[Federal Register Volume 69, Number 237 (Friday, December 10, 2004)]
[Notices]
[Pages 71863-71867]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-26998]


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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, the Paperwork Reduction Act of 1995, effective October 1, 1995. The 
information collection packages that may be included in this notice are 
for 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, Fax: 202-395-6974.
    (SSA), Social Security Administration, DCFAM, Attn: Reports 
Clearance Officer, 1338 Annex Building, 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. Quarterly Statistical Report on Recipients and Payments Under 
State-Administered Assistance Programs for

[[Page 71864]]

Aged, Blind and Disabled (Individuals and Couples) Recipients--20 CFR 
416.2010, 20 CFR 416.2098--0960-0130. The purpose of the statistical 
report is to obtain State data on expenditures and caseloads of State-
administered supplementation under the Supplemental Security Income 
(SSI) program. The statistics are needed to complement information 
available for the federally administered programs and to more fully 
explain the impact of the public income support programs on the needy, 
aged, blind, and disabled. In addition, the expenditure data are used 
to monitor State compliance with the mandatory pass-along provision.
    States use our publications, which are prepared from data submitted 
on this statistical report, for administrative purposes to compare 
their expenditures and caseloads with those of other States, to 
determine the feasibility of program change, and to keep abreast of 
program developments in other States. Federal personnel request data 
about State-administered supplementation programs to compare various 
State programs, to examine the relationship of State supplementation 
expenditures and caseloads to federally financed programs such as 
Medicaid, and to determine the effect of changes in SSI and other 
Federal programs on State supplementation programs. In addition, 
Federal and State personnel have used data obtained from this report in 
developing legislative proposals and budget estimates.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 31.
    Frequency of Response: 4.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 124 hours.
    2. Application for Survivors Benefits--20 CFR 404.611 (a) and (c)--
0960-0062. The information collected by form SSA-24 is needed to 
satisfy the ``Joint Prescribed Application'' of Title 38 U.S.C. 5105. 
That provision requires that survivors who file with either SSA or the 
Veteran's Administration (VA) shall be deemed to have filed with both 
agencies, and that each agency's forms must request sufficient 
information to constitute an application for both SSA and VA benefits. 
The respondents are survivors of members or former members of the armed 
services. When form SSA-24 is received by SSA from the VA, an earnings 
record is requested to determine if insured status exists so that the 
claimant will complete the appropriate SSA survivor application. If 
entitlement does not exist, SSA may disallow the claim.
    If an SSA survivor application has already been filed, form SSA-24 
is treated as a duplicate application.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 3,200.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 800 hours.
    3. Continuing Disability Review Report--20 CFR 404.1589, 20 CFR 
416.989--0960-0072. We use form SSA-454-BK to collect information from 
individuals receiving disability benefits or their representatives. We 
evaluate the information to determine whether the individuals remain 
eligible for benefit payments. Adults are considered eligible for 
payment if they continue to be unable to do substantial gainful 
activity (SGA) by reason of their impairments. Title XVI children are 
considered eligible for payment if they still have marked and severe 
functional limitations by reason of their impairments. We obtain 
information concerning sources of medical treatment, participation in 
vocational rehabilitation programs (if any), attempts to work (if any), 
and the opinions of individuals regarding whether their conditions have 
improved.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 792,020.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 594,015 hours.
    4. Statement Regarding Marriage--20 CFR 404.726--0960-0017. Form 
SSA-753 elicits information from third parties to verify the 
applicant's statement about intent, cohabitation, and holding out to 
the public as married, which are basic tenets of a common-law marriage. 
The responses are used by SSA to determine if a valid marital 
relationship exists and to make an accurate determination regarding 
entitlement to spouse/widow(er) benefits. The respondents are 
individuals who are familiar with and can provide confirmation of an 
applicant's common-law marriage.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 40,000.
    Frequency of Response: 1.
    Average Burden Per Response: 9 minutes.
    Estimated Annual Burden: 6,000 hours.
    5. Advance Notice of Termination of Child's Benefits and Student's 
Statement Regarding School Attendance--20 CFR 404.350-404.352, 404.367-
404.368--0960-0105. The information collected on form SSA-1372 is 
needed to determine whether children of an insured worker are eligible 
for student benefits. The data allows SSA to determine student 
entitlement and whether entitlement will end. The respondents are 
student claimants for Social Security benefits, their respective 
schools and, in some cases, their payees.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 200,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Average Burden: 33,333 hours.
    6. Request for Address Information From Motor Vehicles Records; 
Request for Address Information From Employment Commissions Records--4 
CFR 104.2 --0960-0341. SSA sends form SSA-L711 to State Motor Vehicle 
Administrations to obtain the last known address from driver's license 
and registration records. SSA sends form SSA-L712 to State Employment 
Commissions to obtain the last known address from State unemployment/
employment wage records. SSA uses the information to locate debtors to 
arrange for payment of debts owed to SSA. The respondents are State 
Motor Vehicle Administrations and State Employment Commissions.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 2,400.
    Frequency of Response: 1.
    Average Burden Per Response: 2 minutes.
    Estimated Average Burden: 80 hours.
    7.General Request for Social Security Records, eFOIA--20 CFR 
402.130 --0960-NEW. SSA uses the information collected on this 
electronic request for Social Security records to respond to the 
public's request for information under the rights provided by the 
Freedom of Information Act (FOIA), and to track those requests by 
amount received, type of request, fees charged and responses sent 
within the required 20 days. Respondents are individuals or agencies 
requesting documents under FOIA.
    Type of Request: New information collection.
    Number of Respondents: 300,000.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 15,000 hours.
    8. Social Security Number Verification Service (SSNVS)--0960-0660

[[Page 71865]]

Background

    Under Internal Revenue Service regulations, employers are obligated 
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 their 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 their 
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, SSA piloted SSNVS with 100 employers and now 
plans to implement the service nationally.

SSNVS Collection

    SSNVS is an optional free and secure Internet service for employers 
that allows them to perform advance verification of their employees' 
name and SSN information against SSA records. SSA will use the 
information collected through the SSNVS to verify that 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 who 
provide wage and tax data to SSA and elected to use the service.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 200,000.
    Frequency of Response: 120.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 2,000,000 hours.
    9. Report of Death by Funeral Director--20 CFR 404.715, 404.720, 
416.635--0960-0142. SSA uses the information on form SSA-721 to make 
timely and accurate decisions based on the report of death including: 
(1) proving the death of an insured individual, (2) learning of the 
death of a beneficiary whose benefits should terminate, and (3) 
determining who is eligible for the Lump-Sum Death Payment (LSDP) or 
may be eligible for benefits. The respondents are funeral directors 
with knowledge of the fact of death.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 741,113.
    Frequency of Response: 1.
    Average Burden Per Response: 3.5 minutes.
    Estimated Annual Burden: 43,231 hours.
    10. Application for SSI--20 CFR 416.305-335--0960-0229.
    SSA uses the information collected on form SSA-8000-BK or its 
electronic equivalent, the Modernized SSI Claims System (MSSICS), to 
determine eligibility for SSI and the amount of benefits payable to the 
applicant. During the personal interview process the MSSICS system 
takes less time to complete because the system propagates like 
information and only asks relevant questions of the applicant. 
Approximately 97% of SSI applications are taken via MSSICS. The 
respondents are applicants for SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

Form SSA-8000

    Number of Respondents: 33,851.
    Frequency of Response: 1.
    Average Burden Per Response: 41 minutes.
    Estimated Annual Burden: 23,132 hours.

MSSICS

    Number of Respondents: 1,094,523.
    Frequency of Response: 1.
    Average Burden Per Response: 36 minutes.
    Estimated Annual Burden: 656,714 hours.
    Total Burden Hours: 679,846.
    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 at 410-965-0454, 
or by writing to the address listed above.
    1. Work Activity Report (Self-Employed)--20 CFR 404.1520(b) 20 CFR 
1571-.1576 20 CFR 404.1584-.1593 20 CFR 416.971-.976--0960-0598. The 
information on form SSA-820-F4 is used by SSA to determine initial or 
continuing eligibility for SSI or Social Security disability benefits. 
Under Title II and Title XVI of the Act, applicants for disability 
benefits must prove an inability to perform any kind of substantial 
gainful activity (SGA) generally available in the national economy for 
which they might be expected to qualify on the basis of age, education, 
and work experience. SSA needs to secure information about this work in 
order to ascertain whether the applicant was (or is) engaging in SGA. 
Work after a claimant becomes entitled can cause the cessation of 
disability benefits. The information obtained from form SSA-820-F4 is 
needed to determine if a cessation of benefits should occur.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 100,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 50,000 hours.
    2. Cessation or Continuance of Disability or Blindness 
Determination--20 CFR 404.1615-20 CFR 404.1512-20 CFR 404.1588-1599--
0960-0443. The information on form SSA-832-U3/C3 is used by SSA to 
document determinations as to whether an individual's disability 
benefits should be terminated or continued on the basis of his/her 
impairment. The respondents are State Disability Determination Services 
(DDS) employees adjudicating Title XVI disability claims.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 392,191.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 196,096 hours.
    3. Representative Payee Report--20 CFR 404.2035, 404.2065, 416.635, 
and 416.665--0960-0068. The information on forms SSA-623 and SSA-6230 
is used by SSA to determine whether payments certified to a 
representative payee have been used for the beneficiary's current 
maintenance and personal needs and to determine whether the 
representative payee continues to be concerned with the beneficiary's 
welfare. The respondents are representative payees.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 5,250,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 1,312,500 hours.
    4. Modified Benefit Formula Questionnaire--0960-0395. SSA uses the 
information collected by form SSA-150 to determine the correct formula 
to be used in computing the Social Security benefit for someone who 
receives a pension from employment not covered by Social Security. The 
Windfall Elimination Provision (WEP) requires use of a benefit formula 
that replaces a smaller percentage of a worker's pre-retirement 
earnings. However, the difference in the benefit computed using the 
modified and regular formulas cannot be greater than

[[Page 71866]]

one-half the amount of the pension received in the first month an 
individual is entitled to both the pension and the Social Security 
benefit. Form SSA-150 collects the information needed to make all the 
necessary benefit computations. The respondents are claimants for 
Social Security benefits who are entitled to both benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 90,000.
    Frequency of Response: 1.
    Average Burden Per Response: 8 minutes.
    Estimated Average Burden: 12,000 hours.
    5. Modified Benefit Formula Questionnaire-Employer--0960-0477. The 
information collected on form SSA-58 is used by SSA to verify the 
claimant's allegations on form SSA-150 (OMB 0960-0395). SSA 
must make a determination regarding whether the modified benefit 
formula is applicable and when to first apply it to a person's benefit. 
This form will be sent to an employer for pension-related information 
if the claimant is unable to provide it. The respondents are people who 
are eligible after 1985 for both Social Security benefits and a pension 
based on work not covered by SSA.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Average Burden: 10,000 hours.
    6. Acknowledgement of Receipt (Notice of Hearing)--part 404, 
subpart J, 404.936(d), (e) and (f); 404.938(c); 404.950(a); part 416, 
subpart N, 416.1436(d), (e) and (f); 416.1438(c); 416.1450(a)--0960-
0671. The information collected under 20 CFR 404.938(c) and 416.1438(c) 
through form HA-504 is used by SSA to process requests for hearings on 
unfavorable determinations of entitlement or eligibility to disability 
payments. SSA needs the information to determine if the individual 
received the notice of hearing issued by an Administrative Law Judge 
(ALJ) and whether the individual intends to appear at the scheduled 
time and place. The respondents are applicants for Social Security and 
SSI disability payments who want to have a hearing to appeal an 
unfavorable decision.
    Information collected under 20 CFR 404.936(d), (e) and (f) and 
416.1436(d), (e) and (f) (not on a prescribed form, but in writing, if 
possible) is used to determine if the individual objects to the 
scheduled time and place for his or her hearing and, if so, the 
individual's reasons for objecting and the time and place he or she 
would like to have the hearing held. Documentary evidence that a party 
presents at his or her hearing under 20 CFR 404.950(a) and 416.1450(a) 
is used in deciding if the individual qualifies for benefits. For those 
collections cleared through SSA forms, the public reporting burden is 
accounted for in the ICRs for the various forms. Consequently, a 1-hour 
placeholder burden is being assigned to the specific reporting 
requirements contained in the rule.

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                                                                                      Average
                                                  Annual  number   Frequency of     burden per       Estimated
                     Section                       of  responses     response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
404.936(d), (e) & (f)...........................          92,000               1              10          15,333
404.938(c) & 416.1438(c)-HA-504.................         550,000               1               1           9,166
404.950(a)......................................         210,000               1              30         105,000
416.1436(d), (e) & (f)..........................          75,000               1              10          12,500
416.1450(a).....................................         172,000               1              30          86,000
                                                 -----------------
      Total.....................................       1,099,000  ..............  ..............         227,999
----------------------------------------------------------------------------------------------------------------

    Type of Request: Extension of an OMB-approved information 
collection.
    7. State Death Match--20 CFR 404.301, 20 CFR 404.310-311, 20 CFR 
404.316, 20 CFR 404.330-341, 20 CFR 404.350-352, 20 CFR 404.371, and 20 
CFR 416.912--0960-NEW.

Background

    Section 205(r) of the Social Security Act requires SSA to contract 
with the States to obtain death certificate information in order to 
compare it to SSA's payment files. This match ensures the accuracy of 
our payment files by detecting unreported or inaccurate deaths of 
beneficiaries.
    Entitlement to retirement, disability, wife's, husband's or 
parent's benefits under the provisions of the Social Security Act 
terminates when the beneficiary dies. About 2.5 million people die in 
the United States each year. Approximately 2.0 million are SSA 
beneficiaries. Therefore, the information is instrumental in 
maintaining payment integrity.
    SSA is seeking clearance of both the current state death match 
reporting process and the new Web-based Electronic Death Registration 
(EDR) process described below:

State Death Match--Current Process

    The first participants in the death registration process, usually 
funeral directors, are charged by State law to complete the demographic 
information on the decedent and obtain necessary physicians' signatures 
to complete the death registration. Once the death registration 
information is completed, the first participant sends the information 
to the State's bureau of vital statistics (SBVS). The SBVS officially 
registers the death and is the official keeper of the death record.
    Each State then furnishes this information to SSA, using current 
technology including Vital Information Systems Network (VISN), 
electronic Vital Information Systems Network (eVISN), and 
ConnectDirect.
    Under this process SSA must independently verify the State death 
data before taking a termination action. The respondents are the SBVS.

State Death Match--EDR Online Verification of the SSN in State Death 
Registration Process

    The States are now updating and further automating the death 
registration processes. This State reengineering effort is widely known 
as the EDR initiative. The EDR system permits electronic transfer of 
the death certificate. Under EDR the first participant completes a 
portion and electronically sends the document to the next participant 
for completion and submission to the SBVS.
    An additional feature of EDR is the Online Verification System 
(OVS) developed by the National Association for Public Health 
Statistics and Information System (NAPHSIS) in conjunction with SSA. 
The process allows the first participants in the death registration 
process to enter the

[[Page 71867]]

decedent's demographic information including the SSN into the EDR 
system. The system will verify the SSN online in real time and creates 
an electronic death certificate as well as a fact of death report. The 
States have agreed that the on-line verification of the SSN at the 
first point of collection in the registration process will satisfy the 
requirement to independently verify the SSN.
    EDR reduces the processing time needed to register deaths and 
greatly improves the business practices of the various participants in 
death registration process. EDR will result in the State's ability to 
send SSA the report with a verified SSN within 5 days of the date of 
death and within 24 hours of receipt in the State repository. SSA is 
using a phased-in approach to EDR. When fully implemented, SSA will 
save significant program dollars and work years annually. The 
respondents are the SBVS.
    Type of Request: New information collection.
    Estimated Annual Cost for all respondents:

----------------------------------------------------------------------------------------------------------------
                                                                   Frequency of    Average cost      Estimated
                Collection format                    Number of       responses      per record      annual cost
                                                    respondents     (per state)       request         burden
----------------------------------------------------------------------------------------------------------------
State Death Match--Current Registration process.              52          50,000            $.67      $1,742,000
State Death Match--Electronic Death Registration               3          50,000            2.48         372,000
 (EDR)..........................................
----------------------------------------------------------------------------------------------------------------

    Please note that both of these data matching processes are entirely 
electronic and there is no hourly burden for the respondent to provide 
this information.
    III. Agency Information Collection Activities: Emergency 
Consideration Request. In compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, SSA is providing notice that it is 
submitting to OMB information collections for emergency consideration. 
SSA is revising these forms as a result of the Social Security 
Protection Act of 2004. SSA is requesting emergency consideration from 
OMB by January 10, 2005 of the information collections listed below. 
Therefore, comments should be submitted to OMB and SSA by that date.
    1. Petition To Obtain Approval Of A Fee For Representing A Claimant 
Before the Social Security Administration--20 CFR Subpart R, 404.1720, 
404.1725; Subpart F, 410.686b; Subpart O, 416.1520 and 416.1525--0960-
0104. A representative of a claimant for Social Security benefits must 
file either a fee petition or a fee agreement with SSA in order to 
charge a fee for representing a claimant in proceedings before SSA. The 
representative uses form SSA-1560-U4 to petition SSA for authorization 
to charge and collect a fee. A claimant may also use the form to agree 
or disagree with the requested fee amount or other information the 
representative provides on the form. SSA uses the information to 
determine a reasonable fee that a representative may charge and collect 
for his or her services. The respondents are claimants, their attorneys 
and other persons representing them.
    Type of Request: Emergency.
    Number of Respondents: 34,624.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 17,312 hours.
    2. Appointment of Representation--20 CFR 404.1707, 404.1720, 
404.1725, 410.684 and 416.1507--0960-0527. The information collected by 
SSA on form SSA-1696-U4 is used to verify the applicant's appointment 
of a representative. It allows SSA to inform the representative of 
items which affect the applicant's claim. The affected public consists 
of applicants who notify SSA that they have appointed a person to 
represent them in their dealings with SSA when claiming a right to 
benefits.
    Type of Request: Emergency.
    Number of Respondents: 551,520.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 91,920 hours.

    Dated: December 3, 2004.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 04-26998 Filed 12-9-04; 8:45 am]
BILLING CODE 4191-02-P