[Federal Register Volume 75, Number 119 (Tuesday, June 22, 2010)]
[Notices]
[Pages 35512-35513]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-15045]


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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 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions 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 ways to minimize 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 SSA Reports Clearance Officer to the following 
addresses or fax numbers.
    (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: 410-965-0454, E-mail address: [email protected].
    I. The information collections below are pending at SSA. SSA will 
submit them 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 
August 23, 2010. Individuals can obtain copies of the collection 
instruments by calling the SSA Reports Clearance Officer at 410-965-
8783 or by writing to the above email address.
    1. Medical Report (General)--20 CFR 404.1512-404.1515, 416.912-
416.915--0960-0052. Using the state Disability Determination Services 
(DDS) as agents, SSA uses Form SSA-3826-F4 to make accurate 
determinations in disability claims cases. SSA uses the information 
from this form to determine the claimant's physical and mental status 
prior to making a disability determination, and to document the 
disability claims folder with the medical evidence. The form provides 
disability adjudicators and reviewers with a narrative record and 
history of the alleged disability and with the objective medical 
findings necessary to make a disability determination. SSA uses the 
medical evidence from this form to determine if an individual's 
impairment meets the severity and duration requirements for disability 
benefits. The respondents are members of the medical community, 
including individual physicians, hospital doctors, medical records 
librarians, and other medical sources.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 150,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 75,000 hours.
    2. Letter to Custodian of Birth Records/Letter to Custodian of 
School Records--20 CFR 404.704, 404.716, 416.802, and 422.107--0960-
0693. SSA prepares Form SSA-L106 and SSA-L706 for individuals who need 
help in obtaining evidence of their age in connection with Social 
Security number (SSN) card applications and claims for benefits. SSA 
uses the SSA-L706 to determine the existence of primary evidence of age 
for SSN applicants. SSA also uses both letters to verify with the 
issuing entity, when necessary, the authenticity of the record 
submitted by the SSN applicant or claimant. The respondents are 
schools, state and local bureaus of vital statistics, and religious 
entities.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
                      Form                           Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
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SSA-L106........................................           3,600               1              10             600
SSA-L706........................................           3,600               1              10             600
Totals..........................................           7,200  ..............  ..............           1,200
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    II. SSA has submitted the information collection listed below to 
OMB for clearance. Your comments on the information collection 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 July 22, 2010. You can

[[Page 35513]]

obtain a copy of the OMB clearance package by calling the SSA Reports 
Clearance Officer at 410-965-8783 or by writing to the above email 
address.
    Disability Report-Appeal--20 CFR 404.1512, 416.912, 404.916(c), 
416.1416(c), 405 Subpart C, 422.140--0960-0144. SSA requires disability 
claimants who are appealing an unfavorable disability determination to 
complete Form SSA-3441-BK. This form allows claimants to disclose any 
changes to their disability or resources that might influence SSA's 
unfavorable determination. SSA may use the information to: (1) 
Reconsider and review an initial disability determination; (2) review a 
continuing disability; and (3) evaluate a request for a hearing. This 
information assists the state DDSs and administrative law judges (ALJ) 
in: (1) Preparing for the appeals and hearings; and (2) issuing a 
determination or decision on an individual's entitlement (initial or 
continuing) to disability benefits. Respondents are individuals who 
appeal denial, reduction, or cessation of Social Security Disability 
Income and Supplemental Security Income payments, or who are requesting 
a hearing before an ALJ.

    *Note:  This is a correction notice. SSA inadvertently published 
incorrect burden information for this collection at 75 FR 27036 on 
May 13, 2010. We provide the correct burden information below.

    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                     Estimated
                Collection method                    Number of     Frequency of   Average burden   annual burden
                                                    respondents      response     per  response:       hours
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SSA-3441 (Paper Form)...........................          12,604               1      45 minutes           9,453
Electronic Disability Collect System (EDCS).....         843,090               1      45 minutes         632,318
I3441 (Internet Form)...........................         417,268               1      30 minutes         208,634
Totals..........................................       1,272,962  ..............  ..............         850,405
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    Dated: June 17, 2010.
Liz Davidson,
Director, Center for Reports Clearance, Social Security Administration.
[FR Doc. 2010-15045 Filed 6-21-10; 8:45 am]
BILLING CODE 4191-02-P