Addendum to Supporting Statement 0960-0349

Addendum to the Supporting Statement for Form SSA-789

Request for Reconsideration – Disability Cessation

20 CFR 404.909, 404.1597(b), 416.995, & 416.1409

OMB No. 0960-0349

Terms of Clearance

OMB placed the following Terms of Clearance on this Information Collection when they last approved it on 05/15/2024:

The agency made significant revisions to the Supporting Statement A to provide additional detail regarding the purpose and use of the collection. The agency also updated the burden estimates. Approved consistent with the agency's commitments under Sec. 4 (k)(iii) and (iv) of E.O.14058.

No later than six months after approval of this information collection request, the agency will conduct a non-substantive change to update the form to at least reflect the agreed-upon changes between the agency and OMB. The agency will continue to engage with OMB regarding further changes to this form which may reduce burden associated with requesting a reconsideration and requesting statutory benefits continuation during the reconsideration process.

• OMB Term #1: We would like to suggest that SSA adds an option to the SSA-789 to initiate the request for SBC. "[ ] I would like to ask SSA to continue to receive my benefits until a decision is made at the disability hearing. By choosing this option, I understand that SSA will follow-up with me with the necessary paperwork so that I may still receive benefits while I appeal my case."

We believe that this change would help reduce burden on respondents by consolidating two highly related transactions, the request for recon and the SBC request, into a single transaction with the agency. While we recognize SBC itself may have further nuances (e.g. opting in to dependents benefits, Medicare/Medicaid; explaining the overpayment liability), we believe that as a first-order burden-reducing improvement including this checkbox allows respondents to pursue both rights simultaneously. It also likely reduces learning costs for claimants given that the SBC opt-in currently has no clear form associated with it.

SSA Response: The SSA-789 contains a checkbox for the field office (FO) to complete when the individual elects SBC.  Part of the FO’s responsibility is to check the box next to “Benefit Continuation” if the individual’s payments will continue. This box requires FO completion because of the additional explanation and nuances that are required for an SBC election. The FO must explain the options available to claimants and most importantly, ensure that they understand that receipt of SBC payments can become overpayments if the determination is not reversed at appeal. All these important details cannot be clearly explained on the SSA-789. Creating an SBC election checkbox on the SSA-789 for the individual to complete could be misleading to the public, cause confusion, and would further complicate the process because the individual or the FO may incorrectly interpret that checking this option is all that is needed to continue benefits. The FO will need to recontact the individual to explain SBC requirements.

SSA created the SSA-792, Statutory Benefit Continuation Election Statement

(OMB No. 0960-0845) which will capture all the information required to elect SBC during a claimant’s reconsideration and hearing appeals. Our recommended approach is to not make any additions to the SSA-789 involving SBC. SSA can consider additional SBC language in a future renewal and when the SBC ICR is available for use.

Public Comments

60-Day Comment Period Federal Register Notice (FRN):

The 60-day Comment Period FRN published on February 12, 2025, at 90 FR 9488. The comment period began on February 12, 2025, and ended on April 14, 2025, at 11:59pm. We received a total of 10 public comments on the 60-day comment period FRN. The following contains a summary of the comments we received, as well as SSA’s responses.

Comment #1: Several commentor noted the current version of the SSA-789 does not allow the beneficiary to elect SBC, instead, the beneficiary must complete a separate form – the SSA-795 Statement of Claimant or Other Person – in order to elect SBC. The commentors urge SSA to consolidate the SSA-789 and SBC election statement. The commentors states consolidation will support the reduction of agency administrative inefficiencies in processing the cessation appeal and SBC election, while also reducing administrative burdens experienced by beneficiaries in filing their appeal and request for SBC.

• SSA Response #1: SSA reviewed your suggestions and are happy to note that SSA is already in the process of providing some responsive changes. SSA does not believe that consolidating the SSA-789 and the SBC election statement would be advisable due to the amount of information SSA must provide to the individual, we are taking steps to make SBC elections easier to complete and submit. The election form must include space for the individual to specify the type(s) of benefits to be continued and to make a good cause statement if the election is late. Because the Agency is required to recoup SBC payments made when the appeal is unsuccessful, the election request must also include a statement that informs the individual of their responsibility to repay or request a waiver of any overpayment resulting from an unsuccessful appeal. Additionally, Title II auxiliaries receiving benefits on the record of the number holder entitled to disability benefits, must also complete their own elections form.  It is not practicable to append all of this information to the existing appeal form SSA 789 or its replacement.

In addition, we are excited to share that we created and recently obtained OMB approval

Form, SSA-792, Statutory Benefit Continuation Election Statement, a new stand-alone SBC election form that will replace the SSA-795. We are working to finalize this form, and we will make it available on SSA’s internet page. Once this form is available, claimants can access the document at-will. This will facilitate quicker access to the form for many of the Agency’s beneficiaries and should reduce the overall level of administrative inefficiency inherent in the current process. It is also consistent with our goal of enabling more automated processing by bringing more services online. We expect to have the new form available very soon.

Comment #2: Several commentors suggested SSA to consider an online version of a consolidated medical cessation appeal request and SBC election. This process improvement will reduce beneficiary interaction with field office (FO) staff while also allowing for automated processing of the appeal and SBC election.

• SSA Response #2: SSA expects to have the new SBC election form available very soon for printing, and we are planning for online submission in the near future. Even prior to online submission, online accessibility will allow appellants to fill-in the form online, print it out, and submit it via mail or in-person. Moving forward, SSA will strive make all of our forms even more accessible and easier to submit. In addition, while the

SSA-789 cannot be completed online via iAppeals, the form has undergone recent changes to include removal of the signature and the ability to complete the form via Upload Documents. Upload Documents is an online tool that allows customers to upload and submit certain forms to SSA from their personal desktop and mobile devices through their mySocial Security account. Completion of the form via Upload Documents allows for customers to initiate the document upload and eliminate delays caused by waiting for FO technician outreach.

Comment #3: Several commenters suggested SSA to consider increasing the time period to elect SBC.

• SSA Response #3: SSA is investigating the possibility of extending the window period for statutory benefit continuation elections. However, this change is not imminent. In the meantime, we are attempting to ensure that claimants have quicker access to the election form allowing more individuals to submit timely elections and as a result directly reducing the processing time our representatives spend on making good cause determinations.

Comment #4: One commenter stated the language on the SSA-773 is structured for someone appearing at a Continuing Disability Review hearing, and current language does not actually capture those who might want to waive their right to a standard disability hearing. The commenter recommends SSA change the language to encompass both types of hearings or creating a second form that speaks to disability hearings specifically.

• SSA Response #4: A disability hearing with a disability hearings officer takes place at the reconsideration level of appeal for beneficiaries, or recipients, who received an initial continuing disability review (CDR) or adverse medical reopening (at the initial or CDR level) that resulted in a medical cessation. The SSA-773 is not just for individuals at the CDR level. The SSA-773 informs these beneficiaries and recipients of the effects of the decision to waive their right to a disability hearing with a Disability Hearing Officer (DHO). SSA does not use the SSA-773 in the appeal process for a hearing with an administrative law judge (ALJ).

Comment #5: One commenter recommended changing “represent” to “appear on my behalf” in the following sentence: “Although the above has been explained to me, I do not want to appear at a disability hearing or have someone represent me at a disability hearing.” The commenter notes a respondent could have someone representing them for their Social Security disability case while simultaneously waiving their right (and that of the representative) to appear in front of the decision-maker. Due to this, they stated that the language should accurately reflect this.

• SSA Response #5: Thank you for the suggestion. Immediately preceding the sentence you noted above, the SSA-773 states, “I have been given an explanation of my right to representation, including representation at my hearing by an attorney or other person of my choice.” As this sentence explains, the term “represent” applies to any person the individual chooses to appear on their behalf, not just a representative. Due to this explanation, SSA does not find it necessary to change the language from “represent” to “appear on my behalf”.

Comment #6: One commenter suggested SSA include Form SSA-789 with the SSA-L141, Notice of Disability Cessation along with a Prepaid Postage and Pre-addressed return envelope to reduce SSA administrative burden.

• SSA Response #6: Thank you for the suggestion of including the SSA-789 with the cessation notice. We agree with the need to reduce administrative burden whenever possible; however, we inclusion of the SSA-789 with the medical cessation notice is not an option as this time. The agency continues to look for ways to reduce our paper footprint by increasing digital options and streamlining our internal processes. To lessen the administrative burden, the SSA-789 has undergone recent changes to include removal of the signature and the ability to complete the form via Upload Documents. Upload Documents is an online tool that allows customers to upload and submit certain forms to SSA from their personal desktop and mobile devices through their mySocial Security account. Completion of the form via Upload Documents allows for customers to initiate the document upload and eliminate delays caused by waiting for FO technician outreach. This also reduces the need to complete a paper version of the form.

Comment #7: One commentor suggested that SSA pre-fill the included 789 form with information to assist claimants and SSA staff processing appeals.

• SSA Response #7: Thank you for the suggestion of the pre-filled SSA-789. As noted above, the SSA-789 is not included with the medical cessation notices; therefore, a pre-filled option is not feasible at this time. SSA understands individuals may have questions when completing the form, for which they can contact their local field office to schedule a time to ask questions and complete the form with technician assistance.

Comment #8: One commenter suggested SSA to expand the use of checkboxes and directed short answer responses on SSA Form 789 to increase administrative efficiency.

• SSA Response #8: Increased administrative efficiency is a something we continue to strive for in SSA forms and notices. With regards to the reason for the appeal and good cause statement, these are statements that are highly individualized and specific, and therefore not amenable to checkbox options. The reason for the appeal and the good cause statement should be written in the individual’s own words and not influenced by pre-determined options. Regarding the addition of elements from the SSA-3441 – Disability Report – Appeal onto the SSA-789, this would result in a duplication of information, causing extra work for the individual completing the form. The SSA-3441 is specifically used to collect updated information about the claimant’s impairments and is completed in all requests for reconsideration of a medical CDR. Adding components of this form on to the SSA-789 would result in a larger burden on the individual completing the form.

Comment #9: One commentor stated Form SSA-789 should have the same language as Form SSA-773 to fully inform claimants of their hearing rights.

• SSA Response #9: Form SSA-773 (Waiver of Rights to Appear-Disability) explain the hearing rights in more detail as it is directly related to the disability hearing. The

SSA-789 is completed in the first step of the appeals process, filing a reconsideration. Previous versions of the SSA-789 contained the same hearing rights language as the SSA-773; however, SSA shorted it to improve readability and redundancy of information. If an individual selects the option to not appear nor have a representative appear at the hearing for them, they then must complete the SSA-773, which has the full hearing rights explained. Therefore, removing the full hearing rights language from the SSA-789 does not deny respondents the ability to choose to waive a hearing nor to review the disclaimer in its entirety, rather it puts the full hearing rights on the follow-up form, the SSA-773. In addition, as part of the appeal process SSA encourages individuals to schedule an interview with the FO due to the volume of information to convey. During this FO interview, the FO technician explains the DDS disability hearing process and the individual’s rights and responsibilities with respect to the hearing process. The technician may also assist the individual with completing the SSA-789 to ensure proper completion.

Comment #10: One commentor recommended that SSA create an appeal form for individuals who are banned from SSA Offices that is sent with the notice. In addition one commentor stated that all updates to SSA forms should be written with clear and simple language.

• SSA Response #10: We appreciate your recommendation, if this comment is regarding the appeal of a ban, this topic is outside of the purview of the SSA-789. SSA does not use the SSA-789 in the appeal of a ban. The ban letter provides the necessary information for the individual to appeal the ban. Thank you for the feedback on our form language and readability. SSA continuously strives to make our forms as simple and comprehensive as possible while balancing the needs to explain legal and policy information as concisely as possible. SSA uses plain language to make our forms easier to understand and use, which is in line with the Plain Writing Act of 2010. We will continue to review the form to use language that avoids jargon and complex sentence structures.