[Federal Register Volume 74, Number 97 (Thursday, May 21, 2009)]
[Notices]
[Pages 23916-23918]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-11716]


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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 requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law (Pub. L.) 
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
This notice includes revisions and extensions of OMB-approved 
information collections and a new collection.
    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 ways to minimize the 
burden on respondents, including the use of automated collection 
techniques or other forms of information technology. Mail, e-mail, or 
fax your comments and recommendations on the information collection(s) 
to the OMB Desk Officer and the SSA Reports Clearance Officer to the 
addresses or fax numbers shown below.

(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974, E-mail address: [email protected].

[[Page 23917]]

(SSA), Social Security Administration, DCBFM, Attn: Reports Clearance 
Officer, 1332 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, 
Fax: 410-965-6400, E-mail address: [email protected].

    I. The information collection below is pending at SSA. SSA will 
submit it to OMB within 60 days from the date of this notice. To be 
sure we consider your comments, we must receive them no later than July 
20, 2009. Individuals can obtain copies of the collection instrument by 
calling the SSA Reports Clearance Officer at 410-965-3758 or by writing 
to the e-mail address we list above.
    1. Disability Report--Adult--20 CFR 404.1512, 416.912--0960-0579. 
State Disability Determination Services (DDS) use the information 
collected by the SSA-3368 and its electronic versions to determine if 
an adult disability applicant's impairment(s) is severe and, if so, how 
the impairment(s) affects the applicant's ability to work. This 
determination dictates whether the DDSs and SSA will find the applicant 
to be disabled. Therefore, the information the DDSs collect on this 
form is crucial in making disability determinations for all adult 
claimants filing for SSA disability benefits and/or Supplemental 
Security Income (SSI) payments. The respondents are applicants for 
Title II benefits and/or Title XVI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
                Collection method                    Number of     Frequency of    per response    annual burden
                                                    respondents      response         (hours)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper Form)...........................          22,950               1               1          22,950
Electronic Disability Collection System (EDCS)..       2,238,826               1               1       2,238,826
i3368 (Internet)................................         319,994               1          1\1/2\         479,991
i3368PRO (Internet professional users-rollout             10,264               1          1\1/2\          15,396
 only)..........................................
                                                 ---------------------------------------------------------------
    Totals......................................       2,592,034  ..............  ..............       2,757,163
----------------------------------------------------------------------------------------------------------------

    2. Function Report Adult-Third Party--20 CFR 404.1512 & 416.912--
0960-0635. Disability Determination Services (DDS) use the information 
from the SSA-3380-BK to determine eligibility for SSI and Social 
Security Disability Insurance (SSDI) claims. The information is an 
evidentiary source DDS evaluators use to determine eligibility for SSI 
and SSDI claims. The respondents are third parties familiar with the 
functional limitations (or lack thereof) of claimants who apply for SSI 
and SSDI benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
                Respondent types                     Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Individuals.....................................         500,000               1              61         508,333
Private Sector..................................         500,000               1              61         508,333
                                                 ---------------------------------------------------------------
    Total:......................................       1,000,000  ..............  ..............       1,016,666
----------------------------------------------------------------------------------------------------------------

    3. Function Report Adult--20 CFR 404.1512 & 416.912--0960-0681. 
State DDSs use Form SSA-3373-BK to collect information about a 
disability applicant's or recipient's impairment-related limitations 
and ability to function. The information is an evidentiary source DDS 
evaluators use to determine eligibility for SSI and SSDI claims. The 
respondents are Title II and Title XVI applicants (or current 
recipients undergoing redeterminations) for disability benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 4,005,367.
    Frequency of Response: 1.
    Average Burden per Response: 61 minutes.
    Estimated Annual Burden: 4,072,123 hours.
    II. SSA has submitted the information collections we list below to 
OMB for clearance. Your comments on the information collections would 
be most useful if OMB and SSA receive them within 30 days from the date 
of this publication. To be sure we consider your comments, we must 
receive them no later than June 22, 2009. You can obtain a copy of the 
OMB clearance packages by calling the SSA Reports Clearance Officer at 
410-965-3758 or by writing to the above email address.
    1. Request for Workers' Compensation/Public Disability Benefit 
Information--20 CFR 404.408(e)--0960-0098. SSA uses Form SSA-1709 to 
verify Worker's Compensation/Public Disability Benefits (WC/PDB). SSA 
uses the information to compute the correct reduction of disability 
insurance benefits. The claimant may be able to furnish adequate 
verification of the WC/PDB benefits by submitting a copy of his or her 
award notice, benefit check, etc. SSA considers the claimant the 
primary source of verification. If he or she provides the necessary 
evidence, we do not use the form. If the claimant cannot provide 
evidence, the other reliable source of this information is the entity 
giving the benefits, its agent (such as an insurance carrier), or an 
administering public agency. The respondents are Federal, state, and 
local agencies administering WC/PDB, insurance carriers, and public or 
private self-insured companies.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 120,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 30,000 hours.
    2. Prohibition of Payment of SSI Benefits to Fugitive Felons and 
Parole/Probation Violators--20 CFR 416.708(o)--0960-0617. Section 
1611(e)(4) of the Social Security Act precludes eligibility for SSI 
payments for certain fugitives and probation/parole violators. 
Regulations at 20 CFR 416.708(o) require individuals to report to SSA 
that he or she is fleeing to avoid

[[Page 23918]]

prosecution for a crime, fleeing to avoid custody or confinement after 
conviction of a crime, or violating a condition of probation or parole. 
SSA will use the information reported to deny eligibility or to suspend 
recipient's SSI payments. The respondents are SSI applicants/recipients 
or representative payees of SSI recipients who are reporting the 
applicant's/recipient's status as a fugitive felon or probation/parole 
violator.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden per Response: 1 minute.
    Estimated Annual Burden: 17 hours.

    Dated: May 14, 2009.
John Biles,
Reports Clearance Officer, Center for Reports Clearance, Social 
Security Administration.
[FR Doc. E9-11716 Filed 5-20-09; 8:45 am]
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