custody, flight to avoid prosecution or confinement, or flight-escape. The Clark v. Astrue Court Order prohibits the agency from using probation and parole violation warrants to suspend or deny payments. Therefore, we are revising this reporting instruction to remain in compliance with these Court cases.

Change 3: We are no longer reporting separate burden hours for Modernized Supplemental Security Income Claims System (MSSICS) and MSSICS w/Signature Proxy, we are now reporting the two together.

Justification: The Management Information Database no longer allows us to see if signature proxy is used, we can only determine whether the our field offices took the claim in MSSICS and non-MSSICS. In addition, we now require attestation (or Signature Proxy) for all MSSICS claims.