[Federal Register Volume 67, Number 140 (Monday, July 22, 2002)]
[Notices]
[Pages 47876-47877]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-18189]


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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. 
The information collection packages that may be included in this notice 
are for new information collections, revisions to OMB-approved 
information collections and extensions (no change) of OMB-approved 
information collections.
    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 
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 410-965-0454, or by 
writing to the address listed above.

1. Employee Verification Service (EVS)

Background

    Under Internal Revenue Service regulations, employers are required 
to provide wage and tax data to SSA using form W-2, Wage and Tax 
Statement or its electronic equivalent. As part of this process, the 
employer must furnish the employee's name and Social Security Number 
(SSN). This information must match SSA's records in order for the 
employee's wage and tax data to be properly posted to the Earnings 
Record. Information that is incorrectly provided to the Agency must be 
corrected by the employer using an amended reporting form, which is a 
labor-intensive and time-consuming process for both SSA and the 
employer. Therefore, to help ensure that employers provide accurate 
name and SSN information on their wage reports, SSA is offering the EVS 
service whereby employers can verify, via magnetic tape, cartridge, 
diskette, paper, and telephone, if the reported name and SSN of their 
employee matches SSA's records.

EVS Collection

    SSA will use the information collected through the EVS to verify 
that the employee name and SSN information, provided by employers, 
matches SSA records. SSA will respond to the employer informing them 
only of matches and mismatches of submitted information. Respondents 
are employers

[[Page 47877]]

who provide wage and tax data to SSA who elect to use EVS to verify 
their employees' names and SSNs.
    Type of Request: New Information Collection.
    Number of Respondents: 100,000.
    Frequency of Response: 5.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 83,333 hours.

2. 20 CFR Part 422.527, Private Printing and Modification of Prescribed 
Applications and Other Forms--0960-NEW

    SSA uses the information required by this regulation to process 
requests from a person, institution or organization (requesting 
entities) that want to reproduce, duplicate, or privately print any SSA 
application or other form prescribed by SSA. The requesting entities 
must obtain prior approval from SSA and make their requests in writing, 
providing the required information set forth in the regulation. 
Respondents are the requesting entities that want to reproduce, 
duplicate, or privately print any SSA application or other form.
    Type of Request: New Information Collection.
    Number of Respondents: 4.
    Frequency of Response: 1.
    Average Burden Per Response: 8 minutes.
    Estimated Annual Burden: 1/2 hour.

3. Medical Source Statement of Ability To Do Work-Related Activities 
(Physical), Form HA-1151; Medical Source Statement of Ability To Do 
Work-Related Activities (Mental), Form HA-1152--0960-NEW

    SSA's Office of Hearing and Appeals (OHA) uses the HA-1151 
(Physical) and its companion form HA-1152 (Mental) to collect 
information that Administrative Law Judges and the Appeals Council of 
OHA require to determine the residual functional capacity (RFC) of 
individuals who are appealing denied claims for benefits based on 
disability. RFC must be determined to decide cases that cannot be 
decided based on current work activity or on medical facts alone. Both 
forms are completed by medical sources that provide medical reports 
based either on existing medical evidence or on consultative 
examinations conducted for the purposes of the report. Respondents to 
these forms are medical sources that provide medical reports.
    Type of Request: New Information Collections.

HA-1151

    Number of Respondents: 5,000.
    Frequency of Response: 20.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 25,000 hours.

HA-1152

    Number of Respondents: 5,000.
    Frequency of Response: 20.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 25,000 hours.
    II. The information collection listed below has 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 package 
by calling the SSA Reports Clearance Officer on (410) 965-0454, or by 
writing to the address listed above.
    The Census Bureau Survey of Income and Program Participation (SIPP) 
on Behalf of the Social Security Administration (SSA)--0960-NEW. SSA 
has requested the Census Bureau to include in its SIPP interviews 
scheduled for January 2003 a sample of social security disabled 
insurance beneficiaries and supplemental security income recipients. 
SSA will use these data to conduct statistical research of recipients 
of SSA-administered programs. The SIPP for SSA Beneficiaries is a 
household-based survey molded around a central ``core'' of labor force 
and income questions. The core is supplemented with questions designed 
to address specific needs, such as obtaining information about assets 
and liabilities, as well as expenses related to work, health care, 
child support and real estate/dependent care. These supplemental 
questions are included with the core and are referred to as ``topical 
modules.''
    The survey is currently scheduled for one month and will include 
approximately 1,000 households. We estimate that each household will 
average 2.1 people, yielding 2,100 interviews. Interviews take 30 
minutes on average. The total burden for the SIPP for SSA Beneficiaries 
would be 1,050 hours.
    The topical modules for the SIPP for SSA Beneficiaries collect 
information about:
     Medical Expenses and Utilization of Health Care (Adults 
and Children)
     Work Related Expenses, Child Support Paid and Child Care 
Poverty
     Assets, Liabilities, and Eligibility
     Real Estate and Dependent Care
    The survey interviews will be conducted from January 1, 2003 
through January 31, 2003.
    Type of Request: New Information Collection.
    Number of Respondents: 2,100.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 1,050 hours.

    Dated: July 15, 2002.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 02-18189 Filed 7-19-02; 8:45 am]
BILLING CODE 4191-02-P