Addendum to the Supporting Statement for 0960-0052

Addendum to supporting Statement

Form SSA-3826, Medical Report (General)

20 CFR 404.1512-404.1515 and 416.912-.416.915

OMB No. 0960-0052

Revisions to the Collection Instrument

Change 1: We are revising the language on page 3, Part III-LABORATORY AND SPECIAL STUDIES by removing the initial capitalization from all but the first word.

Old Language:

Give Results of all Pertinent Studies With Dates.

New Language:

Give results of all pertinent studies with dates.

Justification

To conform to the Government Printing Office style manual rules.

Change 2: We are revising the language in the parenthesis on page 3, Part III-LABORATORY AND SPECIAL STUDIES by deleting language in the section and removing apostrophes from the sentence.

Old Language:

(In the case of ECG’s and PFS’s please attach a copy of the tracing or a detailed description thereof

New Languge:

(In the case of ECGs and PFSs please attach a copy of the tracing.)

Justification 2

When studies include an electrocardiogram(s) (ECGs) or pulmonary function study(ies) (PFSs), we need a copy of the tracing(s). We cannot accept a detailed description of the test results in lieu of the actual tracing. We also deleted the apostrophe in ECGs and PFSs to conform to the Government Printing Office style manual rule for use of apostrophes. The intent is to refer to multiples of the tests.

Most of the changes we are making merely bring the language on the form into compliance with the way in which people use the form. However, we can continue using the current form until the next scheduled reprinting.

Minor Revisions to the Collection Instrument

SSA is making the following revisions:

We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.

SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on the first page of the form.