Justification for the Non-Substantive Changes to 0960-0229

Justification for Non-Substantive Changes for Form SSA-8000BK

Application for Supplemental Security Income (SSI)

20 CFR 416.207 & 416.305-416.335, Subpart C

OMB No. 0960-0229

Background

The Social Security Administration (SSA) uses Form SSA-8000 to gather information to: (1) determine whether claimants meet all statutory and regulatory requirements for SSI eligibility; and (2) calculate SSI payment amounts. Currently, an SSA employee can fill out the form during an interview ( telephone or face-to-face) or trained third parties such as authorized representatives and advocates assisting respondents can complete Form SSA‑8000 and mail it back to SSA. At this time, trained third parties must print the blank PDF and fill it out using a pen to complete the form. As some handwriting is difficult to read, or illegible, this non-fillable version of the form is inefficient and ineffective since SSA employees who cannot read the submitted form must re-contact the respondent to get further clarification.

SSA developed a fillable, printable version of the SSA-8000, as trained third parties may find it easier to use. The fillable version allows the trained third parties to complete the form electronically using a personal computer, or other computing device, print the completed form, have the respondent (claimant) review the information, and submit it to SSA. We developed this fillable version, as we want to ensure SSA provides effective communication and remains in compliance with the requirements of 45 CFR 85.51 of the Code of Federal Regulations and section 504 of the Rehabilitation Act of 1973. We propose the fillable PDF version as a more accessible modality. In addition, the new fillable modality will improve our public service efforts.

While this fillable PDF version does not allow for electronic submission, we believe it is the first step we need to make this form more accessible to some of the respondents. We will discuss our plans for future changes when we submit the full renewal. However, as the third-party respondents have requested this initial change to a fillable PDF, we would like to implement the fillable version as soon as possible, and prior to submitting the full information collection for renewal.

Since the OMB approval for this information collection expires in December 2021, we are asking for a quick approval for this fillable PDF version.

Revisions to the Information Collection

• Change #1: SSA intends to provide Form SSA-8000 in a fillable PDF file on our Public Affairs Resource Center (PARC) website for trained third party Community Partners to utilize when assisting responders filing for SSI.

Justification #1: This change will allow the respondents to continue to print and complete the form by hand, or, alternatively, complete the form using a computing device, such as a personal computer or handheld (mobile) device, print, and submit the form to SSA for processing.

This action does not affect the public reporting burden.