Continuing Disability Review Report

Forms and Documents

Document Name	Status
Form SSA-454-BK SSA-454-BK, Continuing Disability Review Report - Full Paper Version Form	Modified
Supporting Statement - 0072.docx Supporting Statement A	2020-03-26
Addendum - 0072.docx Supplementary Document	2020-03-26

IC Document Collections

IC ID	Document Title	Status
9017	SSA-454-BK, Continuing Disability Review Report - Full Paper Version Form	Modified
189923	EDCS Screens/Interview - Full Version Other-Internal Use Screens	Modified

ICR Details

OMB Control No: 0960-0072	ICR Reference No: 201912-0960-003
Status: Received in OIRA	Previous ICR Reference No: 201609-0960-009
Agency/Subagency: SSA	Agency Tracking No:
Title: Continuing Disability Review Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/26/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2021
Responses	541,000	541,000
Time Burden (Hours)	541,000	541,000
Cost Burden (Dollars)	0	0

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Abstract: SSA uses Form SSA-454-BK, Continuing Disability Review Report to complete a mandatory review for the continue disability review (CDR). SSA considers adults eligible for payment if they continue to be unable to do substantial gainful activity because of their impairments, and we consider Title XVI children eligible for payment if they have marked and severe functional limitations because of their impairments. SSA also use the Form SSA-454-BK to obtain information on sources of medical treatment; participation in vocational rehabilitation programs (if any); attempts to work (if any); and if individuals believe their conditions are improved. When a disabled individual requires a CDR, a claims representative (CR) will mail Form SSA-454-BK, the respondent completes the form and sends it back to SSA, or the CR will interview the respondent and enters the information into the Electronic Disability Collection System (EDCS). EDCS electronically stores the information of the paper version of Form SSA-454-BK. The respondents are Title II or Title XVI disability recipients or their representatives.

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Authorizing Statute(s): US Code: 42 USC 421 Name of Law: Social Security Act
   US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 423 Name of Law: Social Security Act
   US Code: 42 USC 1382c Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 1383b Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 70610	12/23/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 17155	03/26/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
SSA-454-BK, Continuing Disability Review Report - Full Paper Version	SSA-454-BK	Continuing Disability Review Report
EDCS Screens/Interview - Full Version

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ICR Summary of Burden

	Total Request	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	541,000	541,000	0	0	0	0
Annual Time Burden (Hours)	541,000	541,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $14,465,629

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/26/2020

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