[Federal Register Volume 72, Number 113 (Wednesday, June 13, 2007)]
[Notices]
[Pages 32697-32700]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-11383]


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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 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 emailed 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, DCBFM, 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. National 800 Number--Claims Status--20 CFR 401.45--0960-NEW. SSA 
has established a process for authenticating the information of 
individuals who use the automated telephone services or speak to an 
agent to request information from SSA records. Prior to SSA responding 
to requests for personal information through the automated telephone 
services, we must authenticate the requester's information by obtaining 
the appropriate identification elements. This automated telephone 
service will provide callers with status of a Social Security claim 
which they have filed. All information provided will then be compared 
to the information contained in our records so that the appropriate 
claim is accessed and the respondent is given the status of that claim. 
Respondents are current Social Security beneficiaries.
    Type of Request: Request for a new information collection.
    Number of Respondents: 704,422.
    Frequency of Response: 1.
    Average Burden per Response: 1 minute.
    Estimated Annual Burden: 11,740 hours.
    2. Function Report-Child: Birth to 1st Birthday (SSA-3375), Age 1 
to 3rd Birthday (SSA-3376), Age 3 to 6th Birthday (SSA-3377), Age 6 to 
12th Birthday (SSA-3378), and Age 12 to 18th Birthday (SSA-3379)--20 
CFR 416.912--0960-0542. State Agency adjudicative teams use the 
information gathered by these forms in combination with other medical 
function evidence to form a complete picture of a child's ability to 
function. This information is used to help determine if a child is 
disabled, especially in cases in which disability cannot be found on 
medical grounds alone. The respondents are applicants for Title XVI 
childhood disability benefits and their caregivers.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 550,000.
    Frequency of Response: 1.
    Average Burden per Response: 20 minutes.
    Estimated Annual Burden: 183,333 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. Notice Regarding Substitution of Party On Death of Claimant--
Reconsideration of Disability Cessation--20 CFR 404.917-404.921 and 
416.1407-416.1421--0960-0351. Form SSA-770 is used when a claimant dies 
before a determination is made on that person's request for 
reconsideration on his/her disability cessation. SSA seeks a qualified 
substitute party to pursue the appeal. If the qualified

[[Page 32698]]

substitute party is located, the SSA-770 is used to collect information 
regarding whether to pursue or withdraw the reconsideration request. 
The information collected on the SSA-770 forms the basis of the 
decision to continue or discontinue the appeals process. Respondents 
are substitute applicants who are pursuing a reconsideration request 
for a deceased claimant.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,200.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 100 hours.
    2. State Agency Report of Obligations for SSA Disability Programs 
(SSA-4513); Time Report of Personnel Services for Disability 
Determination Services (SSA-4514); State Agency Schedule of Equipment 
Purchased for SSA Disability Programs (SSA-871)--20 CFR 404.1626--0960-
0421 (Correction to Burden Data). Forms SSA-4513, SSA-4514 and SSA-871 
are used to collect data necessary for detailed analysis and evaluation 
of costs incurred by State Disability Determination Services (DDS) in 
making determinations of disability for SSA. The data are also utilized 
in determining funding levels for each DDS. Respondents are State DDSs.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 52.
    Estimated Annual Burden: 756 hours.

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                                                                              Average burden
                                         Respondents        Frequency of       per response     Estimated annual
                                                              response          (minutes)       burden  (hours)
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SSA-4513 & Addendum.................                 52                  4                 90                312
SSA-4514............................                 52                  4                 90                312
SSA-871.............................                 52                  4                 30                104
                                     ---------------------------------------------------------------------------
    Totals..........................                 52  .................  .................                728
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    Please note: We are correcting the number of respondents to this 
collection. In our notice published March 23, 2007 at 72 FR 13851 we 
initially state there are 54 State DDS's, whereas there are only 52.

    3. Subpoena-Disability Hearing--20 CFR 404.916(b)(1) & 
416.1416(b)(1)--0960-0428. Form SSA-1272-U4 is completed by State and 
Federal disability hearing officers to subpoena evidence or testimony 
in connection with hearings required by the Social Security Act. Actual 
issuance of the subpoena will be done by that appropriate delegated SSA 
official. Respondents are disability hearing officers.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 36.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 18 hours.
    4. Summary of Evidence--20 CFR 404.913(b), 404.914(a), 416.1707, 
416.1313(b), 416.1414(a)--0960-0430. Form SSA-887 is completed by a 
Disability Hearing Officer (DHO) from the claimant's State Disability 
Determination Service (DDS). The DHO summarizes all medical and 
vocational reports that were used to make the no-disability 
determination. This form, which is used to prepare for and conduct the 
disability hearing, is also made available to claimants so that they 
are aware of the basis for the no-disability decision and they can 
prepare for the reconsideration accordingly. Respondents are Disability 
Hearing Officers.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 49,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 12,250 hours.
    5. Information About Joint Checking/Savings Accounts--20 CFR 
416.1201(b), 416.1208--0960-0461. The SSA-2574 is used to collect 
information when a Supplemental Security Income (SSI) applicant/
recipient objects to the assumption that he/she owns all or part of the 
funds in a joint checking or savings account which bears his or her 
name. Information about the account is collected from both the SSI 
applicant/recipient and other accountholder(s). These statements 
regarding ownership are required to determine whether the account is a 
resource of the SSI claimant. The amount of resources a person owns is 
one of the factors considered in determining eligibility for SSI. 
Respondents are applicants and recipients of SSI and individuals who 
are joint owners of financial accounts with SSI applicants/recipients.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 200,000.
    Frequency of Response: 1.
    Average Burden per Response: 7 minutes.
    Estimated Annual Burden: 23,333 hours.
    6. Beneficiary Recontact Form--20 CFR 404.703, 404.705--0960-0502. 
SSA must ensure that eligibility for benefits continues after 
entitlement. Studies show that mothers/fathers who marry fail to report 
the marriage and or the fact that they no longer have a child entitled 
in their care. SSA uses the SSA-1588-OCR-SM to ask mothers/fathers 
about their marital status and children in care to detect overpayments 
and avoid continuing payment to those no longer entitled. Respondents 
are recipients of survivor mother/father Social Security benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 133,400.
    Frequency of Response: 1.
    Average Burden per Response: 5 minutes.
    Estimated Annual Burden: 11,117 hours.
    7. Earnings Record Information--20 CFR 404.801-404.803 and 404.821-
404.822--0960-0505. The information collected by form SSA-L3231-C1 is 
used to ensure that the proper person is credited for working when 
earnings are reported for a minor under the age of 7 years. The 
respondents are businesses reporting earnings for children under age 7.
    Type of Information Collection: Extension of an OMB-approved 
information collection.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 3,333 hours.
    8. Wage Reports and Pension Information--20 CFR 422.122(b)--0960-
0547. The information collected through 20 CFR 422.122(b) is used by 
SSA to identify the requestor of pension plan information and to 
confirm the individual is entitled to the data SSA provides. 
Respondents are requestors of pension plan information.

[[Page 32699]]

    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 600.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 300 hours.
    9. Youth Transition Process Demonstration Evaluation Data 
Collection--0960-0687.

Background

    The Youth Transition Demonstration YTD projects are intended to 
help young people with disabilities make the transition from school to 
work. By waiving certain disability program rules and offering services 
to youth who are either receiving disability benefits or at risk of 
receiving them, these projects are expected to encourage youth to work 
and/or continue their education. YTD projects will be fully implemented 
in 10 sites across the country. The evaluation will produce empirical 
evidence on the impacts of the waivers and project services not only on 
educational attainment, employment, earnings, and receipt of benefits 
by youth with disabilities but also on the Social Security Trust Fund 
and federal income tax revenues. This type of project is authorized by 
sections 1110 and 234 of the Social Security Act.

Project Description

    Given the importance of estimating YTD impacts as accurately as 
possible, the evaluation will be conducted using rigorous analytic 
methods based on the random assignment of youth to a treatment or 
control group. Several data collection efforts are planned. These 
include (1) baseline interviews with youth and their parents or 
guardians prior to random assignment; (2) follow-up interviews at 12 
and 36 months after random assignment; (3) interviews and/or roundtable 
discussions with local program administrators, program supervisors, and 
service delivery staff; and (4) focus groups of youth, their parents, 
and service providers. The respondents will be youth with disabilities 
who have enrolled in the project, their parents or guardians, program 
staff, and service providers.
    Type of Request: Revision of an existing OMB Clearance.

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                                                                                 Number of        Responses per    Average burden per    Total response
            Data collection year                       Collection               respondents         respondent      response (hours)     burden (hours)
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2007.......................................  Baseline......................                962                  1                0.55                529
                                             Informed Consent..............                962                  1                0.83                 80
                                             12 month follow-up \1\........                437                  1                0.83                363
                                             Focus group...................                140                  1                1.5                 210
                                             Program staff/service provider                 32                  1                1                    32
                                            ------------------------------------------------------------------------------------------------------------
    Total 2007.............................  ..............................  .................  .................  ..................             1,214
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\1\ We conduct follow-up interviews only for those baseline respondents who sign consent forms.

    10. Request for Program Consultation--20 CFR 404.1601-1661--0960-
New. The Disability Determination Services (DDS) offices are staffed by 
State employees who perform disability determinations for applicants 
for Social Security disability benefits under Title II and Title XVI of 
the Social Security Act. SSA's federal regional quality assurance 
office has the authority to review DDS determinations, to assess 
errors, and to return cases for corrective action by the DDS.
    The information collected on the Request for Program Consultation 
(RPC) will be used by the DDS's that request a review of the regional 
quality assurance evaluations. The DDS's use the RPC to present their 
rationale that supports their determinations. The information collected 
includes a short rationale and policy citations supporting their 
rebuttal. The RPC team will use the information to reassess their 
initial determination. The respondents are DDS's who request a review 
of the regional quality assurance determination.
    Type of Request: Request for a new information collection.
    Number of Respondents: 4,500.
    Frequency of Response: 1.
    Average Burden per Response: 50 minutes.
    Estimated Annual Burden: 3,750 hours.
    11. Request to Decision Review Board To Vacate the Administrative 
Law Judge Dismissal of Hearing--20 CFR 405.427--0960-NEW. The 
information collected on Form SSA-525 will be used by Social Security 
Administration's Decision Review Board (Board) when a hearing on a 
claim for Title II or Title XVI disability payments is dismissed and 
the claimant requests that the dismissal be vacated. The Board will use 
this information to (1) establish the continued involvement of the 
requester in his or her claim; (2) consider the requester's arguments 
for vacating the dismissal; and (3) vacate or decline to vacate the 
administrative law judge's dismissal order. The respondents are Social 
Security disability or Supplemental Security Income (SSI) claimants who 
are requesting that the dismissal be vacated.
    Type of Request: Request for a new information collection.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 5,000 hours.
    12. Medical History and Disability Report, Disabled Child--20 CFR 
416.912--0960-0577. The Social Security Act requires claimants to 
furnish medical and other evidence to prove they are disabled. The form 
SSA-3820 is used to obtain various types of information about a child's 
condition, his/her treating sources and/or other medical sources of 
evidence. The information collected on the SSA-3820 is needed for the 
determination of disability by the State DDSs. The respondents are 
applicants for Title XVI child disability benefits.
    Type of Request: Revision to an OMB-approved information 
collection.

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                                                                                                    Estimated
          Collection format              Number of       Frequency of      Average burden per     annual burden
                                        respondents       responses            responses              (hour)
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SSA-3820 (Paper Form)...............              500                1  1 hour.................              500
Electronic Disability Collection              422,000                1  34 minutes.............          239,133
 System (EDCS).

[[Page 32700]]

 
i3820 (Internet)....................           39,500                1  2 hours................           79,000
                                     ---------------------------------------------------------------------------
    Totals..........................          462,000  ...............  .......................          318,633
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    13. Social Security Disability Report--20 CFR 404.1512 & 416.912--
0960-0579. The Social Security Administration requires applicants for 
disability payments to furnish medical, work history, and other 
evidence or information indicating they have an impairment which is 
disabling. This information is collected by form SSA-3368, the Adult 
Disability Report, and is used by State DDS's to make disability 
determinations for SSA.
    The respondents are applicants for Title II and Title XVI 
disability benefits. These applicants may complete the form using any 
of the following modalities: (1) The traditional paper form; (2) an 
interview with an SSA field office representative, using the EDCS; (3) 
the Internet (i3368); and (4) a modality, the i3368-PRO, an Internet 
form designed to be completed by representatives of applicants for 
disability payments. The latter three versions of the form collect the 
same information as the paper form, but may be formatted differently 
and include certain enhancements (ex: self-help screens) to guide the 
claimant or interviewer through the application process.
    Type of Request: Revision to an OMB-approved information 
collection.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                Collection format                   respondents      response        response     annual  burden
                                                                                      (hours)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper version)........................           9,364               1               1           9,364
Field office/EDCS...............................       3,138,920               1               1       3,138,920
i3368 (Internet version; Hour burden varies from         101,135               1          2\1/2\         252,837
 1\1/2\-3 hours, depending on information
 required)......................................
i3368-PRO.......................................         101,135               1         1 \1/2\         151,702
                                                 ---------------------------------------------------------------
    Totals......................................       3,350,554  ..............  ..............       3,552,823
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    14. Certification of Contents of Document(s) or Record(s)--20 CFR 
404.715ff--0960-0689. SSA must secure evidence necessary for 
individuals to establish rights to benefits. Some of the types of 
evidence needed are evidence of age relationship, citizenship, 
marriage, death, and military service. Form SSA-704 allows SSA 
employees, state record custodians, and other custodians of evidentiary 
documents to record information from documents and records to establish 
these types of evidence. SSA employees use this form but it is also 
used by state record custodians and other custodians of evidentiary 
documents.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 4,800.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 800.
    15. Waiver of Your Right to Personal Appearance before an 
Administrative Law Judge--20 CFR 404.948(b)(l)(i) and 
416.1448(b)(l)(i)--0960-0284. Each claimant has a statutory right to 
appear in person (or through a representative) and present evidence 
about his/her claim at a hearing before an Administrative Law Judge 
(ALJ). If a claimant wishes to waive his/her statutory right to appear 
before an ALJ, he/she must complete a written request. The claimant may 
use Form HA-4608 for this request. The information collected is used to 
document an individual's claim to show that an oral hearing is not 
preferred in the appellate process. The respondents are applicants for 
Title II benefits and Title XVI payments who request a hearing.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden per Response: 2 minutes.
    Estimated Annual Burden: 400 hours.

    Dated: June 7, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
 [FR Doc. E7-11383 Filed 6-12-07; 8:45 am]
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