Request for Reconsideration--Disability Cessation

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

Sections 205(a) and (b), and 1631(c)(1)(A) and (B) of the Social Security Act, as amended, allow
us to collect this information. Furnishing us this information is voluntary. However, failing to
provide all or part may prevent us reconsideration a determination on your claim.
We will use the information to reconsider your eligibility for disability benefits. We may also
share your information for the following purposes, called routine uses:
•

To third party contacts, where necessary, to establish or verify information provided by
representative payees or representative payee applicants; and,

•

To third party contacts (including private collections agencies under contract with us), for
the purpose of their assisting us in recovering overpayments.

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 Notices
(SORN) 60-0009, entitled Hearings and Appeals Case Control System, as published in the
Federal Register (FR) on October 13, 1982, at 47 FR 45589; 60-0010, entitled Hearing Office
Tracking System of Claimant Cases, as published in the FR on January 11, 2006 at 71 FR 1806;
and 60-0089, entitled Claims Folders Systems, as published in the FR on October 31, 2019 at 84
FR 58422. Additional information, and a full listing of all of 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 13 minutes to read the instructions,
gather the facts, and answer the questions. Send only comments regarding this burden estimate
or any other aspect of this collection, including suggestions for reducing this burden to: SSA,
6401 Security Blvd, Baltimore, MD 21235-6401.