Authorization to Disclose Information to the Social Security Administration

ICR 201104-0960-003

OMB: 0960-0623

Federal Form Document

ICR Details
0960-0623 201104-0960-003
Historical Active 200806-0960-010
SSA
Authorization to Disclose Information to the Social Security Administration
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/27/2011
Retrieve Notice of Action (NOA) 04/08/2011
  Inventory as of this Action Requested Previously Approved
11/30/2011 11/30/2011 11/30/2011
4,829,651 0 16,001,944
722,330 0 864,329
0 0 0

SSA must obtain sufficient medical evidence to make eligibility determinations for title II and title XVI payments. Therefore, the applicant must authorize their medical source(s) to release the information to SSA. The applicant may use form SSA-827 to provide consent for the release of information. Generally, the State DDS completes the form(s) based on information provided by the applicant, and sends the form(s) to the designated medical source(s).

US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 423 Name of Law: Social Security Act
   US Code: 42 USC 1382c Name of Law: Social Security Act
   US Code: 42 USC 405 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  73 FR 40005 07/11/2008
73 FR 53919 09/17/2008
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,829,651 16,001,944 0 -11,561,784 389,491 0
Annual Time Burden (Hours) 722,330 864,329 0 -192,696 50,697 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
SSA is reducing the burden by eliminating the need for three of the four signed SSA-827s (see the Justification for the Non-Substantive Changes). In addition, due to an increase in respondents, we increased the overall burden for the SSA-827. We also increased the burden for reading the Internet explanation of the SSA-827 as our data shows more people using the Internet to read the instructions for the form.

$23,740,196
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@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.
04/08/2011


© 2024 OMB.report | Privacy Policy