Justification for Non-Substantive Changes to 0960-0618

Justification for Non-Substantive Changes for

Social Security Benefits Applications:

Form SSA-1: Application for Retirement Insurance Benefits

Form SSA-2: Application for Wife’s or Husband’s Insurance Benefits

Form SSA-16: Application for Disability Insurance Benefits

20 CFR 404.310-404.311, 404.315-404.322, 404.330-404.333,

404.601-404.603, and 404.1501-404.1512

OMB No. 0960-0618

Background

The Social Security Administration (SSA) provides Retirement, Survivors, and Disability benefits to members of the public who meet the required eligibility criteria, and who file an application (as per Sections 202(b)-(c) and 223 (a) of the Social Security Act (Act) and Sections 20 CFR 404.310-404.311, 404.315-404.322, 404.330-404.333, 404.601-404.603, and 404.1501-404.1512 of the Code of Federal Regulations). The public can apply for the appropriate benefit type using one of three modalities: 1) filling out a paper application; 2) filing via a technician at the field office or telephone interview; or

3) filing online via internet (i.e., iClaim). Third-parties can also use any of these modalities to apply for an individual who meets the required eligibility criteria and needs assistance filing an application. When a third-party submits an application using any of these modalities, and additional information is needed, SSA technicians contact the individual to complete the application process via telephone interview.

SSA also administers the Supplemental Security Income (SSI) program. Applicants filing an application for Retirement, Survivors, or Disability benefits can also notify us of their intent to file for SSI payments. In this situation, technicians obtain additional information to complete an application for SSI payments (as per Section 1631(e)(1) of the Act and 20 CFR 416.305-416.335) using the SSI application (OMB #0960-0229).

Individuals using the iClaim modality can also provide information for the SSI application if they meet certain criteria for online filing.

Justification for Non-Substantive Changes to the Collection

We are removing the obsolete questions about the sex of the claimant from the paper SSA-1, SSA-2 and SSA-16 forms to align with our 2012 policy changes for identity verification for benefit application purposes. In support of Executive Order (EO) 13988, “Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation,” we are revising the iClaim screens that third-parties complete to replace gender-specific pronouns. We will continue to revise our forms and systems in support of the EO as we secure the required resources. In addition, we are updating some of the iClaim screens in support of other systems updates that interact with iClaim.

Revisions to Paper Forms SSA-1, SSA-2, and SSA-16

• Change #: We are removing the questions that collect the sex of the claimant from the benefit application forms.

Justification #1: We are removing obsolete questions about the sex of the claimant to align the form with our 2012 policy changes for identity verification which no longer require us to collect this information as part of the core identity factors.

Note: the agency still needs to collect this information from the claimant for medical evaluation purposes on agency medical forms. SSA will assess the requirements for collecting this information for medical purposes and will submit the required OMB clearance package(s) for the applicable information collection tool(s) to request approval.

• Change #2: We are removing the reference to the “Retirement Estimator” (RE) on the “Changes to Report” page of the SSA-1 Application for Retirement Insurance Benefits and replacing it with the “Retirement Calculator.”

Justification #2: We are removing the Retirement Estimator (RE) tool (OMB #0960‑0596) effective September 2022 and members of the public will be directed to their “my Social Security” account to use the secured Retirement Calculator to obtain an estimate online.

Revisions to iClaim Screens

• Change #1: We are revising the language in the Terms of Service screen and replacing the link to the Privacy Act Statement page with a link to our Internet Privacy Policy page and moving this informational message to below the agreement statement.

Justification #1: We are making these revisions to better inform individuals on the privacy policies relating to their use of the iClaim application.

• Change #2: We are updating the Supplemental Information screen to display a new informational message and removing the option to select “Not sure or I do not have a statement” from this screen. This change will only apply to applicants who entered iClaim through their “my Social Security” account, reviewed their earnings records on the Earnings Correction – Earnings Review page (OMB #0960-0819), and responded “Yes” to the question “Do you agree with your earnings history as shown on your Social Security Statement?” The informational message informs the applicants that the system has prefilled their answer to this question based on the answer they previously provided but they still can modify their answer, if needed.

Justification #2: We are adding this system functionality to leverage the information an individual previously provided and avoid duplicate collection. The informational message is to ensure that applicants are aware that the information was prefilled based on the response they previously submitted on their “my Social Security” account.

• Change #3: We are removing all references and links to the RE tool from the “When to Start Retirement Benefits” screen and replacing it with language regarding the Retirement Calculator in “my Social Security.”

Justification #3: We are removing the RE tool (OMB 0960-0596) effective September 2022 and members of the public will be directed to their “my Social Security” account to use the secure Retirement Calculator to obtain an estimate online.

• Change #4: We are revising the Overall Summary screen to display information about the new Application For Medicare Part A and Part B Special Enrollment Period - Exceptional Circumstances (CMS-10797) (OMB 0938-New) for when individuals opt to apply for an SEP at the same time they are completing the Retirement or Medicare application via iClaim. For these individuals, this screen will include a new sub header informing them of their selections for this form and a revised Electronic Signature Statement. This change will be effective December 2022.

Justification #4: We are updating this screen to ensure individuals are clearly informed that as part of this online submission, they are completing more than one form and providing one signature for both a Social Security benefit application and the Centers for Medicare and Medicaid Services (CMS-10797) form.

• Change #5: We are making a minor revision to the “Electronic Signature Agreement” language on the Overall Summary screen for all first party individuals. We are revising the statement from:

“I understand and agree that my application will be signed electronically when I select the check box below.”

To: “I understand and agree that by selecting the check box and clicking “Submit Now/Accept & Continue” below, I am electronically signing my application.”

• Justification #5: We are changing this statement from passive to active voice for clarity and plain language purposes.

• Change #6: We are revising the iClaim screens that third-parties complete to replace gender-specific pronouns.

Justification #6: We are updating these screens in support of Executive Order (EO) 13988, “Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation.” We will continue to revise our forms and systems in support of the EO as we secure the required resources.

SSA plans to implement the changes to the iClaim screens on September 10, 2022.

These actions do not affect the public reporting burden.

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