Supporting Statement for Form SSA-770
Notice Regarding Substitution of Party Upon Death of Claimant
Reconsideration of Disability Cessation
20 CFR Sections 404.907-404.921 and 416.1407-416.1421
OMB 0960-0351
Justification
Introduction/Authoring Laws and Regulations
Section 205(b) of the Social Security Act and sections 20 CFR 404.907-404.921 and 416.1407-416.1421 of the Code of Federal Regulations require the Social Security Administration (SSA) to provide claimants who have received an initial or revised determination that a disability ceased, or did not exist, an evidentiary hearing at the reconsideration level of appeal.
Description of Collection
When a claimant dies before we make a determination on their request for reconsideration of a disability cessation, SSA conducts a search through the applicant’s records on the Master Beneficiary Record (MBR), for a qualified substitute party to pursue the appeal. We search for a widow or widower of the deceased; a surviving divorced spouse; a child; a disabled child; a parent; the administrator or executor of the estate of the deceased; or any person whom we can consider qualified to pursue the appeal. The information we collect on Form SSA-770 is the basis of our decision to continue, or discontinue, the appeals process. Respondents are substitute applicants who are pursuing a reconsideration request for a deceased claimant.
Use of Information Technology to Collect the Information
SSA did not create an electronic version of Form SSA-770 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 1,200 respondents complete the form annually. This is less than the GPEA cut-off of 50,000.
Why We Cannot Use Duplicate Information
The nature of the information we collect and the manner in which we collect it precludes duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
This collection does not significantly affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If we did not use Form SSA-770, we would not have a structured format for establishing substitute parties who wish to pursue reconsideration requests on behalf of deceased applicants. Because we only collect the information once, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.
Special Circumstances
There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on December 6, 2018 at 83 FR 62943, and we received no public comments. The 30-day FRN published on February 15, 2019 at 84 FR 4597. If we receive any comments in response to this Notice, we will forward them to OMB. SSA did not consult with the public in the revision of this form.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information we collect 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.
Justification for Sensitive Questions
The information collected does not contain any sensitive questions.
Estimates of Public Reporting Burden
Modality of Completion |
Number of Respondents |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Total Annual Burden (hours) |
SSA-770 |
1,200 |
1 |
5 |
100 |
The total burden for this ICR is 100 hours. We based these figures on current management information data. This figure represents burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents (Other)
This collection does not impose a known cost burden on the respondents.
Annual Cost to Federal Government
The annual cost to the Federal Government is approximately $1,848. This estimate accounts for costs from the following areas: (1) designing, printing, and distributing the form; and (2) SSA employee (e.g., field office, 800 number) information collection and processing time.
Program Changes or Adjustments to the Information Collection Request
There are no changes to the public reporting burden.
Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
Displaying the OMB Approval Expiration Date
OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.
Exceptions to Certification Statement
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).
Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Supporting Statement for Form SSA-770 |
| Author | 030060 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-20 |