[Federal Register Volume 61, Number 236 (Friday, December 6, 1996)]
[Notices]
[Pages 64784-64785]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-31009]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Collection 
Request

    The Social Security Administration publishes a list of information 
collection packages that will require submission to the Office of 
Management and Budget (OMB) for clearance in compliance with Public Law 
104-13 effective October 1, 1995, The Paperwork Reduction Act of 1995. 
The information collection(s) listed below requires extension of the 
current OMB approval(s):
    1. State Agency Schedule for Equipment Purchases for SSA Disability 
Program--0960-0406. The information collected on form SSA-871 is used 
by the Social Security Administration to budget and account for 
expenditures of funds for equipment purchases by the State Disability 
Determination Services that administer the disability program. The 
respondents are State Disability Determination Services.
    Number of Respondents: 54.
    Frequency of Response: Annually.
    Average Burden Per Response: 1 hour.
    Estimated Annual Burden: 54 hours.
    2. Work Reintegration Study--0960-0543. The purpose of the Work 
Reintegration Study is to identify those incentives and interventions 
that are most successful in assisting persons who are disabled due to a 
back condition to return to work. The information collected will be 
used primarily to complete a cross-national analysis of this issue. 
Data will also be gathered on subjects of particular importance in the 
U.S. The findings will provide policy-makers with information that will 
be highly useful in establishing disability policy. The respondents are 
persons entitled to Social Security Disability Insurance, Supplemental 
Security Income (SSI) or State Temporary Disability Insurance.
    Number of Respondents: 800.
    Frequency of Response: 1.
    Average Burden Per Response: 1 hour.
    Estimated Annual Burden: 800 hours.
    3. Statement for Determining Continuing Eligibility for 
Supplemental Security Income Payments--0960-0416. The information 
collected by the Social Security Administration on form SSA-8203 is 
used to determine whether SSI recipients have met and continue to meet 
all statutory and regulatory requirements for SSI eligibility and 
whether they have been and are still receiving the correct payment 
amount. The information collected also will assist agencies 
administering Medicaid programs in ascertaining the legal liability of 
third parties to pay for care and services. The respondents are 
recipients of SSI benefits or their representative payees.
    Number of Respondents: 552,000.
    Frequency of Response: 1.
    Average Burden Per Response: 17 minutes.
    Estimated Annual Burden: 156,400 hours.
    To receive a copy of the form(s) or clearance package(s), call the 
SSA Reports Clearance Officer on (410) 965-4125 or write to her at the 
address listed below. Written comments and recommendations regarding 
these information collections should be sent within 60 days from the 
date of this publication directly to the SSA Reports Clearance Officer 
at the following address: Social Security Administration, DCFAM, Attn: 
Judith T. Hasche, 1-A-21 Operations Bldg., 6401 Security Blvd., 
Baltimore, MD 21235.
    In addition to your comments on the accuracy of the agency's burden 
estimate, we are soliciting comments on the need for the information; 
its practical utility; ways to enhance its quality, utility and 
clarity; and on ways to minimize burden on respondents, including the 
use of automated collection techniques or other forms of information 
technology.

Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

    The information collections listed below, which were published in 
the Federal Register on October 2 and October 11, 1996 have been 
submitted to OMB.
    1. Privacy and Disclosure of Official Records and Information; 
Availability of Information and Records to the Public--20 CFR 401 and 
402; 0960-NEW. The respondents are individuals requesting access to 
their SSA records, correction of their SSA records and disclosure of 
SSA records. The information is required to:
    (a) Identify individuals who request access to their records.
    Number of Respondents: 10,000.
    Frequency of Response: On occasion.
    Average Burden Per Response: 11 minutes.
    Estimated Annual Burden: 1,833 hours.
    (b) Designate an individual to receive and review a recordholder's 
sensitive medical records in accordance with 20 CFR 401.55, and for the 
disclosure of such records to the recordholder by his/her designee.
    Number of Respondents: 3,000.
    Frequency of Response: On occasion.
    Average Burden Per Response: 2 hours (This includes the time needed 
for the designee to review the recordholder's medical records.)
    Estimated Annual Burden: 6,000.
    (c) Correct or amend records.
    Number of Respondents: 100.
    Frequency of Response: On occasion.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 17 hours.
    (d) Obtain consent from an individual to release his/her records to 
others. Consents are submitted by letter in writing or by use of a form 
SSA-3288.
    Number of Respondents: 200,000.
    Frequency of Response: On occasion.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,000 burden hours.
    (e) Facilitate the release of information under the Freedom of 
Information Act (FOIA).
    Number of Respondents: 15,000.
    Frequency of Response: On occasion.
    Average Burden Per Response: 5 minutes.

[[Page 64785]]

    Estimated Annual Burden: 1,250 hours.
    (f) Grant a waiver or reduction of fees for records requested under 
FOIA.
    Number of Respondents: 400.
    Frequency of Response: On occasion.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 33 hours.
    2. Report of New Information in Disability Cases--0960-0071. The 
information collected on form SSA-612 is needed by the Social Security 
Administration to determine whether an event or change in circumstances 
will affect an individual's disability benefits. The information will 
be used to determine continued eligibility for disability payments. The 
respondents are disabled social security beneficiaries or their 
representative payees.
    Number of Respondents: 200,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 16,667.
    3. Instructions for Completion of Federal Assistance Application 
Form SSA-96 for SSA Research and Demonstration Grant Programs --0960-
0184. The information collected on form SSA-96 is needed by the Social 
Security Administration to evaluate and select grant proposals for 
funding. The respondents are applicants for federal assistance, 
including State and local governments, educational institutions and 
other nonprofit and for-profit organizations.
    Number of Respondents: 200.
    Frequency of Response: On occasion.
    Average Burden Per Response: 14 hours.
    Estimated Annual Burden: 2,800 hours.
    4. Request to be Selected as Payee--0960-0014. The information 
collected on form SSA-11-BK is needed by the Social Security 
Administration to determine the proper payee for a Social Security 
beneficiary. The information is used to establish an applicant's 
relationship to the beneficiary, his/her justification and concern for 
the beneficiary, and the manner in which the benefits will be used. The 
respondents are applicants for representative payee of individuals 
receiving title II, title XVI and Black Lung benefits.
    Number of Respondents: 1,709,657.
    Frequency of Response: 1.
    Average Burden Per Response: 11 minutes.
    Estimated Annual Burden: 313,437.
    5. Supplemental Security Income Claim Information Notice--0960-
0324. The information collected on form SSA-L8050-U3 is used by the 
Social Security Administration to ensure that all sources of potential 
income which can be used to provide for an individual's own support and 
maintenance are utilized. The respondents are applicants for SSI and 
recipients who are potentially eligibile for benefits from other public 
or private programs.
    Number of Respondents: 7,500.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 1,250 hours.
    6. Supplemental Security Income--Quality Review Case Analysis; 
0960-0133. The information collected on form SSA-8508-BK is used by the 
Social Security Administration to assess the effectiveness of SSI 
policies and procedures and to establish payment accurate rates. The 
respondents are a random sample of SSI recipients.
    Number of Respondents: 14,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 14,000 hours.
    7. Marital Relationship Questionnaire--0960-0460. The information 
collected on form SSA-4178 is needed by the Social Security 
Administration to determine whether unrelated individuals of the 
opposite sex who are living together present themselves to the public 
as husband and wife. The information is used to determine whether 
correct payment is being made to SSI couples and individuals.
    Number of Respondents: 5,100.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 425 hours.
    8. Psychiatric Review Technique--0960-0413. The information 
collected on form SSA-2506 by the Social Security Administration is 
needed to assist in the adjudication of claims involving mental 
impairments. The information is used to identify the need for 
additional evidence for the determination of impairment severity; to 
consider aspects of the mental impairment relevant to the individual's 
ability to work; and to organize and present the findings in a clear, 
concise manner. The respondents are State Disability Determination 
Services administering title II and title XVI disability programs.
    Number of Responses: 796,346.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 199,087.
    9. Letter to Employer Requesting Information About Wages Earned--
0960-0034. The information collected on form SSA-L725 will be used by 
the Social Security Administration (SSA) to establish the exact amount 
of wages earned by a beneficiary. The data is requested only in cases 
where the information in SSA's records is incomplete or has been 
questioned. The respondents are employers who provide the wage 
information necessary to resolve wage discrepancies.
    Number of Respondents: 150,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30-50 minutes.
    Estimated Annual Burden: 100,000.
    To receive a copy of the form(s) or clearance package(s), call the 
SSA Reports Clearance Officer on (410) 965-4125 or write to her at the 
address listed below under SSA. Written comments and recommendations 
regarding these information collections should be sent within 30 days 
of the date of this publication. Comments may be directed to OMB and 
SSA at the following addresses:
(OMB)
Office of Management and Budget, OIRA, Attn: Laura Oliven, New 
Executive Office Building, Room 10230, 725 17th St., NW, Washington, 
D.C. 20503
(SSA)
Social Security Administration, DCFAM, Attn: Judith T. Hasche, SSA 
Reports Clearance Officer, 1-A-21 Operations Bldg., 6401 Security Blvd, 
Baltimore, MD 21235.

    Dated: November 27, 1996.
Judith T. Hasche,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 96-31009 Filed 12-5-96; 8:45 am]
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