Request for Reconsideration--Disability Cessation

Documents and Forms

Document Name Document Type
Form SSA-789 Request for Reconsideration--Disability Cessation Form
Revised PA and PRA Statements.docx www.ssa.gov Other-Revised PA & PRA Statements
SSA-789 Request for Reconsideration--Disability Cessation SSA-789 (revised).pdf www.ssa.gov Form
SSA-789 (current).pdf SSA-789 - Current IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Reconsideration--Disability Cessation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.1409 20 CFR 404.909

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SSA-789	Request for Reconsideration--Disability Cessation	SSA-789 (revised).pdf	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Revised PA & PRA Statements			Revised PA and PRA Statements.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 49,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	49,000	49,000
Annual IC Time Burden (Hours)	54,717	54,717
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA-789 - Current	SSA-789 (current).pdf	06/14/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.