No
material or nonsubstantive change to a currently approved
collection
No
Regular
10/06/2023
Requested
Previously Approved
08/31/2026
08/31/2026
151,600
151,600
123,175
123,175
0
0
Claimants have a statutory right under
the Act and current regulations to request review of an ALJ’s
hearing decision or dismissal of a hearing request on Title II and
Title XVI claims. Claimants may request Appeals Council review by
filing a written request using Form HA-520, or the Internet version
of Form HA-520, the i520. SSA uses the information to establish the
claimant filed the request for review within the prescribed time,
and to ensure the claimant completed the requisite steps permitting
the Appeals Council review. The Appeals Council uses the
information to: (1) Document the claimant’s reason(s) for
disagreeing with the ALJ’s decision or dismissal; (2) determine
whether the claimant has additional evidence to submit; and (3)
determine whether the claimant has a representative or wants to
appoint one. The respondents are claimants requesting review of an
ALJ’s decision or dismissal of hearing. We are making
non-substantive changes to update the mailing address for the
HA-520, and to incorporate inclusive language consistent with
executive orders on diversity, equity, and inclusion.
US Code:
42
USC 405 Name of Law: The Public Health and Welfare
US Code: 42
USC 1383 Name of Law: The Public Health and Welfare
PL:
Pub.L. 106 - 169 251 Name of Law: Foster Care Independence Act
of 1999
PL:
Pub.L. 106 - 169 809 Name of Law: Foster Care Independence Act
of 1999
When we last cleared this IC in
2018, the burden was 35,000 hours. However, we are currently
reporting a burden of 104,225 hours. This change stems from a
decrease in the number of responses from 175,000 to 151,600. In
addition, we agreed with OMB to increase our burden per response
for this form, which increased the overall burden for the ICR.
Although the number of responses changed, SSA did not take any
actions to cause this change. These figures represent current
Management Information data. Note: The total burden reflected in
ROCIS is 123,175, while the burden cited in #12 of the Supporting
Statement is 104,225. This discrepancy is because the ROCIS burden
reflects the following components: field office waiting time + a
rough estimate of a 30-minute, one-way, drive burden. In contrast,
the chart in #12 of the Supporting Statement reflects actual
burden.
$923,457
No
Yes
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.
Form HA-520 Request for Review of Hearing Decision/Order - Paper Version
Justification for Non-Substantive Change 0960-0277.docx
Request for Review of Hearing Decision/Order - Paper Version