[Federal Register Volume 72, Number 33 (Tuesday, February 20, 2007)]
[Notices]
[Pages 7809-7811]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-2662]


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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 P.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, faxed or e-mailed 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, E-mail address: [email protected].
    (SSA) Social Security Administration, DCFAM, Attn: Reports 
Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, 
MD 21235, Fax: 410-965-6400, E-mail address: [email protected].
    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. Application for Benefits under the Italy-U.S. International 
Social Security Agreement--0960-0445--20 CFR 404.1925. The United 
States and Italy entered into an agreement on November 1, 1978. Article 
19.2 of that agreement provides that an applicant for benefits can file 
his application with either country. Article 4.3 of the Protocol to the 
Agreement provides that the country that receives the application will 
forward agreed upon forms and applications to the other country. Form 
SSA-2528 is the form agreed upon that is completed by individuals who 
file an application for U.S. benefits directly with one of the Italian 
Social Security Agencies. The information collected on Form SSA-2528 is 
required by SSA in order to determine entitlement to benefits. The 
respondents are applicants for old-age, survivors or disability 
benefits, who reside in Italy.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 200.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 67 hours.
    2. Social Security Benefits Applications--20 CFR Subpart D, 
404.310-404.311 and 20 CFR Subpart F, 404.601-401.603--0960-0618. One 
of the requirements for obtaining Social Security benefits is the 
filing of an application so that a determination may be made on the 
applicant's eligibility for monthly benefits. In addition to the 
traditional paper application, SSA has developed various options for 
the public to add convenience and operational efficiency to the 
application process. The total estimated number of respondents to all 
application collections formats is 3,843,369 with a cumulative total of 
995,457 burden hours. The respondents are applicants for retirement 
insurance benefits (RIB), disability insurance benefits (DIB), and/or 
spouses' benefits.
    Type of Request: Extension of an OMB-approved information 
collection.

Internet Social Security Benefits Application (ISBA)

    ISBA, which is available through SSA's Internet site, is one method 
that an individual can choose to file an application for benefits. 
Individuals can use ISBA to apply for retirement insurance benefits 
RIB, DIB and spouse's insurance benefits based on age. SSA gathers only 
information relevant to the individual applicant's circumstances and 
will use the

[[Page 7810]]

information collected by ISBA to entitle individuals to RIB, DIB, and/
or spouses' benefits. The respondents are applicants for RIB, DIB, and/
or spouses benefits.
    Number of Respondents: 169,000.
    Frequency of Response: 1.
    Average Burden Per Response: 21.4 minutes.
    Estimated Annual Burden: 60,277 hours.

Paper Application Forms

Application for Retirement Insurance Benefits (SSA-1)

    The SSA-1 is used by SSA to determine an individual's entitlement 
to retirement insurance benefits. In order to receive Social Security 
retirement insurance benefits, an individual must file an application 
with the SSA. The SSA-1 is one application that the Commissioner of 
Social Security prescribes to meet this requirement. The information 
that SSA collects will be used to determine entitlement to retirement 
benefits. The respondents are individuals who choose to apply for 
Social Security retirement insurance.
    Approximately 1,460,692 respondents complete the SSA-1 annually. Of 
this total 97% (1,416,871) are completed through SSA's Modernized 
Claims System (MCS) and 50% of the MCS respondents will use Signature 
Proxy (708,435.5). The breakdown is displayed on the following chart.

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                                                   Number of
               Collection method                  respondents       Estimated completion time      Burden hours
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MCS...........................................         708,436  10.5 minutes....................         123,976
MCS/Signature Proxy...........................         708,435  9.5 minutes.....................         112,169
Paper.........................................          43,821  10.5 minutes....................           7,669
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    Totals....................................       1,460,692  ................................         243,814
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Application for Wife's or Husband's Insurance Benefits (SSA-2)

    SSA uses the information collected on Form SSA-2 to determine if an 
applicant (including a divorced applicant) can be entitled to benefits 
as the spouse of the worker and the amount of the spouse's benefits. 
The respondents are applicants for wife's or husband's benefits, 
including those who are divorced. Approximately 700,000 respondents 
complete the SSA-2 annually. Of this total 95% (665,000) are completed 
through MCS and 50% of the MCS respondents will use Signature Proxy 
(332,500). The breakdown is displayed on the following chart:

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                                                   Number of
               Collection method                  respondents       Estimated completion time      Burden hours
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MCS...........................................         332,500  15 minutes......................          83,125
MCS/Signature Proxy...........................         332,500  14 minutes......................          77,583
Paper.........................................          35,000  15 minutes......................           8,750
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    Totals....................................         700,000  ................................         169,458
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Application for Disability Insurance Benefits (SSA-16)

    Form SSA-16-F6 obtains the information necessary to determine 
whether the provisions of the Act have been satisfied with respect to 
an applicant for disability benefits, and detects whether the applicant 
has dependents who would qualify for benefits on his or her earnings 
record. The information collected on form SSA-16 helps to determine 
eligibility for Social Security disability benefits. The respondents 
are applicants for Social Security disability benefits.
    Approximately 1,513,677 respondents complete the SSA-16 annually. 
Of this total 97% (1,468,267) are completed through SSA's Modernized 
Claims System (MCS) and 50% of the MCS respondents will use Signature 
Proxy (734,133.5). The breakdown is displayed on the following chart:

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                                                   Number of
               Collection method                  respondents       Estimated completion time      Burden hours
----------------------------------------------------------------------------------------------------------------
MCS...........................................         734,134  20 minutes......................         244,711
MCS/Signature Proxy...........................         734,133  19 minutes......................         232,476
Paper.........................................          45,410  20 minutes......................          15,137
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    Totals....................................       1,513,677  ................................         492,324
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    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. Pain Report Child--20 CFR 416.912 and 416.1512--0960-0540. The 
information collected by form SSA-3371-BK will be used to obtain the 
types of information specified in SSA's regulations, and to provide 
disability interviewers (and applicants/claimants in self-help 
situations) with a convenient means of recording the information. This 
information is used by the State disability determination services 
(DDS) adjudicators and administrative law judges to assess the effects 
of symptoms on functionality for determining disability under the 
Social Security Act. The respondents are applicants for Supplemental 
Security Income (SSI) benefits.

[[Page 7811]]

    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 250,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 62,500 hours.
    2. Request for Hearing by Administrative Law Judge--20 CFR 404.929, 
404.933, 416.1429, 404.1433, 405.722, 418.1350--0960-0269. SSA uses 
form HA-501 to document when applicants for Social Security benefits 
have their claims denied and want to request an administrative hearing 
to appeal SSA's decision. The scope of this form is now being expanded 
to include people who wish to appeal the decision that has been made 
regarding their obligation to pay a new Income-Related Monthly 
Adjustment Amount (IRMAA) for Medicare Part B, as per the requirements 
of the Medicare Modernization Act of 2003. Although this information 
will be collected by SSA, the actual hearings will take place before 
administrative law judges (ALJ) who are employed by the Department of 
Health and Human Services (HHS). The current respondents include 
applicants for various Social Security benefits programs who want to 
request a hearing where they can appeal their denial; the new 
additional respondents are Medicare Part B recipients whom SSA has 
determined will have to pay the new Medicare Part B IRMAA and who wish 
to appeal this decision at a hearing before an HHS ALJ.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 669,469.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 111,578 hours.
    3. Request to Resolve Questionable Quarters of Coverage (QC); 
Request for QC History Based on Relationship--0960-0575. Form SSA-512 
is used by states to request clarification from SSA on questionable QC 
information. The Personal Responsibility and Work Opportunity 
Reconciliation Act states that aliens admitted for lawful residence 
that have worked and earned 40 qualifying QCs for Social Security 
purposes can generally receive state benefits. Form SSA-513 is used by 
states to request QC information for an alien's spouse or child in 
cases where the alien does not sign a consent form giving permission to 
access his/her Social Security records. QCs can also be allocated to a 
spouse and/or to a child under age 18, if needed, to obtain 40 
qualifying QCs for the alien. The respondents are state agencies that 
require QC information in order to determine eligibility for benefits.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Collections                      respondents      response        response      annual burden
                                                                                     (minute)         (hours)
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SSA-512.........................................         200,000               1               2           6,667
SSA-513.........................................         350,000               1               2          11,667
                                                 ---------------------------------------------------------------
    Totals......................................         550,000  ..............  ..............          18,334
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    Dated: February 9, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
 [FR Doc. E7-2662 Filed 2-16-07; 8:45 am]
BILLING CODE 4191-02-P