Notice Regarding Substitution of Party Upon Death of Claimant

ICR 202107-0960-009

OMB: 0960-0288

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2021-07-30
Supporting Statement A
2021-09-30
IC Document Collections
ICR Details
0960-0288 202107-0960-009
Received in OIRA 201807-0960-010
SSA
Notice Regarding Substitution of Party Upon Death of Claimant
Revision of a currently approved collection   No
Regular 09/30/2021
  Requested Previously Approved
36 Months From Approved 10/31/2021
4,000 4,000
333 333
0 0

An ALJ may dismiss a request for a hearing on a pending claim of a deceased individual for Social Security benefits or Supplemental Security Income (SSI) payments. Individuals who believe they may be adversely affected by the dismissal may ask to be a substitute party for the deceased claimant by completing Form HA-539. The ALJs and the hearing office support staff use this form to (1) maintain a written record of the request; (2) establish the relationship of the requester to the deceased claimant; (3) determine the substituted individual's wishes regarding an oral hearing or decision on the record; and (4) admit the data into the claimant's official record as an exhibit. The respondents are individuals requesting to be a substitute party for a deceased claimant.

US Code: 42 USC 405 Name of Law: Social Security Act
   US Code: 42 USC 1383 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  86 FR 40221 07/27/2021
86 FR 54007 09/29/2021
No

1
IC Title Form No. Form Name
Notice Regarding Substitution of Party Upon Death of Claimant HA-539 Notice Regarding Substitution of Party Upon Death of Claimant

  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 4,000 4,000 0 0 0 0
Annual Time Burden (Hours) 333 333 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$15,017
No
    No
    Yes
No
No
No
No
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/30/2021


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