Information Collection Request

Request for Hearing By Administrative Law Judge

ICR 201910-0960-002 · OMB 0960-0269 · Active

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2022-04-06
Public Comments
2019-08-23
Supplementary Document
2019-10-11
Supplementary Document
2019-10-11
Supporting Statement A
2022-04-06
Supporting Statement A
2019-10-11
ICR Details
0960-0269 201910-0960-002
Active 201907-0960-003
SSA
Request for Hearing By Administrative Law Judge
Revision of a currently approved collection   No
Regular
Approved with change 04/18/2022
10/11/2019
The agency made modifications to the Supporting Statement to provide additional clarity and to update burden estimations. The agency made modifications to the instructions (iClaims terms of service and paper forms) to provide improved guidance to respondents. Following the approval of this ICR, the agency will continue to consult with OMB about additional improvements to the instruments to improve burden reduction on this information collection, including identifying opportunities for funding requests related to improving the instruments.
  Inventory as of this Action Requested Previously Approved
04/30/2025 36 Months From Approved 04/30/2022
663,643 0 669,469
56,164 0 56,702
0 0 0

When SSA denies applicants’, claimants’, or beneficiaries’ requests for new or continuing disability benefits or payments, the Act entitles those applicants, claimants, or beneficiaries to request a hearing to appeal the decision. To request a hearing, individuals complete Form HA-501; the associated Modernized Claims System (MCS) or Supplemental Security Income (SSI) Claims System interview; or the Internet application (i501). SSA uses the information to determine if the individual: (1) filed the request within the prescribed time; (2) is the proper party; and (3) took the steps necessary to obtain the right to a hearing. SSA also uses the information to determine: (1) the individual’s reason(s) for disagreeing with SSA’s prior determinations in the case; (2) if the individual has additional evidence to submit; (3) if the individual wants an oral hearing or a decision on the record; and (4) whether the individual has (or wants to appoint) a representative. The respondents are Social Security disability applicants and recipients who want to appeal SSA’s denial of their request for new or continued benefits for disability and non-medical hearing requests; and Medicare Part B recipients who must pay the Medicare Part B Income-Related Monthly Adjustment Amount.

US Code: 42 USC 1383 Name of Law: Social Security Act
   US Code: 42 USC 1395ff Name of Law: Social Security Act
   US Code: 42 USC 1320c-4 Name of Law: Social Security Act
   PL: Pub.L. 108 - 173 1350 & 931 Name of Law: Medicare Modernization Act of 2003
   PL: Pub.L. 103 - 296 105(a)(2)(B) Name of Law: Social Security Independence and Program Improvements Act
   US Code: 42 USC 405 Name of Law: Social Security Act
   PL: Pub.L. 106 - 169 251 & 809 Name of Law: Foster Care Independence Act of 1999
   US Code: 42 USC 1395r Name of Law: Social Security Act
  
None

Not associated with rulemaking

  84 FR 31972 07/03/2019
84 FR 48694 09/16/2019
No

2
IC Title Form No. Form Name
Request for Hearing By Administrative Law Judge--Internet Version (i501)
Request for Hearing By Administrative Law Judge--Paper/MCS/MSSICS Versions HA-501

  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 663,643 669,469 0 0 -5,826 0
Annual Time Burden (Hours) 56,164 56,702 0 0 -538 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The decrease in burden hours is because there are fewer claimants and beneficiaries filing hearing requests. We based our burden information on current management information data. There is no change in our average burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change.

$55,000
No
    Yes
    Yes
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.
10/11/2019

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