Medical Consultant's Review of Psychiatric Review Technique Form

ICR 200609-0960-005

OMB: 0960-0677

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2006-09-13
ICR Details
0960-0677 200609-0960-005
Historical Inactive 200309-0960-006
SSA
Medical Consultant's Review of Psychiatric Review Technique Form
Extension without change of a currently approved collection   No
Regular
Improperly submitted and continue 12/11/2006
Retrieve Notice of Action (NOA) 09/14/2006
  Inventory as of this Action Requested Previously Approved
10/31/2006 36 Months From Approved 12/31/2006
68,000 0 68,000
13,600 0 13,600
0 0 0

SSA measures the performance of the State Disability Determination Services (DDSs) in the area of quality of documentation and determinations on claims. In mental claims, a Psychiatric Review Technique form (PRTF) is completed by the DDS medical/psychological consultant (MC/PC). Form SSA-3023 is used by the regional review component to facilitate the MC/PC review of the PRTF. The MC/PC completes an SSA-3023 only when adjudicating component's PRTF is in the file. An SSA-3023 is required for each PRTF. In this way, Form SSA-3023 is used by the regional review component to facilitate SSA's medical/psychological consultants' review of the PRTF for quality purposes. The respondents are MC/PCs who review the Psychiatric Review Technique Form for quality purposes.

US Code: 42 USC 421 Name of Law: null
   US Code: 42 USC 1383b Name of Law: null
  
None

Not associated with rulemaking

  71 FR 34181 06/13/2006
71 FR 53485 09/11/2006
No

No
No
The decrease in the annual burden hours is a result of recalculating the incidence of mental disability claims based on current 2005 fiscal year statistical data.

$1,198,396
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Elizabeth Davidson 411-965-0454 liz.davidson@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.
09/14/2006


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