Addendums for RIN 0960-AH86

Addendum to the Supporting Statement for Form SSA-454-BK
Continuing Disability Review Report
20 CFR 404.1589 & 416.989
OMB No. 0960-0072
Background
This is a request for modification of the Form SSA-454-BK, Continuing Disability
Review Report, related to new regulation, Removing the Education Category - Inability
to Communicate in English - from the Disability Determination Process, RIN
0960-AH86. This new regulation will eliminate one of the five existing education
categories, namely the “inability to communicate in English” (20 CFR 404.1564 and
416.964). The new regulation will not affect the other educational categories. We will
amend the Medical Vocational Guidelines in 20 CFR Part 404, Subpart P Appendix 2, as
appropriate, under the new regulations.
The effect of this regulation is to remove the consideration of English proficiency when
determining a claimant’s education category. We will consider the claimant’s actual
education attained without regard to the claimant’s proficiency in the use of English and
assign the claimant to one of the four remaining education categories, as appropriate:
illiteracy; marginal education; limited education; and high school education and above.
Sections 223(d)(2)(A) and 1614(a)(3)(B) of the Act require SSA to consider a claimant’s
education when determining an adult’s claim of disability. Sections 205(a) and
1631(d)(1) of the Act authorize SSA to establish procedures for collecting and verifying
relevant evidence. We collect such evidence using Form SSA-454-BK, Continuing
Disability Review Report. The information we collect assesses a claimant’s level of
education, and assigns the claimant to a specific education category.
Revisions to the Collection Instruments
SSA is making the following revisions to Form SSA-454-BK due to the new regulation,
RIN 0960-AH86:
Change #1: We added the question, “Can you read and understand English?” to Section
1, and numbered it 1G. We also included Yes and No check boxes.
Justification #1: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations
is to remove the consideration of English proficiency when determining a claimant’s
education category.
Change #2: We added the question, “Can you write more than your name in English?”
to Section 1, and numbered it 1H. We also included Yes and No check boxes.
Justification #2: These changes will conform to the regulation considering a claimant’s

education when determining an adult’s claim of disability. The effect of the regulations is
to remove the consideration of English proficiency when determining a claimant’s
education category.
Change #3: We relabeled the original question 1G as 1I.
Justification #3: We did this to have the questions in sequential order.
Change #4: We revised the wording in Section 7A to add the line, “If YES, describe the
education you received:”, and added additional fill-ins underneath to collect the Name of
School; Telephone; Fax; Mailing Address; Type of program; Date(s) of attendance; Date
completed (or scheduled to be completed); and Degree attained, if any.
Justification #4: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations is
to remove the consideration of English proficiency when determining a claimant’s
education category.
Change #5: We revised the wording in Section 7B to add the line, “If YES, describe the
training you received:”, and added additional fill-ins underneath to collect the Name of
Training Facility; Telephone; Fax; Mailing Address; Type of program; Date(s) of
attendance; Date completed (or scheduled to be completed); and Certificate/License
attained, if any.
Justification #5: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations is
to remove the consideration of English proficiency when determining a claimant’s
education category.
SSA is making the following revisions to the EDCS Screens for the SSA-454-BK due to
the new regulation, RIN 0960-AH86:
Change #1: We added the question, “Can you read and understand English?” in the
Your Language Information section. We also included Yes and No check boxes.
Justification #1: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations
is to remove the consideration of English proficiency when determining a claimant’s
education category.
Change #2: We added the question, “Can you write more than your name in English?”
in the Your Language Information section. We also included Yes and No check boxes.
Justification #2: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations is
to remove the consideration of English proficiency when determining a claimant’s

education category.
Change #3: We revised the wording under the Education Section to reflect, “Have you
received any education since your last disability decision?”. In addition, we added the
line, “If YES, describe the education you received:”, and added additional fill-ins
underneath to collect the Name of School; Telephone; Fax; Mailing Address; Type of
program; Date(s) of attendance; Date completed (or scheduled to be completed); and
Degree attained, if any.
Justification #3: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations is
to remove the consideration of English proficiency when determining a claimant’s
education category.
Change #4: We revised the wording under the Job Training or Vocational School
Section to reflect, “Have you received any type of specialized job, trade, or vocational
training since your last disability decision?”. In addition, we added the line, “If YES,
describe the education you received:”, and added additional fill-ins underneath to collect
the Name of School; Telephone; Fax; Mailing Address; Type of program; Date(s) of
attendance; Date completed (or scheduled to be completed); and Degree attained, if any.
Justification #4: These changes will conform to the regulation considering a claimant’s
education when determining an adult’s claim of disability. The effect of the regulations is
to remove the consideration of English proficiency when determining a claimant’s
education category.
SSA will implement these Changes immediately upon OMB’s approval of the Final Rule
for RIN 0960-AH86.
These revisions do not affect the public reporting burden.

Addendum to the Supporting Statement for Form SSA-3441
Disability Report-Appeal
20 CFR 404.1512, 416.912, 404.916(c), 416.1416(c), 422.140, 404.1713, 416.1513,
404.1740(b)(4), 416.1540(b)(4), and 20 CFR 405, Subpart C
OMB No. 0960-0144
Background
This is a request for modification of the Form SSA-3441, Disability Report - Appeal,
related to new regulation, Removing the Education Category - Inability to Communicate
in English - from the Disability Determination Process, RIN 0960-AH86. This new
regulation will eliminate one of the five existing education categories, namely the
“inability to communicate in English” (20 CFR 404.1564 and 416.964). The new
regulation will not affect the other educational categories. We will amend the Medical
Vocational Guidelines in 20 CFR Part 404, Subpart P Appendix 2, as appropriate, under
the new regulations.
The effect of this regulation is to remove the consideration of English proficiency when
determining a claimant’s education category. We will consider the claimant’s actual
education attained without regard to the claimant’s proficiency in the use of English and
assign the claimant to one of the four remaining education categories, as appropriate:
illiteracy; marginal education; limited education; and high school education and above.
Sections 223(d)(2)(A) and 1614(a)(3)(B) of the Act require SSA to consider a claimant’s
education when determining an adult’s claim of disability. Sections 205(a) and
1631(d)(1) of the Act authorize SSA to establish procedures for collecting and verifying
relevant evidence. We collect such evidence using Form SSA-454-BK, Continuing
Disability Review Report. The information we collect assesses a claimant’s level of
education, and assigns the claimant to a specific education category.
Revisions to the Collection Instruments
SSA is making the following revisions to Form SSA-3441 due to the new regulation, RIN
0960-AH86:
Change #1: In 8B, we added “GED classes” and “college classes” to the question.
Justification #1: We are adding this information due to the new regulation to eliminate
the “inability to communicate in English” education category. This now requires us to
consider a claimant’s formal schooling without regard to the claimant’s proficiency in
English. Therefore, additional collection is required.
Change #2: In 8B, under Date(s) attended, we added two new questions to collect
Certificates/licenses/degrees attained, if any and Date of attainment.
Justification #2: We are adding this information due to the new regulation to eliminate
the “inability to communicate in English” education category. Requesting information on

when education was attained will allow adjudicators to determine how relevant the
information is in the disability adjudication process.
SSA is making the following revisions to the i3441 due to the new regulation, RIN
0960-AH86:
Change #1: We changed the question, “Have you completed any type of special job
training, trade or vocational school” to, “Since you last told us about your education,
have you completed or are you enrolled in any type of GED classes, specialized job
training, trade school, vocational school, or college classes?”
Justification #1: We are adding this information due to the new regulation to eliminate
the “inability to communicate in English” education category. This now requires us to
consider a claimant’s formal schooling without regard to the claimant’s proficiency in
English. Therefore, additional collection is required.
Change #2: Under the revised question, we added two new questions to collect
Certificates/licenses/degrees attained, if any and Date of attainment.
Justification #2: We are adding this information due to the new regulation to eliminate
the “inability to communicate in English” education category. Requesting information on
when education was attained will allow adjudicators to determine how relevant the
information is in the disability adjudication process.
SSA is making the following revisions to the 3441 EDCS Screens due to the new
regulation, RIN 0960-AH86:
Change #1: Under the Education Information section, we changed the question to,
“Since you last told us about your education, have you completed or are you enrolled in
any type of GED classes, specialized job training, trade school, vocational school, or
college classes?”
Justification #1: We are adding this information due to the new regulation to eliminate
the “inability to communicate in English” education category. This now requires us to
consider a claimant’s formal schooling without regard to the claimant’s proficiency in
English. Therefore, additional collection is required.
Change #2: Under the revised question, we added two new questions to collect
Certificates/licenses/degrees attained, if any and Date of attainment.
Justification #2: We are adding this information due to the new regulation to eliminate
the “inability to communicate in English” education category. Requesting information on
when education was attained will allow adjudicators to determine how relevant the
information is in the disability adjudication process.

SSA will implement these Changes immediately upon OMB’s approval of the Final Rule
for RIN 0960-AH86.
These revisions do not affect the public reporting burden.

Addendum to the Supporting Statement for the SSA-3368
Disability Report - Adult
20 CFR 404.1512 and 416.912
OMB No. 0960-0579
Background
This is a request for modification of the Form SSA-3368, Disability Report - Adult, related to
new regulation, Removing the Education Category - Inability to Communicate in English - from
the Disability Determination Process, RIN 0960-AH86. This new regulation will eliminate one
of the five existing education categories, namely the “inability to communicate in English” (20
CFR 404.1564 and 416.964). The new regulation will not affect the other educational categories.
We will amend the Medical Vocational Guidelines in 20 CFR Part 404, Subpart P Appendix 2,
as appropriate, under the new regulations.
The effect of this regulation is to remove the consideration of English proficiency when
determining a claimant’s education category. We will consider the claimant’s actual education
attained without regard to the claimant’s proficiency in the use of English and assign the
claimant to one of the four remaining education categories, as appropriate: illiteracy; marginal
education; limited education; and high school education and above.
Sections 223(d)(2)(A) and 1614(a)(3)(B) of the Act require SSA to consider a claimant’s
education when determining an adult’s claim of disability. Sections 205(a) and 1631(d)(1) of the
Act authorize SSA to establish procedures for collecting and verifying relevant evidence. We
collect such evidence using Form SSA-454-BK, Continuing Disability Review Report. The
information we collect assesses a claimant’s level of education, and assigns the claimant to a
specific education category.
Revisions to the Collection Instrument
SSA is making the following revisions to this collection due to the new regulation, RIN
0960-AH86:


Change #1: We are revising the question about the highest grade completed in 5.A. to
combine 12/High School Graduate/GED/equivalent.



Justification #1: We are making this change to conform to the revisions to the education
categories, namely the “inability to communicate in English” in 20 CFR 404.1564 and
416.964. In accordance with the new rules, we consider the claimant’s formal education
without regard to their English proficiency. Therefore, we are revising the question to
capture education completed foreign countries.



Change #2: We are revising the question about special education in 5.B. as follows:

o We are changing the wording to receive special education and adding IEP
for clarify.
o We are adding questions about the last grade special education was
received, dates attended, and phone and fax numbers for the school.


Justification #2: We are making this change to conform to the revisions to the education
categories, namely the “inability to communicate in English” in 20 CFR 404.1564 and
416.964. In accordance with the new rules, we may need to develop for school records to
document the claimant’s literacy.



Change #3: We are adding a question about the ability to read and write a simple message
in any language with examples in 5.D.



Justification #3: We are making this change to conform to the revisions to the education
categories, namely the “inability to communicate in English” in 20 CFR 404.1564 and
416.964. In accordance with the new rules, we need to document a claimant’s literacy in any
language.

SSA will implement these Changes immediately upon OMB’s approval of the Final Rule for
RIN 0960-AH86.
These revisions do not affect the public reporting burden.

Addendum to the Supporting Statement for Form SSA-3380-BK
Function Report – Adult Third Party
20 CFR 404.1512, 404.1564, 416.912, and 416.964
OMB No. 0960-0635
Background
This is a request for modification of the Form SSA-3380-BK, Function Report – Adult
Third Party, related to new regulation, Removing the Education Category - Inability to
Communicate in English - from the Disability Determination Process, RIN 0960-AH86.
This new regulation will eliminate one of the five existing education categories, namely
the “inability to communicate in English” (20 CFR 404.1564 and 416.964). The new
regulation will not affect the other educational categories. We will amend the Medical
Vocational Guidelines in 20 CFR Part 404, Subpart P Appendix 2, as appropriate, under
the new regulations.
The effect of this regulation is to remove the consideration of English proficiency when
determining a claimant’s education category. We will consider the claimant’s actual
education attained without regard to the claimant’s proficiency in the use of English and
assign the claimant to one of the four remaining education categories, as appropriate:
illiteracy; marginal education; limited education; and high school education and above.
Sections 223(d)(2)(A) and 1614(a)(3)(B) of the Act require SSA to consider a claimant’s
education when determining an adult’s claim of disability. Sections 205(a) and
1631(d)(1) of the Act authorize SSA to establish procedures for collecting and verifying
relevant evidence. We collect such evidence using Form SSA-454-BK, Continuing
Disability Review Report. The information we collect assesses a claimant’s level of
education, and assigns the claimant to a specific education category.
Revisions to the Collection Instrument


Change #1: We are adding the Regulation citations for 20 CFR 404.1564 and
416.964 of the Code of Federal Regulations to this information collection.
Justification #1: We inadvertently did not include this citation previously, and are
correcting for that now.

SSA is making the following revisions to Form SSA-3380-BK due to the new regulation,
RIN 0960-AH86:


Change #1: We are changing Question 22a, Social Activities, to read, “How does
the disabled person spend time with others? (check all that apply)”, with the below
options:
o In person
o On the phone
o Email

o
o
o
o
o

Texting
Mail
Social media
Video chat (for example, Skype or Facetime)
Other:

Justification #1: We are making this change to conform to the regulation, Removing
Inability to Communicate in English as an Education category, to reflect more
modern means of communication, and whether the person is illiterate.
SSA will implement this Change immediately upon OMB’s approval of the Final Rule
for RIN 0960-AH86.
These revisions do not affect the public reporting burden.

Addendum to Supporting Statement for Form SSA-3373-BK
Function Report – Adult
20 CFR 404.1512 and 20 CFR 416.912
OMB No. 0960-0681
Background
This is a request for modification of the Form SSA-3373-BK, Function Report – Adult,
related to new regulation, Removing the Education Category - Inability to Communicate in
English - from the Disability Determination Process, RIN 0960-AH86. This new regulation
will eliminate one of the five existing education categories, namely the “inability to
communicate in English” (20 CFR 404.1564 and 416.964). The new regulation will not
affect the other educational categories. We will amend the Medical Vocational Guidelines in
20 CFR Part 404, Subpart P Appendix 2, as appropriate, under the new regulations.
The effect of this regulation is to remove the consideration of English proficiency when
determining a claimant’s education category. We will consider the claimant’s actual
education attained without regard to the claimant’s proficiency in the use of English and
assign the claimant to one of the four remaining education categories, as appropriate:
illiteracy; marginal education; limited education; and high school education and above.
Sections 223(d)(2)(A) and 1614(a)(3)(B) of the Act require SSA to consider a claimant’s
education when determining an adult’s claim of disability. Sections 205(a) and 1631(d)(1)
of the Act authorize SSA to establish procedures for collecting and verifying relevant
evidence. We collect such evidence using Form SSA-454-BK, Continuing Disability
Review Report. The information we collect assesses a claimant’s level of education, and
assigns the claimant to a specific education category.
Revision to the Collection Instrument
SSA is making the following revisions to Form SSA-3373-BK due to the new regulation,
RIN 0960-AH86:


Change #1: We are changing Question 19a, Social Activities, to read, “How does the
disabled person spend time with others? (check all that apply)”, with the below options:
o In person
o On the phone
o Email
o Texting
o Mail
o Social media
o Video chat (for example, Skype or Facetime)
o Other:
Justification #1: We are making this change to conform to the regulation, Removing
Inability to Communicate in English as an Education category, to reflect more modern

means of communication, and whether the person is illiterate.
SSA will implement this Change immediately upon OMB’s approval of the Final Rule for
RIN 0960-AH86.
These revisions do not affect the public reporting burden.