[Federal Register Volume 63, Number 20 (Friday, January 30, 1998)]
[Notices]
[Pages 4680-4682]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-2199]
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SOCIAL SECURITY ADMINISTRATION
Information Collection Activities: Proposed Collection Requests
and Comment Requests
This notice lists information collection packages that will require
submission to the Office of Management and Budget (OMB), as well as
information collection packages submitted to OMB for clearance, in
compliance with PL. 104-13 effective October 1, 1995, The Paperwork
Reduction Act of 1995.
I. The information collection(s) listed below require(s)
extension(s) of the current OMB approval(s) or are proposed new
collection(s):
1. Government Pension Questionnaire--0960-0160.--The Social
Security Act and Regulations provide that an individual receiving
spouse's benefits and concurrently receiving a Government pension,
based on the
[[Page 4681]]
individual's own earnings, may have the Social Security benefit amount
reduced by two-thirds of the pension amount. The data collected on Form
SSA-3885 is used by the Social Security Administration (SSA) to
determine if the individual's Social Security benefit will be reduced,
the amount of reduction, the effective date of the reduction and if one
of the exceptions in 20 CFR 404.408a applies. The respondents are
individuals who are receiving (or will receive) Social Security
spouse's benefits and also receive their own Government pension.
Number of Respondents: 76,000.
Frequency of Response: 1.
Average Burden Per Response: 12.5 minutes.
Estimated Annual Burden: 15,833 hours.
2. Telephone Replacement Card Interview Script--0960-0570. SSA will
conduct a pilot study by telephone to obtain information from
individuals who need a duplicate Social Security Number (SSN) card. The
information collected will be used to properly identify an individual
prior to releasing a replacement SSN card, thus eliminating the need
for the respondent to take or mail his/her identity documents to a
Social Security office. The information provided, which should be known
by the true Social Security number holder, will be compared to
information available in our current electronic systems. The
respondents are U.S. Citizens applying for a replacement SSN card.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 4 minutes.
Estimated Average Burden: 6,667 hours.
3. Reconsideration Report for Disability Cessation-- 0960-0350.
Form SSA-782-BK will be used by claimants and SSA field offices to
document new developments on the claimant's condition (as perceived by
the claimant), since the prior continuing disability interview was
conducted. The form will also be used by the SSA interviewer to provide
his/her observations of the claimant. The respondents are claimants for
Old-Age, Survivors and Disability Insurance and Supplemental Security
Income, who file a Request for Reconsideration--Disability Cessation.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Average Burden: 50,000 hours.
Written comments and recommendations regarding the information
collection(s) 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:
Nicholas E. Tagliareni, 6401 Security Blvd., 1-A-21 Operations Bldg.,
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.
II. The information collection(s) listed below have been submitted
to OMB:
1. Request to be Selected as Payee--0960-0014. The information
collected on Form SSA-11-BK is used by SSA to determine the proper
payee for a Social Security beneficiary, and it is designed to aid in
the investigation of a payee applicant. The form will establish the
applicant's relationship to the beneficiary, the justification, the
concern for the beneficiary and the manner in which the benefits will
be used. The respondents are applicants for selection as representative
payee for Old-Age, Survivors and Disability Insurance (OASDI),
Supplemental Security Income (SSI) and Black Lung benefits.
Number of Respondents: 1,709,657.
Frequency of Response: 1.
Average Burden Per Response: 10.5 minutes.
Estimated Annual Burden: 299,190 hours.
2. Application for Benefits Under the Federal Mine Safety and
Health Act of 1977, as Amended; (Widow's Claim, Child's Claim and
Dependent's Claim)--0960-0118.
Sections 402(g) and 412(a) of the Federal Mine Safety and Health
Act provide that those widows, surviving children, and dependent
parents, brothers or sisters who are not currently receiving benefits
on the deceased miner's account must file the appropriate application
within 6 months of the deceased miner's death, using Forms SSA-47, 48
and 49. This information is used by SSA to determine eligibility for
benefits. The respondents are Black Lung widows, surviving children and
dependents (parents, brothers or sisters) who were not currently
receiving Black Lung benefits on the Deceased Miner's Account.
Number of Respondents: 1,800.
Frequency of Response: 1.
Average Burden Per Response: 11 minutes.
Estimated Annual Burden: 330 hours.
3. Work History Report--0960-0552. Form SSA-3369-BK is used by the
State Disability Determination Services (DDS) to determine disability
and to record information about the claimant's work history during the
past 15 years. The respondents are claimants who live in Virginia and
are applying for OASDI and SSI benefits.
Number of Respondents: 32,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 16,000 hours.
4. Disability Report-Child--0960-0504. Form SSA-3820-BK is used by
the State DDSs to record claimants' allegations and sources of evidence
in determining eligibility for children filing for SSI disability
benefits. The respondents are SSI claimants who live in Virginia and
are applying for disabled child's benefits.
Number of Respondents: 10,900.
Frequency of Response: 1.
Average Burden Per Response: 40 minutes.
Estimated Annual Burden: 7,267 hours.
5. Work Incapacity and Reintegration Study--0960-0543. The purpose
of this 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 or State Temporary Disability Insurance benefits due to
a back condition.
Number of Respondents: 700.
Frequency of Response: 1.
Average Burden Per Response: 1 hour.
Estimated Annual Burden: 700 hours.
Written comments and recommendations regarding the information
collection(s) should be directed within 30 days to the OMB Desk Officer
and SSA Reports Clearance Officer 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,
[[Page 4682]]
(SSA)
Social Security Administration, DCFAM, Attn: Nicholas E. Tagliareni, 1-
A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 21235.
To receive a copy of any of the forms or clearance packages, call
the SSA Reports Clearance Officer on (410) 965-4125 or write to him at
the address listed above.
Date: January 22, 1998.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-2199 Filed 1-29-98; 8:45 am]
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