This collection includes the various modalities for benefits applications, including forms SSA-1, SSA-2, SSA-16 (and the corresponding MCS/in-person interview systems), and the online iClaim system. In this Information Collection Request, we are clearing several minor changes to iClaim.
US Code:
42 USC 402
Name of Law: Social Security Act
US Code:
42 USC 423
Name of Law: Social Security Act
US Code:
42 USC 426
Name of Law: Social Security Act
US Code:
42 USC 1395j
Name of Law: Social Security Act
US Code:
42 USC 1395o
Name of Law: Social Security Act
The burden increase was due to the addition of the Medicare-only iClaim application, whose response time is slightly longer than paper Medicare-only applications (although the iClaim version is more convenient). There is no actual burden reduction, but ROCIS registers one because we reduced the total SSA-1 paper and MCS ICs number of respondents, as we now have separate ICs for the Medicare-only subsets of those forms.
$6,425,839
No
No
No
Uncollected
No
Uncollected
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 SSA-1 Medicare-only Paper Form SSA-1
Modified iClaim Screens.pdf
Justification for the Non-Substantive Changes - 0618.docx
1st Party Internet Social Security Benefits Application (iClaim)