Request for Hearing By Administrative Law Judge

ICR 201907-0960-003

OMB: 0960-0269

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Supporting Statement A
2019-08-05
Supplementary Document
2019-08-01
Justification for No Material/Nonsubstantive Change
2019-07-30
ICR Details
0960-0269 201907-0960-003
Active 201902-0960-002
SSA
Request for Hearing By Administrative Law Judge
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/05/2019
Retrieve Notice of Action (NOA) 08/01/2019
  Inventory as of this Action Requested Previously Approved
11/30/2019 11/30/2019 11/30/2019
669,469 0 669,469
56,702 0 56,702
0 0 0

When SSA denies applicants' or beneficiaries' requests for new or continuing benefits, those applicants or beneficiaries are entitled to request a hearing to appeal the decision. To request a hearing, individuals use Form HA–501, the associated Modernized Claims System (MCS) or Modernized Supplemental Security Income Claims System (MSSICS) interview, or the Internet application (i501). SSA uses the information to determine if the individual filed the request within the prescribed time; is the proper party; and has taken the steps necessary to obtain the right to a hearing. SSA also uses the information to determine the individual's reason(s) for disagreeing with SSA's prior determinations in the case; if the individual has additional evidence to submit; if the individual wants an oral hearing or a decision on-the-record; and whether the individual has (or wants to appoint) a representative. The respondents are Social Security benefit applicants and recipients who want to appeal SSA's denial of their request for new or continued benefits and Medicare Part B recipients who must pay the Medicare Part B Income-Related Monthly Adjustment Amount. This is a non-substantive Change Request to update the Terms of service for the iAppeals screens.

US Code: 42 USC 1320c-4 Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 1395ff Name of Law: Social Security Act
   PL: Pub.L. 108 - 173 1350 & 931 Name of Law: Medicare Modernization Act of 2003
   PL: Pub.L. 103 - 296 105(a)(2)(B) Name of Law: Social Security Independence and Program Improvements Act
   US Code: 42 USC 405 Name of Law: Social Security Act
   PL: Pub.L. 106 - 169 251 & 809 Name of Law: Foster Care Independence Act of 1999
   US Code: 42 USC 1395r Name of Law: Social Security Act
  
None

Not associated with rulemaking

  81 FR 47845 07/22/2016
81 FR 68088 10/03/2016
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 669,469 669,469 0 0 0 0
Annual Time Burden (Hours) 56,702 56,702 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$55,000
No
    Yes
    Yes
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

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.
08/01/2019


© 2024 OMB.report | Privacy Policy