Request for Accommodation in Communication Method

ICR 201312-0960-015

OMB: 0960-0777

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2013-12-23
ICR Details
0960-0777 201312-0960-015
Historical Active 201304-0960-011
SSA
Request for Accommodation in Communication Method
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/13/2014
Retrieve Notice of Action (NOA) 12/23/2013
  Inventory as of this Action Requested Previously Approved
11/30/2016 11/30/2016 11/30/2016
529,779 0 1,417
88,532 0 472
0 0 0

SSA supplies a designated telephone number allowing Social Security applicants, beneficiaries, recipients, and representative payees who are blind or visually-impaired to tell SSA which of the following seven methods of communication they want SSA to use when it sends them benefit notices and other related communications: (1) standard print notice by first class mail, (2) standard print mail with a follow-up telephone call, (3) certified mail, (4) Braille, (5) Microsoft Word file on data compact disk (CD), (6) large print (18-point font) or (7) audio CD. However, respondents who want to receive notices from SSA through a communication method other than the seven methods listed above use Form SSA-9000 to: (1) describe the type of accommodation they want, (2) disclose their condition necessitating the need for a different type of accommodation, and (3) explain why none of the seven methods described above are sufficient for their needs. SSA uses Form SSA-9000 to determine, based on applicable law and regulation, whether to grant an individual's request for an accommodation based on their blindness, other visual impairment, and as applicable, another disabling condition. SSA collects this information electronically through either an in-person interview or a telephone interview during which the SSA employee keys in the information on Intranet screens. The respondents are Social Security applicants, beneficiaries, recipients, and representative payees who are blind or visually impaired and who ask SSA to send notices and other communications in an alternative method besides the seven modalities we described above. This is a non-substantive Change Request to expand the scope of this information collection to include accommodations for individuals with all impairments or disabilities, and to add a new collection instrument.

US Code: 29 USC 794 Name of Law: Section 504 of the Rehabilitation Act
  
None

Not associated with rulemaking

  78 FR 36291 06/17/2013
78 FR 54363 09/03/2013
No

2
IC Title Form No. Form Name
Section 504 SharePoint Tracker Automated System
Request for Accommodation in Communication Method SSA-9000-F6 Request for Accommodation

  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 529,779 1,417 0 528,362 0 0
Annual Time Burden (Hours) 88,532 472 0 88,060 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
We are expanding the scope for this information collection, and adding a new modality, both of which increase the public reporting burden.

$60,000
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.
12/23/2013


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