[Federal Register Volume 66, Number 18 (Friday, January 26, 2001)]
[Notices]
[Pages 7949-7950]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-2324]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages that will require clearance by the 
Office of Management and Budget (OMB) in compliance with Pub.L. 104-13 
effective October 1, 1995, The Paperwork Reduction Act of 1995. 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.
    Written comments and recommendations regarding the information 
collection(s) should be submitted to the SSA Reports Clearance Officer 
and to the OMB Desk Officer at the following addresses:

(OMB), Attn: Desk Officer for SSA, New Executive Office Building, Room 
10230, 725 17th St., NW., Washington, DC 20503
(SSA), Social Security Administration, DCFAM, Attn: Frederick W. 
Brickenkamp 1-A-21 Operations Bldg., 6401 Security Blvd., Baltimore, MD 
21235

    I. The information collections listed below will be submitted to 
OMB within 60 days from the date of this notice. Therefore, your 
comments should be submitted to SSA within 60 days from the date of 
this publication. You can obtain copies of the collection instruments 
by calling the SSA Reports Clearance Officer at 410-965-4145, or by 
writing to him at the address listed above.
    1. Application for Retirement Insurance Benefits--0960-0007. In 
order to receive Social Security retirement insurance benefits, an 
individual must file an application with the Social Security 
Administration (SSA). The SSA-1 is one application that the 
Commissioner of Social Security prescribes to meet this requirement. 
The information that SSA collects will be used to determine entitlement 
to retirement benefits. The respondents are individuals who choose 
apply for Social Security retirement insurance.
    Number of Respondents: 1,460,692.
    Frequency of Response: 1.
    Average Burden Per Response: 10.5 minutes.
    Estimated Annual Burden: 255,621 hours.
    2. Pain Report-Child--0960-0540. The information collected on form 
SSA-3371-BK will be used to obtain the types of information specified 
in the regulations and to provide disability interviewers (and 
applicants/claimants in self-help situations) with a convenient means 
of recording the information obtained. This information is used by the 
State disability determination services (DDS) adjudicators, and 
administrative law judges, to assess the effects of symptoms on 
functionality for determining disability under the Social Security Act. 
The respondents are applicants for SSI benefits.
    Number of Respondents: 250,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 62,500 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 Annual Burden: 50,000 hours.
    4. Request for Waiver of Overpayment Recovery or Change in 
Repayment Notice--0960-0037. Form SSA-632 collects information on the 
circumstances surrounding overpayment of Social Security Benefits to 
recipients. SSA uses the information to determine whether recovery of 
an overpayment amount can be waived or must be repaid and, if repaid, 
how recovery will be made. The respondents are recipients of Social 
Security, Medicare, Black Lung or Supplemental Security Income 
overpayments.
    Number of Respondents: 500,000.
    Frequency of Response: 1.
    Average Burden Per Response: 120 minutes.
    Estimated Annual Burden: 1,000,000 hours.
    5. Beneficiary Interview and Auditor's Observations Form-0960-0630. 
The information collected through the Beneficiary Interview and 
Auditor's Observations form, SSA-322, will be used by SSA's Office of 
the Inspector General (OIG) to interview beneficiaries and/or their 
caregivers to determine whether representative payees are complying 
with their duties and responsibilities. Respondents to this collection 
will be randomly selected Supplemental Security Income recipients and 
Social Security beneficiaries that have representative payees.
    Number of Respondents: 150.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 38 hours.
    II. The information collections listed below have been submitted to 
OMB for clearance. Your comments on the information collections would 
be most useful if received by OMB and SSA within 30 days from the date 
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 at the address listed above.
    1. Discrimination Complaint Form--0960-0585. The information 
collected on form SSA-437 will be used by SSA to investigate and 
informally resolve complaints of discrimination based on race, color, 
national origin, sex, age, religion and retaliation in any program or 
activity conducted by SSA. A person who believes that he or she has 
been discriminated against on any of the above bases may file a written 
complaint of discrimination. The information will be used to identify 
the complainant; identify the alleged discriminatory act; ascertain the 
date of such alleged act; obtain the identity of the individual(s)/ 
facility/component that allegedly discriminated; and ascertain other 
relevant information that would assist in the investigation and 
resolution of the complaints. The respondents are individuals who 
allege discrimination on the grounds described above.
    Number of Respondents: 300.
    Frequency of Response: 1.
    Average Burden Per Response: 1 hour.
    Estimated Annual Burden: 300 hours.
    2. Claimant's Statement When Request for Hearing is Filed and the

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Issue is Disability--0960-0316. SSA requests that a claimant complete 
an HA-4486 when a claim for title II disability benefits or title XVI 
Supplemental Security Income benefits is denied and the claimant wishes 
a hearing before an Administrative Law Judge (ALJ). SSA uses this form 
to obtain updated information on the claimant's medical treatment to 
assist the ALJ in preparing for the hearing and in issuing a decision 
on entitlement to benefits. The respondents are individuals whose 
claims have been denied and who want a hearing before an ALJ.
    Number of Respondents: 442,720.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 110,680.

    Dated: January 19, 2001.
Frederick W. Brickenkamp,
Reports Clearance Officer.
[FR Doc. 01-2324 Filed 1-25-01; 8:45 am]
BILLING CODE 4191-02-P