Statement for Determining Continuing Eligibility for Supplemental Security Income Payments

Forms and Documents

Document Name	Status
Form SSA-8203 Determining Continuing Eligibility for Supplemental Security Income Payments – SSA-8203-BK Form	Modified
Addendum - 0416.docx Supplementary Document	2019-08-07
Supporting Statement - 0416.docx Supporting Statement A	2019-08-07

IC Document Collections

IC ID	Document Title	Status
37987	Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy Other-Internal Use Screens	Removed
178984	Determining Continuing Eligibility for Supplemental Security Income Payments – SSA-8203-BK Form	Modified
178983	Statement for Determining Continuing Eligibility for Supplemental Security Income Payments –- SSI Claims System Other-Internal Use Screens	Modified

ICR Details

OMB Control No: 0960-0416	ICR Reference No: 201905-0960-003
Status: Active	Previous ICR Reference No: 201807-0960-012
Agency/Subagency: SSA	Agency Tracking No:
Title: Statement for Determining Continuing Eligibility for Supplemental Security Income Payments
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/04/2019
	Date Received in OIRA: 08/07/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	11/30/2019
Responses	1,603,577	0	1,603,577
Time Burden (Hours)	510,055	0	523,418
Cost Burden (Dollars)	0	0	0

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Abstract: To determine whether SSI recipients (1) have met and continue to meet all statutory and regulatory requirements for SSI eligibility, and (2) are receiving the correct SSI payment amount, SSA conducts redeterminations of disability. Periodic collection of this information using Form SSA-8203-BK is the only way SSA can make these redeterminations; and collect the information as mandatory under the law. We routinely collect the information in field offices via personal contact (face-to-face or telephone interview) using the automated Modernized SSI Claim System (MSSICS). The respondents are SSI recipients or their representative payees.

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Authorizing Statute(s): US Code: 42 USC 1382a Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 25891	06/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 38714	08/07/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Statement for determining continuing eligibility for Supplemental Security Income Payments -- MISSIC Screens Signature Proxy
Statement for Determining Continuing Eligibility for Supplemental Security Income Payments –- SSI Claims System
Determining Continuing Eligibility for Supplemental Security Income Payments – SSA-8203-BK	SSA-8203	Statement Determining Continuing Eligibility for Supplemental Security Income Payments

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ICR Summary of Burden

	Total Approved	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	1,603,577	1,603,577	0	0	0	0
Annual Time Burden (Hours)	510,055	523,418	0	-13,363	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: When we last cleared this IC in 2016, the burden was 523,418 hours. However, we are currently reporting a burden of 510,055 hours. This change stems from a decrease in the completion time from 20 minutes to 19 minutes. Because we no longer collect a wet signature for the SSI Claims System, there is a decrease in completion time resulting in a change in burden.

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Annual Cost to Federal Government: $14,485,010

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/07/2019

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