Justification for the Non-Substantive Changes to 0960-0144

Justification for Non-Substantive Changes for i3441

20 CFR 404.1512 & 416.912, 20 CFR 404.916(c) & 416.1416(c), and

20 CFR 405, Subpart C & 20 CFR 422.140

OMB No. 0960-0144

Background

SSA conducted an American Customer Satisfaction Index (ACSI) Insight Review Survey. The survey revealed that respondents found certain introductory and instructions screens within iAppeals confusing and redundant. To resolve this issue, we made some language updates that reduce and clarify instructions and create a central location for navigational and informational instructions. The updates do not affect the current paper information collection instruments associated with iAppeals, in that respondents will not have to provide any additional information in order to complete an appeal request through iAppeals.

Description of iAppeals

iAppeals is an internet application available on Social Security’s official website. It allows respondents to request a reconsideration or hearing on a title II or title XVI medically denied claim. Respondents complete an appeal request by completing and submitting the i561 (Request for Reconsideration) or i501 (Request for Hearing by Administrative Law Judge) as appropriate, and completing the i3341 (Disability Report - Appeal).

Proposed the Changes

Changes to the iAppeals application are listed in the below tables.

Deleted 3441Screens
Screen Number	Screen Name
ap002	About this Internet Appeal Process
ap007	How this Internet appeal request works
ee004	How the online Appeal Disability Report works
ay012	About you: end of part 1
mh001	Medical history: introduction
mh021	Medical history: summary
mh022	Medical history: end of part 2
rs006	Review and send: print your medical release form
rs009	Confirmation
msg023	How the online Disability Report works
msg041	About your notice and claim numbers
msg004	Internet security policy

3441 Screen Updates
Screen Number	Screen Name	Change	Justification
ay001	About you: general information	Streamlined language – See page 1 of current screen package and page 19 of new screen package Renamed heading from “Disability Report – Appeal” to “Disability Appeal” Added “Sign Off (finish later) button Renamed “Continue” button to “Next” Links added – Privacy act Statement and the Paperwork Reduction Act Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly. The Paper Work Reduction Act and Privacy Act Statement is linked to the actual collection instrument which makes it more convenient for users
ay001	About you: general information – fillable (conditional)	Streamlined language – See page 1 of current screen package and page 20 of new screen package Renamed heading “Disability Report - Appeal” to “Disability Appeal” Added “Sign Off(finish later)” button Renamed “Continue” button to “Next” Links added –Privacy Act Statement and the Paperwork Reduction Act Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly. The Paper Work Reduction Act and Privacy Act Statement is linked to the actual collection instrument which makes it more convenient for users
ay002	Print your reentry number (conditional)	Streamlined language – See page 2 of current screen package and page 21 of new screen package number Renamed heading “Disability Report - Appeal” to “Disability Appeal” Added “Sign Off(finish later)” button Renamed “Continue” button to “Next” Increased the reentry number text box and the font size of the reentry Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly. The reentry number is more prominent and clearly visible for users
ee011	Sign off	Streamlined language – See page 3 of current screen package and page 22 of new screen package number Renamed “Disability Report - Appeal” heading to “Disability Appeal” Rename subheading from “Sign Off” to “Are you sure you want to sign off?” Renamed “Return to Report” button to “No, Return to Appeal” Renamed “Sign Off “ button to “Yes, I want to Sign Off” Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly. The reentry number is more prominent and clearly visible for users
ee009	Welcome back	Streamlined language – see page 5 of current screen package and page 23 of the new screen package Renamed heading from “Disability Report - Appeal” to “Disability Appeal” Renamed “Continue” button to “Next” Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly. The reentry number is more prominent and clearly visible for users
rs001	Review and send: summary	Streamlined language – see page 6 of current screen package and page 24 of the new screen package Renamed “Disability Report - Appeal” heading to “Disability Appeal” Renamed “Continue” button to “Next” Added “Sign Off(finish later)” button Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly.
rs002	Review and send: additional remarks about your case	Streamlined language – see page 16 of current screen package and page 25 of the new screen package Renamed heading from “Disability Report - Appeal” to “Disability Appeal” Renamed subheading from “Review and send: additional remarks about your case” to “Review and send: additional remarks” Added “Sign Off(finish later)” button Renamed “Continue” button to “Next” Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly.
rs003	Review and send: send this report	Streamlined language – see page 19 of current screen package and page 26 of the new screen package Renamed heading from “Disability Report - Appeal” to “Disability Appeal” Renamed subheading from “Review and send: send this report” to “Review and send: submit this appeal” Added “Sign Off(finish later)” button Renamed “Send” button to “Submit” Changed the footer link from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly.
rs004	Review and send: additional forms we need	Streamlined language – see page 20 of current screen package and page 25-31 of the new screen package New screen name: Confirmation and printing (Reconsideration, 1st party & 3rd party; Hearing, 1st party, did not waive right to appear; Hearing, 3rd party, waived right to appear; Longest possible version) Links added – Cover Sheet, Medical Release Form and instructions, downloading and printing PDF documents, and Contact Us Renamed “Continue” button to “Finish”	The streamlined language is more personal and user friendly Reduced numerous pages Links are dynamic depending on user’s input
msg080	Receipt for disability appeal report	Replaced pages ap010hr & ap010rc	The streamlined language is more personal and user friendly Reduced 2 pages This page is a link on the confirmation page
msg081	Cover Sheet (Reconsideration, 1st party & 3rd party; Hearing, 1st party, did not waive right to appear; Hearing, 3rd party, waived right to appear; Longest possible version)	Replaced page rs005	The streamlined language is more personal and user friendly This page is a link on the confirmation page
msg007	Checklist: information you will need	New page	This is a link on the welcome page The checklist provides users with a list of information they will need to complete the application
msg022	Tips for using this website	Renamed from “How to Move Around This Report” to “Tips for Using this Website”	The streamlined language is more personal and user friendly The information identifies specific areas the user may need on using the website
msg040	What is my notice date?	Streamlined language – see page 24 of current screen package and page 40 of the new screen package Added watermark “SAMPLE”	The streamlined language is more personal and user friendly The watermark signifies the webpage is an example notice The information points out the notice date required to complete the application
msg041	About your notice	Streamlined language – see page 25 of current screen package and page 41 of the new screen package Renamed subheading from “About your notice and claim numbers” to “About your notice” Removed the “Notice of Federal Reviewing Official Decision” bullet	The streamlined language is more personal and user friendly The information points out what type of notice is required to complete the application The “Notice of Federal Reviewing Official Decision” no longer exists
msg043	About your claim number	New page	The information points out the claim number that is required to complete the application
msg046	If you do not want to use this online appeal process	Streamlined language – see page 26 of current screen package and page 43 of the new screen package Renamed subheading from “If you do not want to use this online appeal process” to “Other ways to complete a disability appeal”	The streamlined heading is more personal and user friendly
msg048	Submitting additional evidence	Streamlined language – see page 27 of current screen package and page 44 of the new screen package Renamed subheading from “Submitting additional evidence” to “ Submitting additional medical evidence”	The streamlined heading is more personal and user friendly It specifies the additional evidence is for medical purposes

Revised Burden Information

Form	Number of Respondents	Response Time	Number of Burden Hours
i3441 (Internet Form)	417,268	28 minutes	194,725

The above burden reflects a decrease in response time due to the revised introductory and instructional screens.

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