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Form Pain Questionnaire Pain Questionnaire Pain Questionnaire
Disability Case Development Information Collections
Category III - Pain, Other Symptoms, Impairment Information - Revised
Category III - Pain/Other Symptoms/Impairment Information
OMB: 0960-0555
OMB.report
SSA
OMB 0960-0555
ICR 202402-0960-002
IC 181780
Form Pain Questionnaire Pain Questionnaire Pain Questionnaire
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0555 can be found here:
2024-12-12 - No material or nonsubstantive change to a currently approved collection
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