Supporting Statement - 0618

Supporting Statement for Social Security Benefits Application:

Form SSA-1: Application for Retirement Insurance Benefits

Form SSA-2: Application for Wife’s or Husband’s Insurance Benefits

Form SSA-16: Application for Disability Insurance Benefits

Internet Claim (iClaim) Application Screens

Internet Appointment (iAppointment) Application Screens

20 CFR 404.310-404.311, 404.315-404.322, 404.330-404.333, 404.601-404.603, and 404.1501-404.1512

OMB No. 0960-0618

1. Justification

1. Introduction/Authoring Laws and Regulations

The Social Security Administration (SSA) provides Retirement, Survivors, and Disability benefits to members of the public who meet the required eligibility criteria, and who file the correct application (as per Sections 202(b)-(c) and 223(a) of the Social Security Act (Act) and Sections 20 CFR 404.310-404.311, 404.315-404.322, 404.330-404.333,

404 .601-404.603, and 404.1501-404.1512 of the Code of Federal Regulations. SSA also provides Supplemental Security Income (SSI) for the disabled to members of the public who meet the required eligibility criteria and who file the correct application (as per Section 1631(e)(1) of the Act and CFR 416.305-416-335.

In this Information Collection Request (ICR), SSA is expanding iClaim’s application base by adding the SSI application for disability to iClaim. We are also modifying existing iClaim functions in preparation of upcoming system enhancements.

2. Description of Collection

SSA uses the information we gather through the multiple information collection tools in this ICR to determine applicants’ eligibility for specific Social Security benefits, as well as the amount of the benefits. Individuals filing for disability benefits can, and in some instance SSA may require them to, file applications under both Title II, Social Security disability benefits, and Title XVI, SSI payments. We refer to disability applications filed under both titles as “concurrent applications.” This collection comprises the various application methods for each type of benefit. These methods include the following modalities: Paper forms (Forms SSA-1, SSA-2, and SSA-16); Modernized Claims System (MCS) screens for in-person interview applications; and Internet-based iClaim and iAppointment applications. SSA uses the information we collect through these modalities to determine: (1) The applicants’ eligibility for the above-mentioned Social Security benefits, and (2) the amount of the benefits. Currently, individuals cannot use iClaim to file a concurrent application because the SSI application is not available in iClaim. They must use one of two modalities when applying for SSI; 1) a paper application (Form SSA-8001-BK), or (2) a field office interview, during which SSA employees enter applicant data directly into the Modernized SSI Claims System (MSSICS). We cover these SSI modalities under OMB No. 0960-0444. Individuals who use iClaim to file for Social Security disability and want to file for SSI must visit or call a field office (FO) to file an application for SSI disability. The FO will defer sending the disability claim to the Department of Disability Services DDS until they are able to obtain the SSI application. This process extends the amount of time it takes to obtain a medical determination. In this ICR, we are adding a new path to iClaim that enables the electronic filing of a concurrent disability application (see Addendum for more details).

The following is a list and description of these information collection instruments:

Paper Application Forms:

SSA-1 – Application for Retirement Insurance Benefits: SSA uses Form SSA-1 to determine individuals’ entitlement to retirement insurance benefits. When individuals file for Medicare-only with a paper application, we rename it the “Application for Hospital Insurance” with pen-and-ink changes, and collect only the information needed for hospital insurance.

SSA-2 – Application for Wife’s or Husband’s Insurance Benefits: SSA uses Form

SSA-2 to determine individuals’ entitlement to their spouses’ insurance benefits.

SSA-16 – Application for Disability Insurance Benefits: SSA uses Form SSA-16 to determine individuals’ entitlement to Disability Insurance benefits under Title II of the Act.

SSA makes paper copies of these forms available in field offices; however, since the applications are also part of iClaim, we do not make the paper forms available on our website.

In-person interview/MCS & MSSICS Screens:

The MCS and MSSICS screens mirror the paper application formats using an electronic collection method. Guided by the MCS and MSSICS collection screens, an SSA representative interviews the applicant and inputs the information directly into SSA’s application database. MCS and MSSICS prompt the representative with the required questions based on the type of application the applicant files, and the applicant’s initial responses. MCS and MSSICS also propagate information to other screens in the application. In contrast to the paper application, the in-person interview/MCS or MSSICS process offers the following advantages: (1) it improves accuracy in recording responses; (2) it reduces the overall interview time; and (3) it reduces the number of times we have to re-contact applicants to clarify responses.

Internet Claim (iClaim) Application:

iClaim is an online platform that applicants use to apply for several types of Social Security benefits. In this ICR, SSA is adding SSI disability benefits to iClaim. Depending on their initial answers, iClaim presents applicants with different screens, ensuring they only respond to relevant questions. After completing the online application, claimants, or their third-party representatives, can submit the answers electronically to SSA. iClaim is more convenient for users and reduces their application completion time by eliminating the need for a field office visit. This also saves time and resources for SSA.

There are two ways to complete and submit iClaim:

• First-party iClaim respondents are beneficiaries who complete and submit the entire application online on their own behalf. They may have to submit supplementary supporting documents (e.g., medical evidence for disability benefits applications) to finalize their application.

• Third-party iClaim respondents are representatives of claimants who complete iClaim on behalf of the claimants. Once these third parties submit the online iClaim application, SSA sends application summaries and confirmation notices (included in our online ICR) to the Third parties, or claimants, whom they represent. The claimants must sign the application summary confirming the information and submit it to SSA. Once SSA receives the application summary, and any supplementary information if necessary, we can process the application.

In this ICR, SSA is adding a new function to iClaim which converts an application for Social Security disability benefits into a concurrent application (i.e. adding SSI disability to the Social Security disability application) when a qualified applicant selects “yes” to the intent to file for SSI question. We are also removing and adding one question, providing a new Privacy Act Statement specific to iClaim, adding and revising messages, and revising closeout language (see Addendum for further information).

Currently, the public has the option to complete benefit applications in Spanish through iClaim. The future system enhancements we are planning for iClaim require interaction with different applications that are not compatible with the Spanish version. Therefore, we are removing the ability to create an iClaim in Spanish. Applicants who have already started a Spanish iClaim will still have the ability to update and submit their claim. In response to this removal, we are providing individuals who wish to file their application in Spanish, or any other foreign language, the ability to schedule an appointment in the language of their choice through iAppointment (see Addendum).

Internet Appointment (iAppointment) Application:

iAppointment is an online process that allows members of the public an easy-to-use method to schedule an appointment in the servicing office of their choice. Since the application date can affect when a claimant’s benefit begins, iAppointment establishes a protective filing date and provides respondents information related to the date by which they must file their actual application.

Currently, we offer iAppointment to individuals who attempt, but are unable to establish, an iClaim application because they failed the initial verification checks. In this ICR, we are adding a link to iAppointment for iClaim applicants whose reading language preference is other than English.

The iAppointment application propagates information the applicant already entered into iClaim for SSN, name, date of birth, and gender. However, applicants must provide minimal additional information: mailing address; telephone number; language preference; type of appointment (Disability, Retirement, Medicare); and whether they prefer a telephone interview or in-office appointment. iAppointment is a

customer-centric application.

If the available appointment times do not meet the customer’s needs, iAppointment allows them to enter a different zip code to identify another field office, which may offer different appointment times. At this time, SSA only allows domestic first party applicants, or third parties applying for individuals who are sitting with them to use iAppointment. If users indicate they are filing as third parties, iAppointment provides a message directing them to call the National 800 Number for assistance. If a foreign first party user is unable to complete iClaim, iAppointment directs them to contact a Social Security representative, and provides a link to SSA’s Service Around the World website.

The respondents are applicants for retirement, survivors, and disability benefits under Title II of the Act, their representatives, and in some instances, applicants for SSI payments or their representatives who are requesting to file for SSI through iClaim.

3. Use of Information Technology to Collect the Information

In accordance with the agency’s Government Paperwork Elimination Act plan, SSA created electronic versions of these information collections (specifically, MCS, MSSICS, and iClaim) under the agency’s Government Paperwork Elimination Act plan. Based on our data, we estimate approximately 94% of respondents under this OMB number use the electronic versions.

4. 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 any other collection instrument to gather the data we are collecting here.

5. Minimizing Burden on Small Respondents

This collection does not significantly affect small businesses or other small entities.

6. Consequence of Not Collecting Information or Collecting it Less Frequently

If SSA did not collect this information, the public would have no way to apply for Social Security benefits. Because we only collect the information once, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.

7. 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.

8. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on September 12, 2016, at

81 FR 62788, and we received no public comments. The 30-day FRN published on November 17, 2016 at 81 FR 81224. If we receive any comments in response to this Notice, we will forward them to OMB.

9. Payment or Gifts to Respondents

SSA provides no payments or gifts to the respondents.

10. Assurances of Confidentiality

SSA protects and holds confidential the information we are requesting 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. Additionally, SSA protects and holds confidential the information it receives by adhering to our Internet Privacy Policy, which stipulates:

• The public does not need to give us personal information to visit our site;

• We collect personally identifiable information (name, SSN, DOB or e-mail) only if we know beneficiaries or their representatives provided it;

• We only use personal identifying information in conjunction with services beneficiaries requested at the time they submitted the information to us;

• We sometimes perform statistical analyses of user behavior in order to assess customer interest in the various areas of our site. We will disclose this information to third parties only in aggregate, never specific form;

• We never give, sell, or transfer any personal information to a third party.

We also take the following measures to ensure the confidentiality of applicants’ personal information:

• We encrypt all electronic requests using the Secure Socket Layer (SSL) security protocol. SSL encryption prevents a third party from reading the transmitted data even if they intercept any data. This protocol is an industry standard used by banks such as Wells Fargo and Bank of America for Internet banking;

• We give applicants adequate warnings that the Internet is an open system, and there is no absolute guarantee others will not intercept and decrypt the personal information the applicants submitted. We advise applicants about alternative methods of requesting personal information, i.e., personal visit to a field office or a call to the 800 number;

• We will only allow requestors access to additional screens used for making changes to personal information or requests to SSA once we verify requestor identity.

11. Justification for Sensitive Questions

The information collection does not contain any questions of a sensitive nature.

12. Estimates of Public Reporting Burden

Below we provide annual burden estimates for the multiple components of this information collection:

Form SSA-1

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
MCS/Signature Proxy	2,793,597	1	10	465,600
Paper	115,678	1	11	21,208
Medicare Only MCS	880,763	1	7	102,756
Medicare Only Paper	9,549	1	7	1,114
Totals	3,799,587			590,678

Form SSA-2

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
MCS/Signature Proxy	518,598	1	14	121,006
Paper	54,661	1	15	13,665
Totals	573,259			134,671

Form SSA-16

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
MCS/Signature Proxy	2,483,952	1	19	786,585
Paper	116,294	1	20	38,765
Totals	2,600,246			825,350

iClaim Screens

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
iClaim 3rd Party	345,267	1	15	86,317
iClaim Applicant after 3rd Party Completion	345,267	1	5	28,772
First Party iClaim Domestic Applicant	2,956,208	1	15	739,052
First Party iClaim Foreign Applicant	11,650	1	3	583
Medicare-only iClaim	723,062	1	10	120,510
Totals	4,381,454			975,234

iAppointment Screens

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
iAppointment	20,218	1	10	3,370

Grand Total

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Annual Burden (hours)
Total	11,374,764			2,529,303

The total burden for this ICR is 2,529,303 hours. This figure represents burden hours, and we did not calculate a separate cost burden.

13. Annual Cost Burden to the Respondents (Other)

This collection does not impose a known cost burden to the respondents.

14. Annual Cost To Federal Government

The annual cost to the Federal Government is approximately $61,490,378. This figure represents the cost for printing paper forms, salaries for the SSA representatives who conduct field office interviews with benefits applications, and the cost of making changes to and maintaining the iClaim system.

15. Program Changes or Adjustments to the Information Collection Request

The increase in burden hours stems from an increased number of respondents for all collection methods. The figure reported in 2013 was an estimate. In this ICR, we were able to obtain the actual number of respondents for FY 2015 and adjusted our figure accordingly. Because we are adding the SSI application to a pre-existing first or third party Social Security disability iClaim, and the number of questions for a concurrent application in iClaim remains the same we do not anticipate any changes to the iClaim burden information. We will also capture any changes to the SSA-8001 burden information under OMB No. 0960-0444.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

17. Displaying the OMB Approval Expiration Date

Paper Forms

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.

Internet-Based Applications:

SSA is not requesting an exception to the requirement to display the OMB approval expiration date .

18. Exception 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).

2. Collection of Information Employing Statistical Methodologies

This information collection does not use statistical methods.

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