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 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: OR.Reports.Clearance@ssa.gov.

Or you may submit your comments online through 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-2026-1222] in your submitted response.

The information collections below are pending at SSA. SSA will submit them ( printed page 67379) 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 December 28, 2026. Individuals can obtain copies of the collection instruments by writing to the above email address.

1. Response to Notice of Revised Determination—20 CFR 404.913-404.914, 404.992(b), 416.1413-416.1414, and 416.1492(d)—0960-0347. In certain circumstances, SSA may reopen and revise a final determination. When a determination that an individual is disabled is revised based on medical factors, advance notice of the revised determination is given. In response to this notice, the affected individuals may: (1) request a disability hearing to contest SSA's decision; and (2) submit additional information or evidence for SSA to consider. Affected individuals and their representatives use Form SSA-765 to accomplish these two actions. If respondents request the first option, SSA's Disability Hearings Unit uses the form to schedule a hearing; ensure an interpreter is present, if required; and ensure the disability recipients or claimants, and their representatives, receive a notice about the place and time of the hearing. If respondents choose the second option, SSA uses Form SSA-765 and other evidence to reevaluate the individual's case, and to determine if the new information or evidence will change SSA's proposed revision. The respondents are current disability recipients or their representatives.

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

2. Redetermination of Eligibility for Help with Medicare Prescription Drug Plan Costs—20 CFR 418.3125—0960-0723. As mandated under the Medicare Modernization Act of 2003, SSA conducts low-income subsidy (Medicare Part D) eligibility redeterminations for Medicare beneficiaries who have limited income and resources and who thus currently receive the Medicare Part D subsidy to help with Medicare prescription drug plan costs, including premiums, deductibles, and copays. SSA asks Medicare Part D subsidy recipients to complete Form SSA-1026 (1) for periodic, standard cyclical redeterminations and (2) when recipients report a potentially subsidy-changing event. For the cyclical, periodic redetermination process, SSA's system automatically selects annual respondents based on the following profile and selection criteria: (1) individuals who became entitled to the Medicare Part D subsidy during the past 12 months; (2) individuals who were eligible for the Part D subsidy for more than 12 months; or (3) individuals who reported a change in income, resources, or household size. For the second category of redeterminations, report of the following life-changing events would trigger a redetermination and would require Medicare Part D beneficiaries to complete the form: (1) marriage; (2) spousal separation; (3) divorce; (4) annulment of a marriage; (5) spousal death; or (6) moving back in with one's spouse following a separation.

SSA mails a cover letter explaining the specific need for the redetermination; a Resource and Income Summary form listing the subsidy-eligible individual's income and resource types and amounts, and the individual's current household size on record; and the appropriate version of Form SSA-1026 (based on the category of redetermination) for the beneficiary to complete and return to SSA's Wilkes-Barre Direct Operations Center. Once we receive the form, SSA technicians scan the information it into the Medicare Application Processing System to start the redetermination process. If a beneficiary finds the paper process difficult, they may call or visit their local field office, and a technician completes the form with them through a personal interview.

The respondents are current recipients of Medicare Part D low-income subsidy who will undergo an eligibility redetermination for one of the reasons mentioned above.

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