Revised CCE Screen package for SSA-795 - 5-5-22

Consolidated Claims Experience (CCE) Web-based electronic version of the
SSA-795
CCE will eventually replace other
claims screens or other forms.
Therefore, the electronic SSA-795
displays the program where this
statement is being used i.e., T16 for
SSI or T2 (if for Retirement,
Disability, etc.)

This electronic version allows to
have a drop down with options to
indicate who is providing the
statement and common subjects (see
next page for drop down)

The new web-based CCE platform will
house an electronic version of the SSA-795,
which allows the SSA technician to record
the individual’s statement and obtain a
signature using either the attestation
procedure or wet signature. Once filled out,
the system will save the electronic version
as part of the claim.

This dropdown will display the
name of the claimant and also
provide an option for “other” for
situations where other individuals
provide a statement e.g., parents,
representatives, etc.

If technicians select “other” for the
individual providing the statement,
the system displays new fields to
collect:
•
•

the name of the individual
providing the statement,
their relationship to the claimant
and contact information.

The contact information is collected
here so it can be automatically
propagated to a notice/letter if they
insist on signing the statement with
“ink” i.e., wet signature. Currently
the technician has to go into a
different system and manually enter
the information.