[Federal Register Volume 63, Number 44 (Friday, March 6, 1998)]
[Notices]
[Pages 11325-11326]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-5811]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Collection
Requests
This notice lists information collection packages that will require
submission to the Office of Management and Budget (OMB), in compliance
with Public Law 104-13 effective October 1, 1995, The Paperwork
Reduction Act of 1995.
1. Function Report--Adult, SSA-3373-TEST; Function Report--Third
Party, SSA-3380-TEST--0960-NEW. SSA will be testing new prototype
disability forms. The information collected on the forms is needed for
the determination of disability. The forms record information about the
disability applicant's illnesses, injuries, conditions, impairment-
related limitations and ability to function. The respondents are Title
II and Title XVI disability applicants or individuals who know about
the applicant's impairment, limitations and ability to function.
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Third
Adult party
form form
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Number of respondents............................... 7,000 5,000
Frequency of response............................... 1 1
Average burden per response......................... \1\ 20 \1\ 20
Estimated annual burden............................. \2\ 2,33
3 \2\ 1,66
7
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\1\ Minutes. \2\ Hours.
2. Symptoms Report--0960-NEW. SSA will be testing new prototype
disability forms, including the SSA-3370-TEST. The information
collected on the form is needed for the determination of disability.
The form records information about the disability applicant's
description of symptoms of his or her illness, injury or condition. The
respondents are applicants for Title II and Title XVI disability
benefits.
Number of Respondents: 7,500.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 1,875 hours.
3. Nursing Home Reporting Requirements Related to Supplemental
Security Income (SSI) Recipients--0960-NEW. Public Law 103-387 requires
long term, intermediate care and nursing home administrators to report
SSI recipient admissions to SSA. SSA uses the information to determine
whether SSI benefits should be reduced. The respondents are long term,
intermediate care and nursing home administrators.
Number of Respondents: 16,000.
Frequency of Response: 2 per year.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 8,000 hours.
4. Survey of Interest in International Social Security Agreements--
0960-NEW. Section 233 of the Social Security Act authorizes the U.S. to
enter into agreements with foreign countries for the purpose of
eliminating double social security coverage and taxation and closing
gaps in benefit protection for workers who have divided their careers
between the U.S. and another country. SSA negotiates these agreements
for the U.S. SSA is now planning its agreement negotiating agenda for
the next several years. Since U.S. businesses with overseas operations
are primary stake-holders in these agreements, SSA needs to survey
these companies to determine which countries they believe would be good
candidates for new Social Security agreements. SSA uses the information
together with estimates of potential foreign tax savings and benefit
payments, to determine priorities for new Totalization agreement
negotiations for fiscal years 1999 through 2003. The respondents are
U.S. businesses with overseas operations who have requested
certificates of U.S. coverage from SSA.
Number of Respondents: 600.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 150 hours.
5. Disability Hearing Officer's Report of Disability--0960-0507.
The information of form SSA-1204-BK is used by the Disability Hearing
Officer (DHO) to conduct an document disability hearings and to provide
a structured format that concerns all conceivable issues relating to
SSI claims for disabled children. The completed Form SSA-1204-BK will
aid the DHO in preparing the disability decision and will provide a
record of what transpired at the hearing. The respondents are DHOs in
the State Disability Determination Services (DDS).
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 100,000 hours.
6. Disability Hearing Officer's Report of Disability Heairng--0960-
0440. The information on form SSA-1205 is used by DHOs to conduct and
record disability hearings. The form serves as a guide in conducting
the hearings and ensures that all pertinent issues are considered. The
respondents are DHOs in the State DDSs.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 100,000 hours.
7. Disability Hearing Officer's Decision--0960-0441. The DHO uses
the information on form SSA-1207 and the supplements--which apply to
the type of claim involved--in preparing
[[Page 11326]]
the disability decision. The form will aid the DHO in addressing the
crucial elements of the case in a sequential and logical fashion. The
respondents are DHOs in the State DDSs.
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 45 minutes.
Estimated Annual Burden: 75,000 hours.
8. Chinese Custom Marriage Statement (By One or Both of the
Parties); and Statement Regarding Chinese Custom Marriage--0960-0086.
The information on Forms SSA-1344 and 1345 is used by SSA to determine
if an alleged spouse of the numberholder is legally married, in order
to be paid Social Security benefits. The respondents are individuals
applying for benefits based upon a Chinese custom marriage or
individuals who attended the marriage ceremony.
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SSA-1344 SSA-1345
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Number of Respondents:.............................. 100 100
Frequency of Response:.............................. 1 1
Average Burden Per Response:........................ \1\14 \1\14
Estimated Annual Burden:............................ \2\23 \2\23
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\1\ Minutes. \2\ Hours.
9. Student's Statement Regarding School Attendance--0960-0105. The
information on Form SSA-1372 is used by SSA to determine if a claimant
is entitled to Social Security benefits as a student. The respondents
are student claimants for Social Security benefits.
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 33,333 hours.
10. Application for Benefits under the Italy-U.S. International
Social Security Agreement--0960-0445. The information on form SSA-2528
is used by SSA to determine if a resident of Italy is eligible for
Social Security benefits under the Italy-U.S. Social Security
agreement. The respondents are Italian residents who file for U.S.
benefits with the Italian Social Security Agency.
Number of Respondents: 200.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 67 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.
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.
Dated: February 27, 1998.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 98-5811 Filed 3-5-98; 8:45 am]
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