[Federal Register Volume 67, Number 88 (Tuesday, May 7, 2002)]
[Notices]
[Pages 30747-30749]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-11210]


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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 Public Law 
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 10235, 725 17th St., NW., Washington, 
DC 20503.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance 
Officer, 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 the address listed above.
    1. Letter to Landlord Requesting Rental Information--0960-0454. 
Form SSA-L5061 is used by SSA to provide a nationally uniform vehicle 
for collecting information from landlords in making a rental subsidy 
determination in the Supplemental Security Income (SSI) Program. The 
information is used in deciding whether income limits are met for SSI 
eligibility. The respondents are landlords who provide subsidized 
rental arrangements to SSI applicants and recipients.
    Number of Respondents: 49,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Average Burden: 8,167.
    2. Continuation of Full Benefit Standard for Persons 
Institutionalized--0960-0516. SSA is required by law to establish 
procedures for collecting information on whether an SSI recipient who 
becomes institutionalized (e.g., hospital, nursing home) may be 
eligible for continued benefits, based on the full federal benefit 
rate, if a physician certifies that he expects the period of medical 
confinement will last no more than 90 days. The individual (or someone 
acting on his behalf) must demonstrate that he needs to pay some or all 
of the expenses of maintaining the home to which he expects to return. 
The respondents are applicants for SSI benefits.
    Number of Respondents: 60,000.
    Frequency of Response: 1.

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    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 5,000 hours.
    3. Inquiry To File an SSI Child's Application--0960-0557. The 
information collected on Form SSRO-3-293 (formerly SSA-293) is used by 
SSA to document the earliest possible filing date and to determine 
potential eligibility for SSI child's benefits. The respondents are 
individuals, such as hospital social workers, who inquire about SSI 
eligibility for low birth weight babies.
    Number of Respondents: 2,100.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Average Burden: 105 hours.
    4. Supplemental Security Income Notice of Interim Assistance 
Reimbursement (Two Forms)--0960-0546. Form SSA-8125 and SSA-L8125-F6 
collect interim assistance reimbursement (IAR) information from the 
States that provide such assistance. Form SSA-8125 is used in 
situations where IAR can be distributed directly to the recipient after 
the State has deducted the amount of assistance it provided. Form SSA-
L8125-F6 is used in situations where a recipient entitled to 
underpayments has received IAR from a State and SSA will control the 
benefit through the installment process. SSA uses the information 
collected through these forms for accounting and auditing purposes in 
administering the IAR process. The respondents are States that provide 
IAR to SSI claimants.

------------------------------------------------------------------------
                                      SSA-8125          SSA-L8125-F6
------------------------------------------------------------------------
Number of Respondents..........  50,000...........  50,000.
Frequency of Response..........  1................  1.
Average Burden Per Response....  10 minutes.......  10 minutes.
Estimated Annual Burden........  8,333 hours......  8,333 hours.
------------------------------------------------------------------------

    5. National Employment Activity and Disability Survey --0960-NEW

Background

    The Ticket to Work program (TTW) was established by the 1999 Ticket 
to Work and Work Incentives Improvement Act. The program will provide 
eligible Social Security Disability Insurance (SSDI) and Supplemental 
Security Income (SSI) disability beneficiaries with a Ticket, which can 
be used to obtain vocational rehabilitation (VR) or employment services 
through participating providers, called Employment Networks (ENs).
    The reason for the TTW program is that some beneficiaries currently 
lack the resources necessary to return to work at a level above the 
Substantial Gainful Activity (SGA) level, either because they do not 
have easy access to such services, or because they lack the incentive 
to invest resources in return to work activities because of a variety 
of factors affecting the decision to work. TTW confers upon a 
beneficiary a means to access those resources in a less restrictive 
manner than under the traditional program. The manner in which the 
program is being implemented is expected to increase beneficiary demand 
for employment-related services and activities. It is also expected to 
increase the number and diversity of providers in response to the less 
restrictive participation requirements and increased consumer demand 
for services.

The National Employment Activity and Disability Survey

    The National Employment Activity and Disability Survey will collect 
data on the work-related activities of SSI and Old Age, Survivors and 
Disability Insurance (OASDI) beneficiaries as the TTW program, and 
other initiatives designed to improve beneficiary employment outcomes, 
are implemented. The TTW Survey is specifically designed to be a 
significant resource for the formal evaluation of TTW, but SSA 
anticipates that the survey will provide useful information for a 
variety of evaluation and policy analysis purposes, especially related 
to current efforts that attempt to improve return to work. The survey 
questionnaire focuses on information about beneficiaries and their 
work-related activities that cannot be obtained from SSA's 
administrative records. The survey will provide information about: (1) 
Beneficiaries who assign their Tickets to ENs, and their experience in 
the program; (2) beneficiaries who do not assign their Tickets, and the 
reasons why they do not, including involuntary non-participants; (3) 
the employment outcomes of Ticket users and other beneficiaries; and 
(4) the use of employment services by Ticket users and other 
beneficiaries. The respondents will be selected from SSI and OASDI 
disabled beneficiaries who meet the Ticket to Work program eligibility 
requirements.
    Number of Respondents: 6,557.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated annual Burden: 4,918 hours.
    6. Public Information Campaign Collections--0960-0544. SSA uses the 
information from public broadcasting systems to determine media 
interest in broadcasting SSA's public information materials. The 
respondents are radio and television stations.
    Number of Respondents: 8,000.
    Frequency of Response: 3.
    Average Burden Per Response: 1 minute
    Estimated Annual Burden: 400.
    7. State Mental Institution Policy Review--0960-0110. SSA uses the 
information collected on Form SSA-9584 to determine whether policies 
and practices of State mental institutions conform with SSA's 
regulations in the use of benefits and whether an institution is 
performing other duties and responsibilities required of a 
representative payee. The information also provides a basis for 
conducting an onsite review of the institution and is used in preparing 
the subsequent report of findings. The respondents are State mental 
institutions that serve as representative payees.
    Number of Respondents: 125.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 125 hours.
    8. Record of Supplemental Security Income Inquiry--0960-0140. Form 
SSA-3462 is completed by SSA personnel via telephone or personal 
interview, and it is used to determine potential eligibility for SSI 
benefits. The respondents are individuals who inquire about SSI 
eligibility for themselves or someone else.
    Number of Respondents: 2,341,856.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 195,155 hours.
    II. The information collections listed below have been submitted to 
OMB for

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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 package by 
calling the SSA Reports Clearance Officer on (410) 965-4145, or by 
writing to the address listed above.
    1. Internet Social Security Disability Report--0960-NEW. The Social 
Security Act requires applicants to furnish medical and other evidence 
and information to prove they are disabled. Applicants for disability 
benefits will be given the option to provide information needed to help 
determine they are disabled through the Internet. The Internet Social 
Security Disability Report, which is similar to the Form SSA-3368-BK, 
Disability Report-Adult, will collect allegations of disability and 
gather information about the disabling condition and sources of medical 
evidence. Collecting this information is critical to case development 
and adjudication. The information on the Disability Report, together 
with other evidence and information, will be used by State Disability 
Determination Services (who make disability decisions on behalf of SSA) 
to develop medical evidence, assess the alleged disability, and make a 
determination on whether or not the applicant is disabled under the 
Act. SSA plans to conduct a limited pilot of the Internet Social 
Security Disability Report followed by national implementation. The 
respondents are applicants for title II and title XVI disability 
benefits.

Pilot Burden Hours Estimate

    Number of Respondents: 8,400.
    Frequency of Response: 1.
    Average Burden Per Response: 2 hours.
    Estimated annual Burden: 16,800 hours.

National Implementation Burden Hours Estimate

    Number of Respondents: 66,000.
    Frequency of Response: 1.
    Average Burden Per Response: 2 hours.
    Estimated annual Burden: 132,000 hours.
    2. Employee Work Activity Report--0960-0483. The data collected by 
SSA on Form SSA-3033 is used to determine if the claimant meets the 
disability requirements of the law, when the claimant returns to work 
after the alleged or established onset date of disability. When a 
possible unsuccessful work attempt or nonspecific subsidy is involved, 
Form SSA-3033 will be used to request a description of the employee's 
work effort. The respondents are employers of OASDI and SSI disability 
applicants and beneficiaries.
    Number of Respondents: 12,500.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 3,125 hours.

    Dated: May 1, 2002.
Liz Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 02-11210 Filed 5-6-02; 8:45 am]
BILLING CODE 4191-02-P