Supporting Statement for Form SSA-372
Request for Reinstatement (Title XVI)
20 CFR 416.999 - 416.999d
OMB No. 0960-0744
Justification
Introduction/Authorizing Laws and Regulations
The Social Security Administration (SSA) allows certain previously entitled individuals to request expedited reinstatement (EXR) of Supplemental Security Income (SSI) disability payments under Title XVI of the Social Security Act (Act) when their medical condition no longer permits them to perform substantial gainful activity (SGA). SSA uses Form SSA-372 to document requests for expedited reinstatement. Section 223(i) of the Act contains the authority for collecting this data. This section directs the Commissioner to provide regulations for administering the disability provisions of the law. The appropriate regulations are in 20 CFR 416.999 through 20 CFR 416.999d of the Code of Federal Regulations.
Description of Collection
SSA uses Form SSA-372 to: 1) inform previously entitled beneficiaries of the EXR requirements of SSI payments under Title XVI of the Act, and 2) to document their requests for EXR. We require this application for reinstatement of benefits for respondents to obtain SSI disability payments for EXR. When an SSA claims representative learns of individuals whose medical conditions no longer permit them to perform substantial gainful activity as defined in the Act, the claims representative gives or mails the paper form to the previously entitled individuals if they request EXR over the phone. SSA employees collect this information whenever an individual files for EXR benefits. The respondents are applicants for EXR of SSI disability payments.
Use of Information Technology to Collect the Information
SSA did not create an electronic version of Form SSA-372 under the agency’s Government Paperwork Elimination Act (GPEA) plan because only 2,000 respondents complete the form annually. This is less than the GPEA cut-off of 50,000.
Why We Cannot Use Duplicate Information
The nature of the information we collect and the manner in which we collect it preclude duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
This collection does not significantly affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently
If SSA did not use Form SSA-372 to collect this information, the agency could not ensure the requesting individuals’ awareness of the EXR requirements, nor would we know they made the choice to request EXR. This would be in violation of 20 CFR 416.999b. In addition, since SSA only collects this information on an as needed basis, we cannot collect the information less frequently. There are no technical or legal obstacles to burden reduction.
Special Circumstances
There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on October 30, 2015, at 80 FR 66967, and we received no public comments. The 30-day FRN published on January 19, 2016 at 81 FR 2938. If we receive any comments in response to this Notice, we will forward them to OMB. SSA did not consult with the public in the revision of this form.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.
Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Modality of Completion |
Number of Respondents |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Total Annual Burden (hours) |
SSA-372 |
2,000 |
1 |
2 |
67 |
The total burden for this ICR is 67 hours. This figure represents burden hours, and we did not calculate a separate cost burden.
Annual Cost to the Respondents (Others)
This collection does not impose a known cost burden to the respondents.
Annual Cost to Federal Government
The annual cost to the Federal Government is $4,620. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.
Program Changes or Adjustments to the Information Collection Request
There are no changes to the public reporting burden.
Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
Displaying OMB Approval Expiration Date
OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.
Exceptions to Certification Statement
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/msword |
| File Title | Request for Reinstatement (Title II), SSA-371 |
| Author | Tammy Farmer, OPDR, 59982 |
| Last Modified By | Lowman, Eric |
| File Modified | 2016-02-01 |
| File Created | 2015-12-14 |