Request for Reconsideration--Disability Cessation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0349 can be found here:

Documents and Forms

Document Name Document Type
Form SSA-789 Request for Reconsideration--Disability Cessation Form
Revised PA & PRA Statements.pdf www.ssa.gov Other-Revised PA & PRA Statements
SSA-789 Request for Reconsideration--Disability Cessation SSA-789 - Revised.pdf www.ssa.gov Form
SSA-789 - Current.pdf SSA-789 - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Reconsideration--Disability Cessation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.909 20 CFR 416.1409

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-789	Request for Reconsideration--Disability Cessation	SSA-789 - Revised.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Revised PA & PRA Statements			Revised PA & PRA Statements.pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 49,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	49,000	19,000	30,000
Annual IC Time Burden (Hours)	10,617	4,117	6,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-789 - Current	SSA-789 - Current.pdf	06/23/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.