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SSA. OMB 0960-0511. Periodically SSA uses Form SSA-455, the Disability Report Update, to evaluate current Title II disability beneficiaries and Title XVI disability payment recipients' continued eligibility for Social Security disability payments.
Please read the following information, and the instructions for completing the report form, before you answer the questions. Please complete the report and then sign the form digitally within 30 days of receiving the mailed Disability Update Report. To provide your digital signature, you will need to provide an email address.
You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 0960-0511. We estimate that it will take 15 minutes to read the instructions, gather the facts, and answer the questions.
Form SSA-455 (10-2011) SOCIAL SECURITY ADMI ISTRATIO DISABILITY UPDATE REPORT FORM APPROVED OMB O. 0960-0511 Privacy Act Statement Collection and Use of Personal Information Sections 205(a) and 1631(e)(1)(A) and (B) of the Social Security Act, as amended, and Social Security regulations at 20 C.F.R. 404.1589 and
15 wrz 2020 · Form SSA-455 Disability Update Report. ( ) ⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0511 can be found here: 2023-03-27 - No material or nonsubstantive change to a currently approved collection. 2020-09-15 - Revision of a currently approved collection. Document [pdf]
The OMB control number for this collection is 0960-0511. We estimate that it will take 15 minutes to read the instructions, gather the facts, and answer the questions.
We periodically review your case to determine if you continue to meet the eligibility rules to receive disability benefits. We mail the Disability Update Report, or Form SSA-455, to disabled beneficiaries to obtain updated information about their medical conditions and recent treatments.
