[Federal Register Volume 72, Number 2 (Thursday, January 4, 2007)]
[Notices]
[Pages 357-359]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E6-22528]


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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 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 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. Information Collections Conducted by State Disability 
Determination Services (DDSs) on Behalf of SSA--20 CFR 404.1503a, 
404.1512, 404.1513404.1512, 404.1513, 404.1514 404.1517, 404.1519; 20 
CFR subpart Q, 404.1613, 404.1614, 404.1624; 20 CFR subpart I, 
416.903a, 416.912, 416.913, 416.914, 416.917, 416.919 and 20 CFR 
subpart J, 416.1013, 416.1024, 416.1014--0960-0555. The State 
Disability Determination Services (DDSs) collect certain information 
that SSA needs to correctly administer its disability program. This 
information is divided into the Consultative Examination (CE) and 
Medical Evidence of Record (MER) categories. There are three types of 
CE evidence: (a) medical evidence from CE providers, in which DDSs use 
CE medical evidence to make disability determinations when the 
claimant's own medical sources cannot or will not provide the required 
information, (b) CE claimant completion of a response form where 
claimants indicate if they intend to keep their CE appointment, and (c) 
CE claimant completion of a form indicating whether they want the CE 
report to be sent to their doctor. In the MER category, the DDSs use 
MER information to determine a person's physical and/or mental status 
prior to making a disability determination. Please note that for the 
first time, some of the information included in this collection can be 
submitted electronically through the new Electronic Records Express 
(ERE) systems. The respondents are medical providers, other sources of 
MER, and disability claimants.
    Type of Collection: Revision to an existing OMB-approved 
collection. CE:
    a. Medical Evidence from CE Providers

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                                                    respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper Submissions...............................       1,215,000               1              30         607,500
ERE Submissions.................................         285,000               1              15          71,250
ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
    Totals......................................       1,500,000  ..............  ..............         678,750
----------------------------------------------------------------------------------------------------------------

    b. Claimants re Appointment Letter:
    Number of Respondents: 750,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 62,500 hours.

[[Page 358]]

    c. Claimants re Report to Medical Provider:
    Number of Respondents: 1,500,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 125,000 hours.

                                                       MER
----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden  per      Estimated
                                                    respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper Submissions...............................       2,480,800               1              15         620,200
C/D (Connect Direct, commercially available              218,400               1              15          54,600
 software used for electronically transferring
 medical records)...............................
ERE.............................................         100,800  ..............               7          11,760
ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
    Totals......................................       2,800,000  ..............  ..............         686,560
----------------------------------------------------------------------------------------------------------------

    2. Response to Notice of Revised Determination--20 CFR 404.913-.914 
and 992(b), 416.1413-.1414 and 1492--0960-0347. Form SSA-765 is used by 
claimants to request a disability hearing and/or to submit additional 
evidence before a revised reconsideration determination is issued. The 
respondents are claimants who file for a disability hearing in response 
to a notice of revised determination for disability insurance and/or 
Supplemental Security Income (SSI) under titles II (Old-Age, Survivors 
and Disability Insurance) and XVI (SSI).
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,925.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 963 hours.
    3. Questionnaire for Children Claiming SSI Benefits--0960-0499. The 
information collected on form SSA-3881-BK is used by SSA to evaluate 
disability in children who are appealing an unfavorable disability 
decision or whose continuing disability is being reviewed. The form 
requests the names and addresses of non-medical sources such as 
schools, counselors, agencies, organizations or therapists who would 
have information about a child's functioning. The respondents are 
children or their representatives who are appealing an unfavorable 
decision on their claim or whose continuing disability is being 
reviewed.
    Type of Request: Extension of OMB-approved collection.
    Number of Respondents: 253,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 126,500 hours.
    4. Claimant Statement about Loan of Food or Shelter; Statement 
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. Forms SSA-5062 and SSA-L5063 are used to obtain statements 
about food and/or shelter provided to an SSI claimant or recipient. SSA 
uses this information to determine whether food and/or shelter are bona 
fide loans or should be counted as income for SSI purposes. This 
determination can affect eligibility for SSI and the amount of SSI 
benefits payable. The respondents are claimants/recipients for SSI 
benefits and individuals that provide loans of food and/or shelter to 
SSI claimants/recipients.

                      Type of Request.--Revision of an OMB-approved information collection.
----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Collections                      respondents      response        response     annual  burden
                                                                                     (minute)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-5062........................................          65,540               1              10          10,923
SSA-L5063.......................................          65,540               1              10          10,923
ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
    Totals......................................         131,080  ..............  ..............          21,846
----------------------------------------------------------------------------------------------------------------

    5. Internet Direct Deposit Application--31 CFR 210--0960-0634. SSA 
uses Direct Deposit/Electronic Funds Transfer (DD/EFT) enrollment 
information received from beneficiaries to facilitate DD/EFT of their 
Social Security benefits with a financial institution. Respondents are 
Social Security beneficiaries who use the Internet to enroll in DD/EFT.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 80,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 13,333 hours.
    6. Medical Permit Parking Application--41 CFR 101-20.104-2--0960-
0624. SSA issues medical parking assignments at SSA-owned and -leased 
facilities to individuals who have a medical condition which meets the 
criteria for medical parking. In order to issue a medical parking 
permit, SSA must obtain medical evidence from the applicant's 
physician. Form SSA-3192-F4 is used to collect this information. SSA 
then uses the information to determine whether the individual qualifies 
for a medical parking permit and whether or not to issue the permit. 
The respondents are physicians of applicants for medical parking 
permits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 800.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 800 hours.
    7. Reporting Changes that Affect Your Social Security Payment--20 
CFR 404.301-305, .310-311, .330-.333, .335-.341, .350-.352, .370-.371, 
.401-.402, .408(a), .421-.425, .428-.430, .434-.437, .439-.441, 
.446-.447, .450-.455, .468--

[[Page 359]]

0960-0073. SSA uses the information collected on Form SSA-1425 to 
determine continuing entitlement to Title II Social Security benefits 
and to determine the proper benefit amount. The respondents are Social 
Security beneficiaries receiving SSA retirement, disability or 
survivor's auxiliary benefits who need to report an event that could 
affect payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 70,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 5,833 hours.
    8. Disability Hearing Officer's Decision--20 CFR 404.917 and 
416.1417--0960-0441. The Social Security Act requires that SSA provide 
an evidentiary hearing at the reconsideration level of appeal for 
claimants who have received an initial or revised determination that a 
disability did not exist or has ceased. Based on the hearing, the 
disability hearing officer (DHO) completes form SSA-1207 and all 
applicable supplementary forms (which vary depending on the type of 
claim). The DHO uses the information in documenting and preparing the 
disability decision. The form will aid the DHO in addressing the 
crucial elements of the case in a sequential and logical fashion. The 
respondents are DHOs in the State Disability Determination Services 
(DDS).
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 65,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 48,750 hours.
    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. Non-Attorney Representative Demonstration Project Application--
0960-0669. Section 303 of the Social Security Protection Act of 2004 
(SSPA) provides for a 5-year demonstration project to be conducted by 
SSA under which the direct payment of SSA-approved fees is extended to 
certain non-attorney claimant representatives. Under the SSPA, to be 
eligible for direct payment of fees, a non-attorney representative must 
fulfill the following statutory requirements: (1) Possess a bachelors 
degree or have equivalent qualifications derived from training and work 
experience; (2) pass an examination that tests knowledge of the 
relevant provisions of the Social Security Act; (3) secure professional 
liability insurance or equivalent insurance; (4) pass a criminal 
background check (information on these 4 requirements will be collected 
during initial reporting); (5) demonstrate completion of relevant 
continuing education courses (this information will be collected under 
the Continuing Education (CE) reporting), and (6) complete an annual 
Affirmations Worksheet to verify the participant's continued 
eligibility to participate in the demonstration project. SSA collects 
this information through the services of a private contractor and uses 
it to determine if a non-attorney representative has met and continues 
to meet the statutory requirements to be eligible for direct payment of 
fees for his or her claimant representation services. The respondents 
are non-attorney representatives who apply for direct payment of fees.
    Type of Request: Revision of an existing information collection.
    Application Reporting
    Number of Respondents: 500.
    Frequency of Response: 1.
    Average Burden per Response: 60 minutes.
    Estimated Annual Burden: 500 hours.
    CE Reporting
    Number of Respondents: 300.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 150 hours.
    Annual Reaffirmations Worksheet
    Number of Respondents: 450.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 75 hours.
    Total burden hours for all collection activities--725 hours.

    Dated: December 27, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-22528 Filed 1-3-07; 8:45 am]
BILLING CODE 4191-02-P