Agency Information Collection Activities; Proposals, Submissions, and Approvals

Agency Information Collection Activities: Proposed Request

The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes revisions and one extension of OMB-approved information collections.

SSA is soliciting comments on the accuracy of the agency's burden estimate; the need for the information; its practical utility; ways to enhance its quality, utility, and clarity; and ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and SSA Reports Clearance Officer at the following addresses or fax numbers.

(OMB) Office of Management and Budget, Attn: Desk Officer for SSA.

(SSA) Social Security Administration, OLCA, Attn: Reports Clearance Director, Mail Stop 3253 Altmeyer, 6401 Security Blvd., Baltimore, MD 21235, Fax: 833-410-1631, Email address: [email protected].

Or you may submit your comments online through https://www.reginfo.gov/public/do/PRAmain by clicking on Currently under Review-Open for Public Comments and choosing to click on one of SSA's published items. Please reference Docket ID Number [SSA-2026-0529] in your submitted response.

The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than August 25, 2026. Individuals can obtain copies of the collection instruments by writing to the above email address.

1. Request for Review of Hearing Decision/Order-20 CFR 404.967-404.981, 416.1467-416.1481-0960-0277. Claimants who disagree with SSA's initial determination or decision have a right under current SSA regulations to request an Appeals Council review of a judge's hearing decision, or dismissal of a hearing request on Title II and Title XVI claims. Claimants may request Appeals Council review by filing a written request using paper Form HA-520, or the internet application, i520, and they may submit additional evidence to support their claims at the same time. SSA uses the information gathered on Form HA-520 to establish that the claimant filed the request for review within the prescribed time and to ensure the claimant completed the requisite steps permitting the AC review. The AC uses the information to: (1) document the claimant's reason(s) for disagreeing with the hearing decision or dismissal order; (2) determine whether the claimant has additional evidence to submit; (3) determine whether the claimant is requesting an extension of time (EOT), and (4) confirm whether the claimant has a representative or wants to appoint one, regardless of if they had a representative for their hearing request. In situations where the respondent submits the HA-520 or i520 without providing additional evidence or argument, or requesting an EOT, the AC reviews the request based on the existing file. The respondents are claimants, or their appointed representative, guardian, parent of a minor claimant, or representative payee, requesting review of a hearing decision or order of dismissal.

Type of Request: Revision of an OMB-approved information collection.

2. Application for Benefits Under the Italy-U.S. International Social Security Agreement-20 CFR 404.1925-0960-0445. As per the November 1, 1978 totalization agreement between the United States (U.S.) and Italian Social Security agencies, residents of Italy filing an application for U.S. Social Security benefits directly with one of the Italian Social Security agencies must complete Form SSA-2528-IT. SSA uses Form SSA-2528-IT to establish age, relationship, citizenship, marriage, death, and military service, or to evaluate a family bible or other family record when determining eligibility for U.S. benefits. The Italian Social Security agencies assist applicants in completing Form SSA-2528-IT and then forward the application to SSA for processing. The respondents are individuals living in Italy who wish to file for U.S. Social Security benefits.

Type of Request: Revision of an OMB approved information collection.

3. Medicare Part D Subsidies Regulations-20 CFR 418.3625(c), 418.3645, 418.3665(a), and 418.3670-0960-0702. The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) established the Medicare Part D program for voluntary prescription drug coverage of premium, deductible, and co-payment costs for certain low-income individuals. The MMA also mandated the provision of subsidies for those individuals who qualify for the program and who meet eligibility criteria for help with premium, deductible, or co-payment costs. This law requires SSA to make eligibility determinations, and to provide a process for appealing SSA's determinations. Regulation sections 418.3625(c), 418.3645, 418.3665(a), and 418.3670 contain public reporting requirements pertaining to administrative review hearings. Respondents are applicants for the Medicare Part D subsidies who request an administrative review hearing.

Type of Request: Revision of an existing OMB-approved information collection.

4. Certificate of Election for Reduced Widow(er)s and Surviving Divorced Spouse's Benefits-20 CFR 404.335-0960-0759. Section 202(q) of the Social Security Act (Act) provides SSA with the authority to reduce benefits under certain conditions when elected by a Title II beneficiary. However, reduced benefits are not payable to an already entitled spouse (or divorced spouse) who:

• Is at least age 62 and under full retirement age in the month of the number holder's death; and
• Is receiving both reduced spouse's (or divorced spouse's) benefits and either retirement or disability benefits in the month before the month of the number holder's death.

To elect reduced widow(er) benefits, a recipient completes Form SSA-4111. SSA uses the information collected to pay a qualified dually entitled widow(er) (or surviving divorced spouse) who elects to receive a reduced widow(er) benefit. The respondents are qualified dually entitled widow(er)s (or surviving divorced spouse) who elect to receive a reduced widow(er) benefit.

Type of Request: Revision of an OMB-approved information collection.

5. Report of Adult Functioning-Employer-20 CFR 404.1512 and 416.912-0960-0805. When SSA's Disability Determination Service (DDS) adjudicative team determines that SSA needs additional information to process an applicant's or claimant's case, SSA uses Form SSA-3385, Report of Adult Functioning-Employer, to collect information from a claimant's current or former employer on an as needed basis, specifically to collect information regarding the claimant's job performance as evidence to help inform the disability eligibility for the claimant. SSA sends the SSA-3385 with a pre-addressed and stamped envelope to a claimant's direct supervisor, or another person who has direct knowledge of the claimant's job performance and asks that individual to provide information about the claimant's day-to-day functioning in a work setting. The respondent completes Form SSA-3385 and sends it back to SSA in the enclosed envelope. Once SSA receives the SSA-3385, the field office scans the form into the claimant's electronic folder. Then the DDS adjudicative team uses this information to evaluate the claimant's impairment-related functional limitations to determine eligibility or continued eligibility for SSDI or SSI. The respondents are current or former employers who SSA contacts only when the adjudicative team decides the agency needs additional information and the employer may be a good source for the information.

Type of Request: Revision of an OMB-approved information collection.

6. Generic Clearance for the Collection of Improving Customer Experience (OMB Circular A-11, Section 280 Implementation)-0960-0818. As part of the Administration's commitment to improving customer service delivery, the following Information Collection Request "Improving Customer Experience (OMB Circular A-11, Section 280 Implementation)" is pending at the Social Security Administration. The Social Security Administration will submit it to OMB for approval under the Paperwork Reduction Act (PRA) (44 U.S.C. 3501 et seq. ). The Social Security Administration will submit it to OMB for approval under the Paperwork Reduction Act (PRA) (44 U.S.C. 3501 et seq. ) within 60 days from the date of this notice.

A modern, streamlined and responsive customer experience means: raising government-wide customer experience to the average of the private sector service industry; developing indicators for high-impact Federal programs to monitor progress towards excellent customer experience and mature digital services; and providing the structure (including increasing transparency) and resources to ensure customer experience is a focal point for agency leadership.

This information collection activity provides a means to garner customer and stakeholder feedback in an efficient, timely manner in accordance with the Administration's commitment to improving customer service delivery as discussed in Section 280 of OMB Circular A-11 at https://www.whitehouse.gov/wp-content/uploads/2018/06/s280.pdf.

As discussed in the OMB guidance, agencies should identify their highest-impact customer journeys (using customer volume, annual program cost, and/or knowledge of customer priority as weighting factors) and select touchpoints/transactions within those journeys to collect feedback.

The agency will use these results to improve the delivery of Federal services and programs. It will also provide government-wide data on customer experience that can be displayed on www.performance.gov to help build transparency and accountability of Federal programs to the customers they serve.

As a general matter, these information collections will not result in any new system of records containing privacy information and will not ask questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.

The Social Security Administration will only submit collections if they meet the following criteria.

• The collections are voluntary;
• The collections are low-burden for respondents (based on considerations of total burden hours or burden-hours per respondent) and are low-cost for both the respondents and the Federal Government;
• The collections are non-controversial and do not raise issues of concern to other Federal agencies;
• Any collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the near future;
• Personally identifiable information (PII) is collected only to the extent necessary and is not retained;
• Information gathered is intended to be used for general service improvement and program management purposes; and

• Upon agreement between OMB and the agency all or a subset of information may be released as part of A-11, Section 280 requirements only on performance.gov. Summaries of customer research and user testing activities may be included in public-facing customer journey maps.

• Additional release of data must be done coordinated with OMB.

These collections allow for ongoing, collaborative and actionable communications between the Agency, its customers and stakeholders, and OMB as it monitors agency compliance on Section 280. These responses inform efforts to improve or maintain the quality of service offered to the public. If this information is not collected, vital feedback from customers and stakeholders on services will be unavailable.

The respondents are Individuals and Households, Businesses and Organizations, State, Local or Tribal Government.

Type of Request: Extension of an OMB-approved information collection.

Affected Public: Individuals and households, businesses and organizations, State, Local or Tribal government.

Total Estimated Triennial Number of Respondents: 17,866,680.

Below we provide projected average estimates for the next three years:

Anticipated Annual Respondents: 5,955,560.

Annual Responses: 1,142,475.

Frequency of Response: Once per request.

Average Minutes per Response: 12 minutes (11.51).

Estimated Annual Burden: 384,629 hours.