[Federal Register Volume 65, Number 1 (Monday, January 3, 2000)]
[Notices]
[Pages 156-157]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-34004]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    In compliance with Public Law 104-13, the Paperwork Reduction Act 
of 1995, SSA is providing notice of its information collections that 
require submission to the Office of Management and Budget (OMB). SSA is 
soliciting comments on the accuracy of the agency's burden estimate; 
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.
    I. The information collections listed below will be submitted to 
OMB within 60 days from the date of this notice. Therefore, comments 
and recommendations regarding the information collections would be most 
useful if received by the Agency within 60 days from the date of this 
publication. Comments should be directed to the SSA Reports Clearance 
Officer at the address listed at the end of this publication. You can 
obtain a copy of the collection instruments by calling the SSA Reports 
Clearance Officer on (410) 965-4145, or by writing to him at the 
address listed at the end of this publication.
    1. Report to United States Social Security Administration by Person 
Receiving Benefits for a Child or Adult Unable to Handle Funds--0960-
0049. The information on Forms SSA-7161-OCR-SM and 7162-OCR-SM is used 
by the Social Security Administration (SSA) to determine continuing 
entitlement and proper benefit amounts for Social Security 
beneficiaries who live outside the United States (U.S.). The 
respondents are persons living outside the U.S. who are entitled to 
benefits or who are representative payees for an entitled beneficiary.

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                                                                          SSA-7161-OCR-SM      SSA-7162-OCR-SM
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Number of Respondents:................................................               30,000              200,000
Frequency of Response:................................................                    1                    1
Average Burden Per Response (minutes):................................                   15                    5
Estimated Annual Burden (hours):......................................                7,500               16,667
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    2. State Agency Schedule for Equipment Purchases for SSA Disability 
Programs--0960-0406. SSA uses the information collected on Form SSA-871 
to budget and account for expenditures of funds for equipment purchases 
by the State Disability Determination Services (DDS) that administer 
the disability determination program. The respondents are State 
governments that make disability determinations.
    Number of Respondents: 54.
    Frequency of Response: 4.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 216 hours.
    3. Physical Residual Functional Capacity Assessment; Mental 
Residual Functional Capacity Assessment--0960-0431. The information 
collected on forms SSA-4734-BK and SSA-4734-BK-SUP is needed by SSA to 
assist in the adjudication of disability claims involving physical and/
or mental impairments. The forms assist the State DDS to evaluate 
impairment(s) by providing a standardized data collection format to 
present findings in a clear, concise and consistent manner. The 
respondents are State DDSs administering title II and title XVI 
disability programs.
    Number of Responses: 1,130,772.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 376,924 hours.
    4. Letter to Employer Requesting Wage Information--0960-0138. The 
information collected on form SSA--L4201 is used by SSA to determine 
eligibility and proper benefit payments for SSI applicants/recipients. 
The respondents are employers of applicants for and recipients of SSI 
payments.
    Number of Respondents: 133,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 66,500 hours.
    5. Privacy and Disclosure of Official Records and Information: 
Availability of Information and Records to the Public--20 CFR 401 and 
402--0960-0566. The respondents are individuals requesting access to 
their SSA records, correction of their SSA records and disclosure of 
SSA records. This information is required to:
    (a) Identify individuals who request access to their records:

[[Page 157]]

    Number of Respondents: 10,000.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 11 minutes.
    Estimated Annual Burden: 1,833.
    (b) Designate an individual to receive and review a recordholder's 
sensitive medical records in accordance with 20 CFR 401.55 and for 
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 hrs.
    Estimated Annual Burden: 6,000 hrs.
    (c) Correct or amend records:
    Number of Respondents: 100.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 17 hrs.
    (d) Obtain consent from an individual to release his/her records to 
others. Consents are submitted by letter in writing or by use of an 
SSA-3288:
    Number of Respondents: 200,000.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,000 hrs.
    (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.
    Estimated Annual Burden: 1,250.
    (f) Grant 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 hrs.
    II. The information collections listed below have been submitted to 
OMB for clearance. Written comments and recommendations on the 
information collections would be most useful if received within 30 days 
from the date of this publication. Comments should be directed to the 
SSA Reports Clearance Officer and the OMB Desk Officer at the addresses 
listed at the end of this publication. You can obtain a copy of the OMB 
clearance packages by calling the SSA Reports Clearance Officer on 
(410) 965-4145, or by writing to him.
    1. Partnership Questionnaire--0960-0025. Form SSA-7104 is used to 
establish several aspects of eligibility for benefits, including 
accuracy of reported partnership earnings, the veracity of a 
retirement, and lag earnings where they are needed for insured status. 
The respondents are applicants for OASDI and disability benefits.
    Number of Respondents: 12,350.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 6,175 hours.
    2. Report of New Information in Disability Cases--0960-0071. The 
information collected on Form SSA-612 is used to update the disability 
records of respondents, based on changes reported. The respondents are 
applicants for and recipients of title II disability benefits.
    Number of Respondents: 27,000.
    Frequency of Response: 1.
    Average Burden Per Response: 6 minutes.
    Estimated Annual Burden: 2,700 hours.
    3. Claimant's Recent Medical Treatment--0960-0292. The information 
collected on Form HA-4631 is used to provide an updated medical history 
for a disability claimant who requests a hearing and to afford 
claimants their statutory right to a hearing and decision under the 
Social Security Act. The respondents are claimants requesting hearings 
on entitlement to benefits based on disability under title II (Old-Age, 
Survivors and Disability Insurance) and/or title XVI (Supplemental 
Security Income) of the Social Security Act.
    Number of Respondents: 309,490.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 51,582 hours.
    4. Supplemental Security Income (SSI)--Quality Review Case 
Analysis--0960-0133. Form SSA-8508-BK is used with a sample of SSI 
recipients in a personal interview and covers all elements of SSI 
eligibility. The information obtained is used to assess the 
effectiveness of SSI policies and procedures and to establish payment 
accuracy rates. The respondents are SSI Recipients.
    Number of Respondents: 15,000.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 15,000 hours.
    5. Psychiatric Review Technique--0960-0413. The information 
collected on Form SSA-2506 is needed by SSA to facilitate 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 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 DDS's administering titles II and XVI disability programs.
    Number of Respondents: 1,005,804.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 251,451 hours.
    6. 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 SSA 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: 150.
    Frequency of Response: 1.
    Average Burden Per Response: 14 hours.
    Estimated Annual Burden: 2,100 hours.
    7. Work Activity Report--Employee. 0960-0059. The information on 
form SSA-821-BK will be used by the Social Security Administration 
(SSA) to obtain work issue information from beneficiaries in face-to-
face interviews, telephone interviews, or by mail during the initial 
claims process, during the continuing disability review process, and 
whenever a work issue arises in SSI claims. The purpose of the SSA-821-
BK is to collect information concerning whether beneficiaries have 
worked in employment after becoming disabled and, if so, whether that 
work is substantial gainful activity. The information will be used to 
determine if the recipient continues to meet the disability 
requirements of the law.
    Number of Respondents: 300,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 225,000 hours.
    SSA Address: Social Security Administration, DCFAM, Attn: Frederick 
W. Brickenkamp, 6401 Security Blvd., 1-A-21 Operations Bldg., 
Baltimore, MD 21235.
    OMB Address: Office of Management and Budget, OIRA, Attn: Desk 
Officer for SSA, New Executive Office Building, Room 10230, 725 17th 
St., NW, Washington, DC 20503.

    Dated: December 22, 1999.
Nicholas E. Tagliareni,
Director, Center for Publications Management, Social Security 
Administration.
[FR Doc. 99-34004 Filed 12-30-99; 8:45 am]
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