[Federal Register Volume 68, Number 158 (Friday, August 15, 2003)]
[Notices]
[Pages 48981-48984]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-20730]


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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. The information can be mailed and/or faxed to the individuals 
at the addresses and fax numbers listed below:
    (OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 
New Executive Office Building, Room 10235, 725 17th St., NW., 
Washington, DC 20503, Fax: 202-395-6974.
    (SSA), Social Security Administration, DCFAM, Attn: Reports 
Clearance Officer, 1338 Annex, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-965-6400.
    I. The information collections listed below are pending at SSA and 
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. Integrated Registration for Employers and Submitters (IRES)--
0960-0626. The IRES authentication system is a free service designed to 
allow employers to access SSA's electronic wage reporting services, and 
to replace the use of a handwritten signature with an electronic 
signature. Employer representatives use an IRES generated PIN and 
password as their electronic signature. IRES is designed to be more 
efficient, reducing the costs to both employers and SSA, and will 
facilitate the filing of wage data electronically. SSA's paramount 
interest in the development of IRES was to ensure that the new 
electronic method of identifying wage report submitters provides the 
same security features as the current paper-based method. Security 
features include message integrity, originator authentication, non-
repudiation and confidentiality. The PIN and password will be issued to 
an individual designated by the employer after SSA authenticates the 
company and contact information provided by the individual. SSA uses 
the IRES in conjunction with SSA's wage reporting processes. It is used 
as the gateway for electronic wage reporting and the online employee 
verification service. IRES will also be used when SSA implements 
additional electronic services such as electronic notices and error 
information. Also, the PIN will be used in the Annual Wage Reporting 
diskette process to replace IRS paper form 6559. SSA has received 
approval from IRS to use an alternative signature. Respondents to IRES 
will be Employers and Submitters who utilize SSA's electronic wage 
reporting and online employee verification services.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 250,120.
    Number of Responses: 1.
    Average Burden Per Response: 2 minutes.
    Estimated Annual Burden: 8,337 hours.
    2. Application for Widow's or Widower's Insurance Benefits--20 CFR 
404.335-.338--0960-0004. SSA uses the information collected on the Form 
SSA-10-BK to determine if the applicant meets the statutory and 
regulatory conditions for entitlement to widow(er)'s benefits. The 
respondents are applicants for Widow(er)'s benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 288,580.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 72,145 hours.
    3. Application of Circuit Court Law--0960-0581. SSA regulations at 
20 CFR 404.985 and 416.1485 inform claimants of their right to request 
that a published Acquiescence Ruling (AR) be applied to a prior 
determination when we make a determination or decision on a claim 
between the date of the Circuit Court decision and the date we publish 
the AR. The regulations also specify that claimants can request that 
the AR be applied to a prior determination or decision by submitting a 
statement that demonstrates how the AR could change the prior 
determination or decision. SSA will use the information provided in the 
statement to readjudicate the claim if the claimant demonstrates the 
Ruling could change the prior determination. Claimants may use Form 
SSA-795, Statement of Claimant or Other Person (0960-0045), to request 
and support application of a published AR to the prior determination or 
decision. The respondents are claimants whose determinations or 
decisions on their claims may be affected by an AR.
    Type of Request: Extension of current approved collection.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 17 minutes.
    Estimated Annual Burden: 28,333 hours.
    4. Waiver of Right to Appear--20 CFR 404.913-914, 20 CFR 404 
916(b)(5), 20 CFR 416.1413-1414 and 1416(b)(5)--0960-0534. The Social 
Security Administration uses Form-773-U4 to provide claimants with an 
effective means of requesting a waiver of their right to appear at a 
disability hearing. The information collected will be used as 
documentation that claimants understand their rights to appear and the 
effects of the decision to waive this right. The respondents are 
claimants under Title II (Old-Age, Survivors and Disability Insurance) 
and Title XVI (Supplemental Security Income) of the Social Security 
Act, who wish to waive their right to a disability hearing
    Type of Request: Extension of current approved collection.
    Number of Respondents: 200.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.

[[Page 48982]]

    Annual Burden: 10 hours.
    5. Request for Internet Services--Password--0960-0632. SSA uses a 
personal identification number (PIN)/password process for verifying the 
identity of individuals who choose to use the Internet and Automated 
Telephone Response in order to conduct business with the agency. An 
individual will be requested to provide certain information about 
himself or herself that SSA can verify in its records in order to 
obtain a password for use with its electronic services. The information 
that SSA collects varies depending on individual circumstances. Some 
examples of the information collected are: Name, social security 
number, password request code, benefit payment amount, and other shared 
secret types of information from SSA records. Once the requestor's 
identity is verified, SSA issues a PIN to the requestor which will 
allow them to establish a password for use with SSA Internet/telephone 
transactions. Until now, the services offered have been primarily to 
beneficiaries receiving benefits under title II of the Social Security 
Act, including Retirement, Survivors and Disability benefits. In April 
2003, SSA began offering the opportunity for certain beneficiaries 
receiving benefits under title XVI of the Social Security Act, known as 
Supplemental Security Income (SSI), to report their wages 
electronically. SSA will initiate a 6-month Proof of Concept project to 
test the beneficiary acceptance of this technology for reporting wages. 
Participation in this Proof of Concept is voluntary. Individuals who 
must report wages include SSI beneficiaries, and, in some cases, the 
parent or spouse of the SSI beneficiary. In order to use SSA's 
electronic services, SSA must authenticate the person using its PIN/
password process to protect the information in its records from those 
not authorized to receive it. This technology is expected to be more 
secure, less burdensome, faster and provide better customer service 
than other available options. The respondents are individuals who elect 
to conduct business with the agency in an electronic medium.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 412,267.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 68,711 hours.
    6. Student Reporting Form--20 CFR, Subpart B, 404, and 20 CFR, 
Subparts D & E 422--0960-0088. Form SSA-1383 is used by Social Security 
student beneficiaries to report events or changes that may affect 
continuing entitlement to these benefits. We are revising this form in 
order to solicit information about incarceration in compliance with 
current law. The respondents are Social Security Student Beneficiaries.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 75,000.
    Frequency of Response: 1.
    Average Burden Per Response: 6 minutes.
    Estimated Annual Burden: 7,500 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 at 410-965-0454, or by 
writing to the address listed above.
    1. Disability Hearing Officer's Decision, Title XVI Disabled Child 
Continuing Disability Review--20 CFR 404 Subpart J and 20 CFR 416 
Subpart I&N-OMB No. 0960-0657. Both Federal and state disability 
hearing officers (DHOs) use the SSA-1209 in preparing the disability 
determination. The form provides the framework for addressing the 
crucial elements of the case in a sequential and logical fashion. The 
completed form will be the official document of the decision. A copy 
becomes the personalized portion of the notice to the claimant/
representative. The respondents are both Federal and state disability 
hearing officers.
    Type of Request: Extension of currently approved collection.
    Number of Respondents: 35,000.
    Frequency of Response: 1.
    Average Burden Per Response: 1 hour 25 minutes.
    Estimated Annual Burden: 49,583.
    2. Claimant's Statement About Loan of Food and Shelter, SSA-5062, 
and Statement About Food or Shelter Provided to Another, SSA-L5063--
0960-0529. Forms SSA-5062 and SSA-L5063 are used to obtain statements 
about food and/or shelter provided to an SSI claimant. SSA uses the 
information to determine whether food and/or shelter are a bona fide 
loan or should be counted as income. This determination can affect 
eligibility for SSI and the amount of SSI that is payable. The 
respondents are claimants for SSI benefits and individuals who provide 
(loan) food or shelter to SSI claimants.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of respondents: 65,540.
    Frequency of Response: 1.
    Average Burden of Response: 10.
    Estimated Annual Burden: 10,923.
    3. Medical Consultant's Review of Psychiatric Review Form--20 CFR 
404.1520(a), 20 CFR 404.1640, 20 CFR 404.1643, 20 CFR 404.1645, 20 CFR 
416.920(a)--0960-NEW. The Social Security Administration measures the 
performance of State Disability Determination Services (DDS) in the 
area of quality of documentation and determinations on claims. In 
mental claims, a Psychiatric Review Technique Form (PRTF) is completed 
by DDS medical/psychological consultant (MC/PC). Form SSA-3023 is used 
by the regional review component to facilitate the MC/PC's review of 
the PRTF. The MC/PC completes an SSA-3023 only when adjudicating 
component's PRTF is in file. The SSA-3023 is required for each 
completed PRTF in file.
    Type of Request: Request for Approval of Existing Information 
Collection.
    Number of Respondents: 68,000.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 13,600.
    4. Collection of SSI Overpayments from Special Benefits for Certain 
WWII Veterans; 20 CFR, Subpart E, 416.570 & .572--0960-0653. The 
information collection requirement in 20 CFR 416.570 allows for an 
individual to request to withhold a title XVI overpayment from Title 
II/VIII benefits. The information collection requirement in 20 CFR 
416.572 allows for an individual to elect a higher or lower rate of 
withholding for recovery of an SSI overpayment. The information 
collected will be used to determine the proper rate of withholding of 
benefits to recover program overpayments. The respondents are Title II 
or Title VIII beneficiaries who were overpaid title XVI benefits and 
who request a higher rate of recovery than specified in 20 CFR 416.571.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 2,500.
    Frequency of Response: 1.
    Average Burden Per Response: 1 hour.
    Estimated Annual Burden: 2,500 hours.
    5. Requests for Self-Employment Information, Employee Information, 
Employer Information--20 CFR, Subpart A, 422.120--0960-0508. SSA uses 
Forms SSA-L2765, SSA-L3365 and SSA-L4002 to request correct information 
when an employer, employee or self-employed person reports an 
individual's earnings without a Social Security Number (SSN) or with an 
incorrect name or SSN. The

[[Page 48983]]

respondents are employers, employees or self-employed individuals who 
are requested to furnish additional identifying information.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 3,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 500,000 hours.
    6. State Mental Institution Policy Review--20 CFR, Subpart U, 
404.2001-2065, Subpart F, 416.601-416.665--0960-0110. The Social 
Security Act provides that the Commissioner of Social Security shall 
establish a system of accountability monitoring for institutions in 
each state that serve as a representative payee for recipients of 
Social Security and SSI benefits. As part of this accountability 
process, SSA collects information on Form SSA-9584 to determine whether 
the institutions' policies and practices conform to SSA's regulations 
on the use of benefits and whether the 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 the preparation of the subsequent report 
of findings. The respondents are state mental institutions that serve 
as representative payees.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 125.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 125 hours.
    7. Medical or Psychological Consultant's Review of Childhood 
Disability Evaluation Form--20 CFR, Subpart J, 416.1040, .1043, .1045--
0960-NEW. Form SSA-536 is used by SSA medical or psychological 
consultants to document their review and assessment of the Childhood 
Disability Evaluation Form, SSA-538, prepared by State DDS employees. A 
childhood disability evaluation is required in each SSI childhood 
disability case. Therefore, the consultants must prepare an assessment 
form SSA-536 for each childhood disability case that is reviewed. The 
respondents are 256 SSA medical and psychological consultants.
    Type of Request: Approval of an existing information collection.
    Number of Responses: 17,000.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 3,400 hours.
    8. Privacy and Disclosure of Official Records and Information, 
Availability of Information and Records to the Public--20 CFR 401 and 
402--0960-0566. The information collected is needed (a) to identify 
individuals who request access to their records; (b) designate an 
individual to receive and review sensitive medical records; (c) correct 
or amend records; (d) obtain consent from an individual to release his/
her records to others; (e) facilitate the release of information under 
the Freedom of Information Act; and (f) to grant a waiver or reduction 
of fees for records. The respondents are individuals requesting access 
to their SSA records, correction of their SSA records and disclosure of 
SSA records.
    Type of Request: Extension of an OMB-approved information 
collection. The reporting burden is shown below:
    (a) Number of Respondents: 10,000.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 11 minutes.
    Estimated Annual Burden: 1,833 hours.
    (b) Number of Respondents: 3,000.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 2 hours.
    Estimated Annual Burden: 6,000 hours.
    (c) Number of Respondents: 100.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 17 hours.
    (d) Number of Respondents: 200,000.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 10,000 hours.
    (e) Number of Respondents: 15,000.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 1,250 hours.
    (f) Number of Respondents: 400.
    Frequency of Response: On Occasion.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 33 hours.
    9. Social Security Disability Report--20 CFR 404.1512 & 416.912-
0960. The Social Security Act requires applicants to furnish medical, 
work history and other evidence or information to prove they are 
disabled. The information on the Adult Disability Report, together with 
other evidence and information, will be used by State Disability 
Determination Services (DDS) to develop medical evidence, assess the 
alleged disability, and make a determination on whether or not the 
applicant is disabled under the Act. DDSs are State agencies that make 
disability determinations on behalf of SSA. In addition to the 
traditional paper application, claimants for disability benefits will 
have the option to complete the Disability Report through the Internet 
(i3368) or in an interview format with an SSA representative at an SSA 
field office using the Electronic Disability Collect System (EDCS). 
Both the i3368 and EDCS formats collect the same information as that 
contained on the paper SSA-3368, but include enhancements to guide the 
claimant or interviewer through the application process. For example, 
the i3368 provides applicants with self-help screens and propagates 
certain information. Both the i3368 and EDCS applications will, when 
needed, collect additional information on a claimant's work history. In 
the paper-based process, however, additional work history information 
is collected through another form, the SSA-3369, OMB No. 0960-0578. The 
respondents are applicants for title II and title XVI disability 
benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                 Average  burden     Estimated
               Collection format                    Number of     Frequency  of   per  response   annual  burden
                                                   respondents      responses        (hours)          (hours)
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SSA-3368 (Paper Form)..........................       2,040,667               1              1         2,040,667
Electronic Disability Collection System (EDCS).          10,000               1              1            10,000
I3368 (Internet) (Hour burden varies between             66,000               1             2\.5\        165,000
 1\1/2\ hours and 3 hours based on information
 required).....................................
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[[Page 48984]]

    Total estimated annual burden: 2,215,667.

    Dated: August 8, 2003.
Nicholas E. Tagliareni,
Acting Reports Clearance Officer.
[FR Doc. 03-20730 Filed 8-14-03; 8:45 am]
BILLING CODE 4191-02-U