The basic Social Security disability
benefits application form (cleared under OMB No. 0960-0618)
contains a lead question asking if the applicant cared for their
own or their spouse’s children under age 3, and had no earnings
during that period. If the answer is yes, the applicant completes
Form SSA-4162 (either on paper or through a Social Security
Administration (SSA) claims representative (CR) during a personal
interview). SSA uses the information to determine if the applicant
qualifies for the child-care exclusion. For the modernized claims
system (MCS) application version, the beneficiary provides the
information verbally to the SSA CR during a personal interview, and
the CR inputs the information directly into the MCS application.
The CR prints the MCS application for the beneficiary to verify and
sign. Respondents are applicants for Title II disability
benefits.
US Code:
42
USC 415 Name of Law: Social Security Act
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.