[Federal Register Volume 71, Number 51 (Thursday, March 16, 2006)]
[Notices]
[Pages 13649-13651]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-3797]


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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, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
The information collection packages that may be included in this notice 
are for new information collections, approval of existing 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

[[Page 13650]]

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, 
Fax: 202-395-6974.
    (SSA) Social Security Administration, DCFAM, Attn: Reports 
Clearance Officer, 1333 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. Disability Report-Appeal--20 CFR 404.1512, 416.912, 404.916(c), 
416.1416(c)--0960-0144. The SSA-3441-BK is used to secure updated 
resource and condition information from claimants seeking 
reconsideration of denied disability benefits. The claimant also has 
the option of providing the information during a personal interview or 
through SSA's Internet application. This information assists the State 
Disability Determination Services and administrative law judges in 
preparing for appeals and hearings and in issuing a decision. 
Respondents are individuals who appeal denial of Social Security 
disability income and Supplemental Security Income (SSI) benefits, 
cessation of benefits, or who are requesting a hearing.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                Collection method                   respondents      response        response      annual burden
                                                                                     (minutes)
----------------------------------------------------------------------------------------------------------------
SSA-3441 (Paper Form)...........................         404,506               1              30         202,253
Electronic Disability Collection System (EDCS)..         635,873               1              30         317,937
I3441 (Internet Form)...........................          72,341               1              60          72,341
                                                 -----------------
    Totals......................................       1,112,720  ..............  ..............         592,531
----------------------------------------------------------------------------------------------------------------

    Estimated Annual Burden: 592,531 hours.
    2. Third Party Liability Information Statement--42 CFR 433.136-
433.139--0960-0323. Identification of sources of third party insurance 
liable for medical care or services for Medicaid beneficiaries, which 
could be used to reduce Medicaid costs, is required under 42 U.S.C. 
1396a(a)(25). Medicaid State agencies are mandated under 42 CFR 
433.136-.139 to obtain this information on Medicaid applications and 
redeterminations as a condition of Medicaid eligibility. States are 
permitted to enter into agreements with the Commissioner of Social 
Security to make Medicaid eligibility determinations for aged, blind 
and disabled beneficiaries in those States. Applications for and 
redeterminations of SSI eligibility in jurisdictions with such 
agreements are also applications and redeterminations of Medicaid 
eligibility. Under these agreements, SSA obtains third party liability 
information using form SSA-8019 and provides that information to the 
State agencies which provide Medicaid under the terms of an approved 
plan in Title XIX of the Social Security Act. The Medicaid State 
agencies then use the information provided to attempt to bill any third 
parties liable for medical care, support or services for a beneficiary 
to guarantee that Medicaid remains the payer of last resort. The 
respondents are SSI applicants and beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 73,540.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 6,128 hours.
    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. Report to U.S. SSA by Person Receiving Benefits for a Child or 
Adult Unable to Handle Funds; & Report to U.S. SSA--0960-0049. SSA 
needs the information on Form SSA-7161-OCR-SM to monitor the 
performance of representative payees outside the U.S and the 
information on Form SSA-7162-OCR-SM to determine continuing entitlement 
to Social Security benefits and correct benefit amounts for 
beneficiaries outside the U.S. The respondents are individuals outside 
the U.S. who are receiving benefits either for someone else, or on 
their own behalf, under title II of the Social Security Act.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Form number                      respondents      response        response      annual burden
                                                                                     (minutes)
----------------------------------------------------------------------------------------------------------------
SSA-7161-OCR-SM.................................          30,000               1              15           7,500
SSA-7162-OCR-SM.................................         227,000               1               5          18,917
                                                 -----------------
    Totals......................................         257,000  ..............  ..............          26,417
----------------------------------------------------------------------------------------------------------------

    Estimated Annual Burden: 26,417 hours.
    2. Application for a Social Security Card--20 CFR 422.103-.110--
0960-0066. Forms SS-5 (used in the United States) and SS-5-FS (used 
outside the United States) are used to apply for original and 
replacement Social

[[Page 13651]]

Security cards. Changes are being made to these forms to reflect new 
statutory limits on the number of allowable replacement cards. The 
respondents are requestors of new or replacement Social Security cards.

    Note: This Notice is for the full clearance of the collection, 
which received a temporary emergency clearance through April 2006.


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                                                                     Number of
                      Application scenario                            annual        Completion     Burden hours
                                                                    respondents   time (minutes)
----------------------------------------------------------------------------------------------------------------
Respondents who do not have to provide parents' SSNs............      13,000,000          8\1/2\       1,841,667
Respondents who are asked to provide parents' SSNs (for                  540,000               9          81,000
 application for original SSN cards for children under age 18)..
Applicants age 12 or older who need to answer additional                  40,000          9\1/2\           6,333
 questions so SSA can determine whether an SSN was previously
 assigned.......................................................
Applicants asking for a replacement SSN card beyond the new                4,000              60           4,000
 allowable limits (i.e., who must provide additional
 documentation to accompany the application)....................
                                                                 -----------------
    Totals......................................................      13,584,000  ..............       1,933,000
----------------------------------------------------------------------------------------------------------------

    3. Work Activity Report--Employee--20 CFR 404.1520(b), 
404.1571-.1576, 404.1584-.1593, and 416.971-.976--0960-0059. Form SSA-
821-BK collects information that provides evidence necessary to 
determine initial or continuing eligibility for SSI or Social Security 
disability benefits. An individual's entitlement to benefits ends if 
he/she demonstrates an ability to perform substantial gainful activity 
(SGA). This form is used to determine whether work an individual 
performs in employment is at the SGA level. The respondents are Social 
Security disability applicants and beneficiaries and SSI applicants and 
recipients.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 300,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 225,000 hours.

    Dated: March 9, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
 [FR Doc. E6-3797 Filed 3-15-06; 8:45 am]
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