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Medical Consultant's Review of Mental Residual Functional Capacity Assessment
Medical Consultant's Review of Mental Residual Functional Capacity Assessment
OMB: 0960-0678
IC ID: 43713
OMB.report
SSA
OMB 0960-0678
ICR 200905-0960-005
IC 43713
( )
Documents and Forms
Document Name
Document Type
Form SSA-392-SUP
Medical Consultant's Review of Mental Residual Functional Capacity Assessment
Form
SSA-392-SUP Medical Consultant's Review of Mental Residual Functiona
SSA 392-SUP.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Medical Consultant's Review of Mental Residual Functional Capacity Assessment
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
20 CFR 404.1645
20 CFR 404.1520a
20 CFR 404.1640
20 CFR 404.1643
20 CFR 416.920
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-392-SUP
Medical Consultant's Review of Mental Residual Functional Capacity Assessment
SSA 392-SUP.pdf
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
256
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
45,000
0
0
0
0
45,000
Annual IC Time Burden (Hours)
9,000
0
0
0
0
9,000
Annual IC Cost Burden (Dollars)
0
0
0
0
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.