Disability Update Report (Mail-in process)

Disability Update Report

Documents and Forms

Document Name Document Type
Form SSA-455 Disability Update Report (Mail-in process) Form and Instruction
Form SSA-455 Disability Update Report (Mail-in process) Form and Instruction
SSA-455 Disability Update Report SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf Form and Instruction
SSA-455 Disability Update Report SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf Form and Instruction
SSA-455 Disability Update Report SSA-455 (Revised Version).pdf www.ssa.gov Form and Instruction
SSA-455 Disability Update Report SSA-455 (Revised Version).pdf www.ssa.gov Form and Instruction
SSA-455-OCR-SM Disability Update Report (scannable version) SSA-455-OCR-SM (Revised Version).pdf Form and Instruction
SSA-455-OCR-SM Disability Update Report (scannable version) SSA-455-OCR-SM (Revised Version).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Disability Update Report (Mail-in process)	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 416.988-.996 20 CFR 404.1589-1595

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-455	Disability Update Report	SSA-455 - Revised (Fillable and Submittable for COVID-19 Situation).pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-455	Disability Update Report	SSA-455 (Revised Version).pdf	www.ssa.gov	No		Paper Only
Form and Instruction	SSA-455-OCR-SM	Disability Update Report (scannable version)	SSA-455-OCR-SM (Revised Version).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,299,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,299,900	1,299,900
Annual IC Time Burden (Hours)	324,975	324,975
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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