Acknowledgement of Receipt (Notice of Hearing)

ICR 202404-0960-001

OMB: 0960-0671

Federal Form Document

IC Document Collections
IC ID
Document
Title
Status
9725 Modified
269966 New
269964 New
243049 Removed
243048 Removed
242397
Removed
242396 Removed
242395 Removed
241467 Removed
241466 Removed
241463 Removed
241461 Removed
209530 Modified
209529 Modified
209528 Modified
209527 Modified
209526 Modified
209525 Modified
209524 Modified
202942 Removed
ICR Details
0960-0671 202404-0960-001
Received in OIRA 202304-0960-001
SSA
Acknowledgement of Receipt (Notice of Hearing)
Revision of a currently approved collection   No
Emergency 09/30/2024
08/26/2024
  Requested Previously Approved
6 Months From Approved 01/31/2026
2,567,690 3,827,490
871,229 1,186,999
0 0

SSA uses the information we obtain on Forms HA-55, HA-504, HA 504 OP1, HA-510, and HA-510-OP1 to manage the means by which we conduct hearings before an administrative law judge (judge) or administrative appeals judges (judge), and the scheduling of hearings with an judge. We use the HA-55, Objection to Appearing by Video Teleconferencing, and its accompanying cover letter, HA-L2, to allow claimants to opt-out of an appearance via video teleconferencing (VTC) for their hearing with a judge. The HA-L2 explains the good cause stipulation for opting out of VTC if the claimant misses the window to submit the HA-55, and for verifying a new residence address if the claimant moved since submitting their initial hearing request. SSA uses the HA-504 and HA-504-OP1, Acknowledgement of Receipt (Notice of Hearing), and accompanying cover letter, HA-L83, to: (1) acknowledge the claimants will appear for their hearing with a judge; (2) establish the time and place of the hearing; and (3) remind claimants to gather evidence in support of their claims. The only difference between the two versions of the HA-504 is the language used for the selection check boxes as determined by the type of appearance for the hearing (in person, phone teleconference, or VTC). In addition, the cover letter, HA-L83, explains: (1) the claimants’ need to notify SSA of their wish to object to the time and place set for the hearing; (2) the good cause stipulation for missing the deadline for objecting to the time and place of the hearing; and (3) how the claimants can submit, in writing, any additional evidence they would like the judge to consider, or any objections they have on their claims. The HA-510 and HA-510-OP1, Waiver of Written Notice of Hearing, allow the claimants to waive their right to receive the Notice of Hearing as specified in the HA-L83. We typically use these forms when there is a last minute available opening on an judge’s schedule, so the claimants can fill in the available time slot. If the claimants agree to fill the time slot, we ask them to waive their right to receive the Notice of Hearing. We use the HA-510-OP1 at the beginning of our process for representatives and claimants who wish to waive the 20 day (for amended or continued hearing notices) or 75 day (for all other hearing notices) requirement earlier in the process, and the HA-510 later in the process for those representatives and claimants who want the full 20 or 75 days before the scheduled hearing. The respondents are applicants for Social Security disability payments who request a hearing to appeal an unfavorable entitlement or eligibility determination or their representative payees. We are revising this Information Collection due to our Final Rule for Setting the Manner of Appearance of Parties and Witnesses at Hearings, RIN 0960-AI71.
We published the Final Rule associated with this ICR. The effective date of the Final Rule is November 23, 2024; however, the system would not allow us to submit this as a regular revision, as it is associated with a final rule (and we did not submit the ICR documents at the NPRM stage, since, at that point, we did not have revisions to the associated information collections). We hope that we can resolve this issue and have this corrected to a submission as a regular revision (not an Emergency).

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

0960-AI71 Final or interim final rulemaking 89 FR 68341 08/26/2024

No

10
IC Title Form No. Form Name
Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing) HA-504-OP1 Acknowledgement of Receipt (Notice of Hearing)
Claimant Enhanced Outreach - Follow Up Call – No Representative (Unrepresented Claimant/ProSe)
Claimant Enhanced Outreach - Follow up Call – With Representative
Claimant Enhanced Outreach - Initial Call No Representative (Unrepresented Claimant/ProSe)
Claimant Enhanced Outreach - Initial Call With Representative
Claimant Enhanced Outreach Call
Courtesy Copy of Remote Hearings Options Letter to Claimant
HA-504 - Acknowledgement of Receipt (Notice of Hearing) HA-504-OP2, HA-504, HA-504-OP1 Acknowledgement of Receipt (Notice of Hearing) ,   Acknowledgement of Receipt (Notice of Hearing) ,   Acknowledgement of Receipt (Notice of Hearing)
HA-510 - Waiver of Timely Written Notice of Hearing HA-510 Waiver of Timely Written Notice of Hearing
HA-55 (Objection to Appearing by Audio or Agency video); HA-56 (Agreement to Appearing by Online Video); HA-L54 (Notice of Ways to Attend a Hearing) HA-56, HA-55 Objection to Appearing by Video Teleconferencing ,   Agreement to Appearing by Online Video
HA-L2 - Acknowledgement Letter
HA-L2 - Verification of New Residence
HA-L54 - Notification of objection to audio and agency video and agreement to online video more than 30-days after receipt of notice showing good cause
HA-L83 - Good Cause for Missing Deadline
HA-L83 - Notice of Hearing Cover Letter
HA-L83 - Objection Stating Issues in Notice are Incorrect
Microsoft Teams Video Hearing Call Script - Claimant Outreach
Microsoft Teams Video Hearing Call Script - Representative Payee Outreach
Remote Hearing Options Letter and Form Mailed to Representative N/A Remote Hearing Notice and Agreement Form
Remote Hearings Options Follow up Call with Representative – no form

  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 2,567,690 3,827,490 0 -978,300 -281,500 0
Annual Time Burden (Hours) 871,229 1,186,999 0 -154,521 -161,249 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
Yes
Miscellaneous Actions
When we last cleared this IC in 2023, the burden was 1,186,999 hours. However, we are currently reporting a burden of 833,634 hours. This change is a result of a decrease in the number of responses from 2,762,500 to 2,492,500, as well as the removal of the Enhanced Outreach Notices and the combination of the Enhanced Outreach Calls to one call total. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data. In addition, we are including the new notice, Form HA-L54, Notice of Ways to Attend a Hearing; and the new form, Form HA-56, Agreement to Appearing by Online Video, both of which increase the overall burden for this information collection. We note that the minor burden increase for adding these two new information collections does not affect the overall decrease for this ICR due to the decrease in the number of respondents.

$2,705,717
No
    No
    No
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.
08/26/2024


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