[Federal Register Volume 72, Number 123 (Wednesday, June 27, 2007)]
[Notices]
[Pages 35293-35296]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-12357]


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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

[[Page 35294]]

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, 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.
    Missing and Discrepant Wage Reports Letter and Questionnaire--26 
CFR 31.6051-2-0960-0432. Each year employers report the wage amounts 
they paid their employees to the IRS for tax purposes, and separately 
to SSA for retirement and disability coverage purposes. These reported 
amounts should equal each other; however, each year some of the 
employer wage reports that SSA receives are less than the wage amounts 
reported to the IRS. SSA attempts to ensure that employees receive full 
credit for the wages that they have earned through the use of the forms 
SSA-L93-SM; SSA-L94-SM; SSA-95-SM and SSA-97-SM. Respondents are 
employers who reported less wage amounts to SSA than they reported to 
the IRS.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 360,000.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 180,000 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. Certificate of Responsibility for Welfare and Care of Child Not 
in Applicant's Custody--20 CFR 404.330, 404.339-341 and 404.348-
404.349-0960-0019. SSA uses the information to determine if a non-
custodial parent who is filing for Spouse's or Mother's and Father's 
benefits based on having a child in care meets the in-care 
requirements. Respondents are applicants for Spouse and/or Mother's and 
Father's benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 14,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 2,333 hours.
    2. Request for Waiver of Overpayment Recovery or Change in 
Repayment Notice--20 CFR 404.502-.513, 404.515 and 20 CFR 416.550-.570, 
416.572--0960-0037. The SSA-632-BK is used by a beneficiary/claimant to 
request a waiver of recovery of an overpayment by explaining why they 
feel they are without fault in causing the overpayment and to provide 
financial circumstances so that SSA can determine whether recovery 
would cause financial hardship. It is also used to request a different 
rate of recovery. In those cases the financial information must be 
provided for SSA to determine how much the overpaid person can afford 
to repay each month. Respondents are overpaid beneficiaries or 
claimants who are requesting a waiver of recovery for overpayment or a 
lesser rate of withholding.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 500,000.
    Estimated Annual Burden: 875,000 hours.

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                                          Number of     Frequency of      Average  burden per      Total annual
      Reason for completing form         respondents      response              response              burden
----------------------------------------------------------------------------------------------------------------
Request Waiver.......................         400,000               1  2 hours..................         800,000
Request Change.......................         100,000               1  45 minutes...............          75,000
                                      --------------------------------------------------------------------------
    Totals...........................         500,000  ..............  .........................         875,000
----------------------------------------------------------------------------------------------------------------

    3. Supplemental Statement Regarding Farming Activities of Person 
Living Outside the U.S.A.--0960-0103. Form SSA-7163A is used whenever a 
beneficiary or claimant reports work on a farm outside the United 
States (U.S.). It is designed to obtain sufficient information to 
determine whether or not foreign work deductions are applicable to the 
claimant's benefits. Respondents are beneficiaries or claimants for 
Social Security benefits who are engaged in farming activity outside 
the U.S.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden per Response: 1 hour.
    Estimated Annual Burden: 1,000 hours.
    4. Disability Report-Appeal--20 CFR 404.1512, 416.912, 404.916(c), 
416.1416(c), 405 Subpart C, 422.140--0960-0144. The SSA-3441-BK is used 
to secure updated medical and other information since the claimant's 
last disability determination from claimants who are appealing an 
unfavorable disability determination. This information may be used for 
reconsideration or request for federal reviewing official review of 
initial disability determinations and continuing disability reviews as 
well as a request for a hearing. This information assists the State 
Disability Determination Services, federal reviewing officials, 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: Revision of an OMB-approved information 
collection.

[[Page 35295]]

    Estimated Annual Burden: 1,296,190 hours.

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                Collection method                   respondents      response        response      annual burden
                                                                                       (min)           hours
----------------------------------------------------------------------------------------------------------------
SSA-3441 (Paper Form)...........................          21,282               1              45          15,962
Electronic Disability Collect System (EDCS).....       1,284,019               1              45         963,014
I3441 (Internet Form)...........................         158,607               1             120         317,214
                                                 ---------------------------------------------------------------
    Totals......................................       1,463,908  ..............  ..............       1,296,190
----------------------------------------------------------------------------------------------------------------

    5. Request for Hearing by Administrative Law Judge--20 CFR 404.929, 
404.933, 416.1429, 404.1433, 405.722, 418.1350--0960-0269. The 
information collected on Form HA-501-U5 is used by SSA to document and 
initiate the Administrative Law Judge (ALJ) hearing process for 
determining eligibility or entitlement to Social Security benefits 
(Title II), Supplemental Security Income payments (Title XVI), Special 
Veterans Benefits (Title VIII), Medicare (Title XVIII), and of initial 
determinations regarding Medicare Part B income-related premium subsidy 
reductions. The methods for filing a request for an ALJ hearing are 
being expanded to include the internet. If an individual receives a 
notice of denial of his/her disability claim and the notice provides 
rights to an ALJ hearing, he/she will have the option of filing for the 
ALJ hearing over the internet. The individual will complete the 
appropriate appeal screens and submit the appeal to SSA for processing. 
The respondents are individuals filing for an ALJ hearing.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 669,469.
    Estimated Annual Burden: 178,525 hours.

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                                                                                     Estimated
                Collection method                    Number of     Frequency of     completion     Total burden
                                                    respondents      response       time  (min)        hours
----------------------------------------------------------------------------------------------------------------
Paper & Modernized Claims System................         334,735               1              10          55,789
i501............................................         334,734               1              22         122,736
                                                 ---------------------------------------------------------------
    Totals......................................         669,469  ..............  ..............         178,525
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    6. Request for Earnings and Benefit Estimate Statement--20 CFR 
404.810-0960-0466. SSA uses the information the requestor provides on 
Form SSA-7004 to identify his or her Social Security earnings record, 
extract posted earnings information, calculate potential benefit 
estimates, produce the resulting Social Security Statement and mail it 
to the requestor. Respondents are Social Security number holders 
requesting information about their Social Security earnings records and 
estimates of their potential benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 545,000.
    Frequency of Response: 1.
    Average Burden per Response: 5 minutes.
    Estimated Average Burden: 45,417 hours.
    7. Employer Verification of Earnings After Death--20 CFR 404.821 
and 404.822-0960-0472. The information collected on Form SSAL4112 is 
used by SSA to determine whether wages reported by an employer are 
correct and should be credited to the employee's Social Security number 
when SSA records indicate that the wage earner is deceased. The 
respondents are employers who report wages for a deceased employee.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 8,333 hours.
    8. Appointment of Representative--20 CFR 404.1707, 404.1720, 
404.1725, 410.684 and 416.1507-0960-0527. A person claiming a right or 
benefit under the Social Security Act must notify SSA in writing if he 
or she appoints an individual to represent him or her in dealing with 
SSA. 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, and it also allows the claimant to give permission to their 
appointed representative to designate a person to copy claims files. 
Respondents are applicants who notify SSA that they have appointed a 
person to represent them in their dealings with SSA when claiming a 
right to benefits and representatives of claimants for Social Security 
benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 551,520.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 91,920 hours.
    9. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009-0960-0622. The information collected on Form SSA-
561-U2 is used by SSA to document and initiate the reconsideration 
process for determining eligibility or entitlement to Social Security 
benefits (Title II), Supplemental Security Income payments (Title XVI), 
Special Veterans Benefits (Title VIII), Medicare (Title XVIII), and of 
initial determinations regarding Medicare Part B income-related premium 
subsidy reductions. The methods for filing a request for 
reconsideration are being expanded to include the internet. If an 
individual receives a notice of denial of his/her disability claim and 
the notice provides the right to reconsideration, he/she will have the 
option of filing for the reconsideration over the internet. The

[[Page 35296]]

individual will complete the appropriate appeal screens and submit the 
appeal to SSA for processing. The respondents are individuals filing 
for reconsideration.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 1,461,700.
    Estimated Annual Burden: 341,064 hours.

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                                                                                     Estimated
                Collection method                    Number of     Frequency of     completion     Total burden
                                                    respondents      response       time  (min)        hours
----------------------------------------------------------------------------------------------------------------
Paper & Modernized Claims System................         730,850               1               8          97,447
i561............................................         730,850               1              20         243,617
                                                 ---------------------------------------------------------------
    Totals......................................       1,461,700  ..............  ..............         341,064
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    10. Statement for Determining Continuing Eligibility for 
Supplemental Security Income Payments--Adult, Form SSA-3988; Statement 
for Determining Continuing Eligibility for Supplemental Security Income 
Payments--Child, Form SSA-3989--20 CFR Subpart B--416.204-0960-NEW. 
Forms SSA-3988 and SSA-3989 will be used to determine whether SSI 
recipients have met and continue to meet all statutory and regulatory 
nonmedical requirements for SSI eligibility, and whether they have been 
and are still receiving the correct payment amount. The SSA-3988 and 
SSA-3989 are designed as self-help forms that will be mailed to 
recipients or to their representative payees for completion and return 
to SSA. The respondents are recipients of SSI payments or their 
representatives.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 60,000.
    Estimated Annual Burden: 26,000 hours.

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                                                                                      Average
                                                                   Frequency of     burden per       Estimated
              Collection instrument                 Respondents      response        response      annual burden
                                                                                       (min)          (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3988........................................          30,000               1              26          13,000
SSA-3989........................................          30,000               1              26          13,000
                                                 ---------------------------------------------------------------
    Totals......................................          60,000  ..............  ..............          26,000
----------------------------------------------------------------------------------------------------------------

    11. 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: 30 minutes.
    Estimated Annual Burden: 2,250 hours.*

    *SSA inadvertently cited an incorrect burden hour in the first 
FRN dated April 23, 2007 and the second FRN dated June 13, 2007. 
This notice serves as a correction.

    Dated: June 21, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-12357 Filed 6-26-07; 8:45 am]
BILLING CODE 4191-02-P