Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation

Notice Regarding Substitution of Party Upon Death of Claimant Reconsideration of Disability Cessation

Revised PA & PRA Statements

Notice Regarding Substitution of Party Upon Death of Claimant--Reconsiderationof Disability Cessation

OMB: 0960-0351

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SSA will insert the following revised Privacy Act & PRA Statements into the
form as soon as possible:
Privacy Act Statement
Collection and Use of Personal Information
Section 205(b) of the Social Security Act, as amended, allows us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the
information may prevent an accurate and timely decision on any claim filed, or could result in
loss of benefits.
We will use the information to determine the claimant’s eligibility for benefits. We may also
share your information for the following purposes, called routine uses:


Information may be disclosed to contractors and other Federal agencies, as necessary, for
assisting Social Security Administration (SSA) in the efficient administration of its
programs. We contemplate disclosing information under this routine use only in
situations in which SSA may enter a contractual or similar agreement, with a third party
to assist in accomplishing an agency function relating to this system of records; and



Information may also be disclosed to third party contacts, especially in situations where
the party to be contacted has, or is expected to have, information relating to the
individual’s capability to manage his/her affairs or his/her eligibility for or entitlement to
benefits under the Social Security program; when the data are needed to establish the
validity of evidence; to verify the accuracy of information presented by the individual
and, if it concerns his/her eligibility for benefits under the Social Security program.

In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notice
(SORN) 60-0089, entitled Claims Folders System, as published in the Federal Register (FR) on
April 1, 2003, at 68 FR 15784 and 60-0320, entitled Electronic Disability (eDIB) Claim File, as
published in the FR on December 22, 2003, at 68 FR 71210. Additional information, and a full
listing of all our SORNs, is available on our website at www.ssa.gov/privacy/.

Paperwork Reduction Act Statement - This information collection meets the requirements of
44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not
need to answer these questions unless we display a valid Office of Management and Budget
(OMB) control number. We estimate that it will take about 5 minutes to read the instructions,
gather the facts, and answer the questions. Send only comments relating to our time estimate
above to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401.


File Typeapplication/pdf
File TitleMicrosoft Word - Revised PA & PRA Statements
Author868865
File Modified2018-12-19
File Created2018-12-19

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