[Federal Register Volume 66, Number 63 (Monday, April 2, 2001)]
[Notices]
[Pages 17592-17593]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-8000]


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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 P.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 OMB Desk Officer and the SSA 
Reports Clearance Officer and at the following addresses: (OMB), Office 
of Management and Budget, 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. Function Report--Third Party, SSA-3380-0960-NEW. The Social 
Security Act provides that claimants must furnish medical and other 
evidence to prove they are disabled. The Social Security Act also gives 
the Commissioner authority to make rules and regulations on the nature 
and extent of evidence required as well as the methods of obtaining 
evidence. The information collected from third parties on the form SSA-
3380 is needed for the determination of disability under Title II (Old-
Age, Survivors and Disability Insurance (OASDI)) and/or Title XVI 
(Supplemental Security Income (SSI)). The form records information 
about the disability applicant's illnesses, injuries, conditions, 
impairment-related limitations and ability to function. The respondents 
are individuals who know about the disability applicant's impairment, 
limitations and ability to function.
    Number of Respondents: 1,500,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 750,000 hours.
    2. Disability Hearing Officer's Decision--0960-0441. The Social 
Security Act requires that SSA provide an evidentiary hearing at the 
reconsideration level of appeal for claimants who have received an 
initial or revised determination that a disability did not exist or has 
ceased. Based on the hearing, the disability hearing officer (DHO) 
completes an SSA-1207 and applicable supplementary forms (which apply 
to the type of claim involved). The DHO uses the information in 
documenting and preparing 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 Disability 
Determination Services (DDS).
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 75,000 hours.
    3. Medical History and Disability Report, Disabled Child--0960-
0577. The Social Security Act requires claimants to furnish medical and 
other evidence to prove they are disabled. The form SSA-3820 is used to 
obtain various types of information about a child's condition, his/her 
treating sources and/or other medical sources of evidence. The 
information collected on the SSA-3820 is needed for the determination 
of disability by the State DDSs. The respondents are applicants for 
Title XVI (SSI) child disability benefits.
    Number of Respondents: 523,000.
    Frequency of Response: 1.
    Average Burden Per Response: 40 minutes.
    Estimated Annual Burden: 348,667 hours.
    4. Disability Report-Adult--0960-0579. The Social Security Act 
requires claimants to furnish medical and other evidence to prove they 
are disabled. Applicants for disability benefits will complete form 
SSA-3368. The information will be used, in conjunction with other 
evidence, by State DDSs to develop medical evidence, to assess the 
alleged disability, and to make a disability determination. The 
respondents are adult applicants for Title II (OASDI) and Title XVI 
(SSI) disability benefits.
    Number of Respondents: 2,116,667.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 2,116,667 hours.
    5. Wage Reports and Pension Information--0960-0547. The information 
required by 20 CFR 422.122(b) is used by SSA to identify the requester 
of pension plan information and to confirm that the individual is 
entitled to the data we provide. The respondents are requesters of 
pension plan information.
    Number of Respondents: 600.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 300 hours.
    6. Beneficiary Recontact Report--0960-0502. SSA uses the 
information

[[Page 17593]]

collected on Form SSA-1588-OCR-SM to ensure that eligibility for 
benefits continues after entitlement. SSA asks mothers/fathers 
information about their marital status and children in-care to detect 
overpayments and avoid continuing payment to those no longer entitled. 
The respondents are recipients of survivor mother/father Title II 
(OASDI) benefits.
    Number of Respondents: 133,400.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 11,117 hours.
    7. Quiz Show--Internet Edition--0960-NEW.

Background

    As stated in the 1997 Agency Strategic Plan, one of the SSA's five 
major goals is ``To Strengthen Public Understanding of the Social 
Security Programs'' so the public will understand what benefits are 
valuable to them personally. Accordingly, the public will be able to 
more effectively plan for retirement security. Under this goal, SSA 
established a strategic objective that, by 2005, 90% of the public will 
be knowledgeable about SSA programs. In establishing this goal SSA 
recognized the need to develop innovative methods to help educate and 
continually measure the public's knowledge of SSA programs.

The Collection--``Quiz Show''

    SSA intends to implement an online interactive educational game 
entitled ``Quiz Show--Internet Edition''. The purpose of Quiz Show is 
to help support the Agency's goal of increasing the public's 
understanding of Social Security programs.
    Quiz Show will consist of 10 questions, which are based on 8 key 
messages about SSA programs that the Agency wants the public to 
understand. Participation in the online game will be strictly 
voluntary. Data collected through each Quiz Show question will measure 
the overall responses for the purpose of gauging the public's knowledge 
of each key Social Security message.
    SSA will implement Quiz Show in stages, with the initial stage 
providing performance feedback to the user. However, eventually SSA 
will use Quiz Show to collect performance data and demographic data. 
SSA will not require users to provide demographic data to play the 
game. Rather, users would be asked to provide this data voluntarily. 
Questions related to demographics are for the sole purpose of 
identifying audiences to whom specific key messages should be targeted 
to increase their knowledge. Respondents to Quiz Show will be 
individuals who visit SSA's website, Social Security Online, and elect 
to play the online game.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden Per Response: 8 minutes.
    Estimated Annual Burden: 1,600 hours.
    8. Work History Report--0960-0578. The information collected on 
form SSA-3369 is needed to determine disability by the State DDSs. The 
information will be used to document an individual's past work history. 
The respondents are applicants for disability benefits.
    Number of Respondents: 1,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 500,000 hours.
    9. Internet Social Security Benefits Application--0960-0618. The 
Internet Social Security Benefits Application (ISBA), which is 
available at the Social Security Administration's (SSA) Internet site, 
is one application that the Commissioner of Social Security prescribes 
to meet the requirement to file an application for benefits. Currently, 
the ISBA can only be used to apply for retirement and spouse's 
benefits. SSA plans to expand ISBA to encompass surviving spouse (i.e., 
widow and widower) benefits. The expanded ISBA will enable individuals 
to complete the application electronically on their own and submit the 
application over the Internet. Until SSA develops an acceptable 
electronic signature process, applicants will also print, sign and mail 
the IBSA statement with the required evidence that supports their 
benefit application. The information that SSA collects will be used to 
determine entitlement to Social Security benefits. The respondents are 
individuals who choose to apply for Social Security benefits over the 
Internet.
    Number of Respondents: 150,000.
    Frequency of Response: 1.
    Average Burden Per Response: 25 minutes.
    Estimated Annual Burden: 62,500 hours.
    II. The information collection listed below has been submitted to 
OMB for clearance. Your comments on the information collection 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 package by 
calling the SSA Reports Clearance Officer on (410) 965-4145, or by 
writing to him at the address listed above.
    Function Report--Adult; 0960-0603. Form SSA-3373-TEST is used by 
the SSA to record the claimant's description of his or her impairment-
related limitations and ability to function. The respondents are 
Applicants for Title II (Old-Age, Survivors and Disability Insurance) 
and Title XVI (Supplemental Security Income) benefits.
    Number of Respondents: 7,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30.
    Estimated Annual Burden: 3,500.

    Dated: March 26, 2001.
Frederick W. Brickenkamp,
Reports Clearance Officer.
[FR Doc. 01-8000 Filed 3-30-01; 8:45 am]
BILLING CODE 4191-02-P