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pdfSSA will insert the following revised Privacy Act Statement into the form as soon
as possible:
Privacy Act Statement
Collection and Use of Personal Information
Sections 225(b)(2) and 1631(a)(6) of the Social Security Act, as amended, allow us to collect this
information. Furnishing us this information is voluntary. However, failing to provide all or part
of the information may prevent us from determining the beneficiary’s continued eligibility for
benefits.
We will use the information to determine if the beneficiary who is enrolled in a vocational
rehabilitation or other job-training program is eligible to continue to receive benefits even if their
disability has ceased. We may also share the information for the following purposes, called
routine uses:
1. To Federal, State, or local agencies (or agents on their behalf) for administering cash or
non-cash income maintenance or health maintenance programs (including programs
under the Act); and,
2. To contractors or other Federal agencies, as necessary, for the purpose of assisting the
Social Security Administration (SSA) in the efficient administration of its programs.
In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notices
(SORNs) 60-0050, entitled Completed Determination Record – Continuing Disability
Determinations; 60-0089, entitled Claims Folders System; 60-0221, entitled Vocational
Rehabilitation Reimbursement Case Processing System; and 60-0320, entitled Electronic
Disability (eDib) Claim File. Additional information and a full listing of all our SORNs are
available on our website at www.socialsecurity.gov/foia/bluebook.
File Type | application/pdf |
File Title | Microsoft Word - (FINAL) SSA-4290-F5 Privacy Act Statement (002) |
Author | 868865 |
File Modified | 2016-12-06 |
File Created | 2016-12-06 |