[Federal Register Volume 75, Number 147 (Monday, August 2, 2010)]
[Notices]
[Pages 45190-45194]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-18854]


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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 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: 410-965-6400, 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 
October 1, 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 e-mail address.
    1. Request for Corrections of Earnings Record--20 CFR 404.820 and 
20 CFR 422.125--0960-0029. Individuals alleging inaccurate earnings 
records that SSA maintains for them use Form SSA-7008 to provide the 
information SSA needs to check earnings posted, and as necessary, 
initiate development to resolve any inaccuracies. The respondents are 
individuals who request correction of earnings posted to their Social 
Security earnings record.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                     Estimated
                                                     Number of     Frequency of     burden per       Estimated
              Method of collection                  respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper form......................................          37,500               1              10           6,250
In-person or telephone interview................         337,500               1              10          56,250
                                                 ---------------------------------------------------------------
    Total.......................................         375,000  ..............  ..............          62,500
----------------------------------------------------------------------------------------------------------------

    2. 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 Internal Revenue Service (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 employer wage reports SSA receives are less than the wage 
amounts employers report to the IRS. SSA uses Forms SSA-L93-SM, SSA-
L94-SM, SSA-95-SM, and SSA-97-SM to ensure employees receive full 
credit for their wages. Respondents are employers who reported lower 
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.
    3. Appointment of Representative--20 CFR 404.1707, 4041720, 
404.1725, 410.684 and 416.1507--0960-0527. Persons claiming benefits 
under the Social Security Act must notify SSA in writing when they 
appoint an individual to represent them in dealings with SSA. SSA 
collects the information on Form SSA-1696-U4 to verify the appointment 
of such representatives. The SSA-1696-U4 also allows SSA to inform 
representatives of items affecting the recipient's claim and allows 
claimants to give permission to their appointed representatives to 
designate a person to copy claims files. Respondents are applicants/
recipients of Social Security benefits or Supplemental Security Income 
(SSI) payments who are notifying SSA they have appointed a person to 
represent them in their dealings with SSA.
    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.
    4. Appeal of Determination for Help with Medicare Prescription Drug 
Plan Costs--0960-0695. Public Law 108-173, the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (MMA) established the 
Medicare Part D program for voluntary prescription drug coverage for 
certain low-income individuals. The MMA stipulates subsidies must be 
available for individuals who are eligible for the program and who meet 
eligibility criteria for help with premium, deductible, and/or co-
payment costs. Form SSA-1021, Appeal of Determination for Help with 
Medicare Prescription Drug Plan Costs, obtains information from 
individuals who appeal SSA's decisions regarding eligibility or 
continuing eligibility for a Medicare Part D subsidy. The respondents 
are applicants who are appealing SSA's eligibility or continuing 
eligibility decisions.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 75,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 12,500 hours.
    5. Consent Based Social Security Number Verification Process--20 
CFR 400.100--0960-0760. The Consent-Based Social Security Number (SSN) 
Verification (CBSV) process is a fee-based automated SSN verification 
service available to private businesses

[[Page 45191]]

and other requesting parties. To use the system, private businesses and 
requesting parties must register with SSA and obtain valid consent from 
the SSN number holders prior to verification. We collect the 
information to verify if the submitted name and SSN match the 
information contained in SSA records. After completing a registration 
process and paying the fee, the requesting party can use the CBSV 
Internet application to submit a file containing names of number 
holders who have given valid consent, along with each number holder's 
accompanying SSN and date of birth (if available), or obtain real-time 
results using a web service application or SSA's Business Services 
Online application. SSA matches the information against the SSA master 
file of SSNs, using SSN, name, date of birth and gender code (if 
available). The requesting party retrieves the results file from SSA; 
the results file indicates only a match or no match for each SSN 
submitted.
    Under the CBSV process, the requesting party does not submit the 
consent forms of the number holders to SSA. SSA requires each 
requesting party to retain a valid consent form for each SSN 
verification request. The requesting party retains the consent forms in 
either electronic or paper format.
    To ensure the integrity of the CBSV process, SSA added a strong 
audit component that requires audits (called ``compliance reviews'') at 
the discretion of the agency with all audit costs borne by the 
requesting party. Independent certified public accountants (CPA) 
conduct these reviews to ensure compliance with all the terms and 
conditions of the party's agreement with SSA, including a review of the 
consent forms. CPAs conduct the review at the requesting party's place 
of business to ensure the integrity of the process. In addition, SSA 
reserves the right to perform unannounced onsite inspections of the 
entire process, including review of the technical systems that maintain 
the data and transaction records. The respondents to the CBSV 
collection are the participating companies, members of the public who 
consent to the SSN verification, and CPAs who provide compliance review 
services.
    Type of Request: Revision of an OMB-approved information 
collection.

Time Burden

Participating Companies

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Requirement                      respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
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Registration Process............................             115               1             120             230
Creation of file with SSN holder identification              115            *251              60          28,865
 data; maintaining required documentation/forms.
Using the system to upload request file, check               115             251               5           2,405
 status, and download results file..............
Storing consent forms...........................             115             251              60          28,865
Activities related to compliance review.........             115             251              60          28,865
                                                 ---------------------------------------------------------------
    Total.......................................  ..............  ..............  ..............          89,230
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* Please note: There are 251 Federal business days per year on which a requesting party could submit a file.

    People whose SSNs SSA Will Verify:

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                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Requirement                      respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Reading and signing authorization for SSA to             986,585               1               3          49,329
 release SSN verification.......................
Responding to CPA re-contact....................           4,750               1               5             479
                                                 ---------------------------------------------------------------
    Total.......................................  ..............  ..............  ..............          49,808
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    CPAs (conducting compliance reviews and preparing written report of 
findings):
    Number of Respondents: 115.
    Frequency of Response: 1.
    Average Burden per Response: 4,800.
    Estimated Annual Burden: 9,200 hours.
    Total Collective Burden: 577,408.

Cost Burden

    The public burden cost is dependent upon the number of companies 
and transactions. SSA based the cost estimates below upon 115 
participating companies submitting 986,585 transactions. The total cost 
for developing the system was $5.6 million. SSA has already expended 
$3.0 million that we will recoup over the depreciable life of the 
system based on the fee-per-transaction model.
    One-Time per Company Registration Fee--$5,000.
    Estimated per SSN Transaction Fee--$5.\1\
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    \1\ The annual costs associated with the transaction to each 
company are dependent upon the number of SSN transactions submitted 
to SSA by the company on a yearly basis. For example, if a company 
anticipates submitting one million requests to SSA for the year, its 
total transaction cost for the year would be $5 x 1,000,000 or 
$5,000,000. Periodically, SSA will calculate its costs to provide 
CBSV services and adjust the fee charged. SSA will notify companies 
in writing of any change and companies will have the opportunity to 
cancel the agreement or continue service using the new transaction 
fee.
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    Estimated per Company Cost to Build Web Service--$200,000.\2\
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    \2\ A company may choose to submit batch files via the SSA Web 
site or submit real-time individual requests via the SSA Web site. 
There is no public burden cost with either of these methods using 
the CBSV system.
---------------------------------------------------------------------------

    Estimated per Company Cost to Store Consent Forms--$300.
    Estimated per Company Cost To Contract with CPA for Audit--$8,000.
    II. SSA has submitted the information collections listed below to 
OMB for clearance. Your comments on the information collections would 
be most useful if OMB and SSA receive them

[[Page 45192]]

within 30 days from the date of this publication. To be sure we 
consider your comments, we must receive them no later than September 1, 
2010. You can obtain a copy of the OMB clearance packages by calling 
the SSA Reports Clearance Officer at 410-965-8783 or by writing to the 
above e-mail address.
    1. Request to be Selected as a Payee--20 CFR 404.2010-404.2055, 
416.601-416.665--0960-0014. An individual applying to be a 
representative payee for a Social Security or SSI recipient completes 
Form SSA-11-BK. SSA obtains information from applicant payees regarding 
their relationship to the beneficiary; personal qualifications; their 
concern for the beneficiary's well-being; and their intended use of 
benefits if appointed as payee. The respondents are individuals, 
private sector businesses and institutions, and state and local 
government institutions and agencies.
    Type of Request: Revision of an OMB-approved information 
collection.
    Individuals/Households (90%):

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                                                                                      Average
                Collection method                    Number of     Frequency of     burden per     Total annual
                                                    respondents      response        response         burden
----------------------------------------------------------------------------------------------------------------
Representative Payee System (RPS)...............         135,000               1            10.5          23,625
RPS/Signature Proxy.............................         765,000               1             9.5         121,125
Paper Version...................................         450,000               1            10.5          78,750
                                                 =================================================
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    Private Sector (9%):

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                                                                                      Average
                Collection method                    Number of     Frequency of     burden per     Total annual
                                                    respondents      response        response         burden
----------------------------------------------------------------------------------------------------------------
RPS.............................................          13,500               1            10.5           2,363
RPS/Signature Proxy.............................          76,500               1             9.5          12,113
Paper Version...................................          45,000               1            10.5           7,875
                                                 ---------------------------------------------------------------
    Totals......................................         135,000  ..............  ..............          22,351
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    State/Local/Tribal Government (1%):

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                                                                                      Average
                Collection method                    Number of     Frequency of     burden per     Total annual
                                                    respondents      response        response         burden
----------------------------------------------------------------------------------------------------------------
RPS.............................................           1,500               1            10.5             263
RPS/Signature Proxy.............................           8,500               1             9.5           1,346
Paper Version...................................           5,000               1            10.5             875
                                                 ---------------------------------------------------------------
    Totals......................................          15,000  ..............  ..............           2,484
                                                 ---------------------------------------------------------------
        Grand total.............................       1,500,000  ..............  ..............         248,335
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    2. Representative Payee Evaluation Report--20 CFR 404.2065 & 
416.665--0960-0069. Sections 205(j) and 1631(a)(2) of the Social 
Security Act state that SSA may appoint a representative payee to 
receive Title II benefits and/or Title XVI payments on behalf of 
individuals unable to manage or direct the management of those funds 
themselves. SSA requires the appointed representative payees to report 
once per year on how they used or conserved those funds. When a 
representative payee fails to report adequately to SSA as required, SSA 
conducts a face-to-face interview with the payee and completes Form 
SSA-624, Representative Payee Evaluation Report, to determine the 
continued suitability of the representative payee to serve as a payee. 
The respondents are individuals or organizations serving as 
representative payees for individuals receiving Title II benefits and/
or Title XVI payments who fail to comply with SSA's statutory annual 
reporting requirement.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 266,000.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 133,000 hours.
    3. 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. Applicants for Social Security benefits 
and SSI payments have the statutory right to appear in person (or 
through a representative) and present evidence about their claims at a 
hearing before an administrative law judge (ALJ). If claimants wish to 
waive this right to appear before an ALJ, they must complete a written 
request. The applicants may use SSA Form HA-4608 for this purpose. The 
ALJ uses the information to document an individual's claim to show that 
an oral hearing is not preferred in the appellate process. Respondents 
are claimants or their representatives for Title II benefits and/or 
Title XVI payments who request to waive their right to appear in person 
before an ALJ.
    Type of Request: Revision of an approved-OMB information 
collection.
    Number of Respondents: 12,000.
    Frequency of Response: 1.
    Average Burden per Response: 2 minutes.
    Estimated Annual Burden: 400 hours.

[[Page 45193]]

    4. Request for Change in Time/Place of Disability Hearing--20 CFR 
404.914(c)(2) and 416.1414(c)(2)--0960-0348. At the request of 
claimants or their representatives, SSA schedules evidentiary hearings 
at the reconsideration level for claimants of Title II benefits and/or 
Title XVI payments when we deny their claims for disability. When 
claimants or their representatives find they are unable to attend the 
scheduled hearing, they complete Form SSA-769 to request a change in 
time or place of the hearing. SSA uses the information as a basis for 
granting or denying requests for changes and for rescheduling 
disability hearings. Respondents are claimants or their representatives 
who wish to request a change in the time and/or place of their hearing.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 7,483.
    Frequency of Response: 1.
    Average Burden per Response: 8 minutes.
    Estimated Annual Burden: 998 hours.
    5. Agency/Employer Government Pension Offset Questionnaire--20 CFR 
404.408(a)--0960-0470. When an individual is concurrently receiving 
Social Security spousal or surviving spousal benefits and a government 
pension, the individual may have the amount of Social Security benefits 
reduced by the government pension amount. We call this the Government 
Pension Offset (GPO). SSA uses Form SSA-L4163 to collect accurate 
pension information from the Federal or state government agency paying 
the pension for purposes of applying the pension-offset provision. We 
only use the form when: (1) The claimant does not have the information; 
and (2) the pension-paying agency has not cooperated with the claimant. 
Respondents are state government agencies that have information SSA 
needs to determine if the GPO applies and/or the amount of offset.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 1,000.
    Frequency of Response: 1.
    Average Burden per Response: 3 minutes.
    Estimated Annual Burden: 50 hours.
    6. Child Care Dropout Questionnaire--20 CFR 404.211(e)(4)--0960-
0474. The Social Security Act and SSA's regulations permit the 
exclusion, from a disability computation period, of the years an 
individual was caring for his or her (or the spouse's) child under age 
3 if he or she had no earnings in the benefit computation years. We 
call this the child-care dropout exclusion. SSA uses Form SSA-4162 to 
determine if an individual qualifies for this exclusion. Respondents 
are applicants for Title II disability benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 2,000.
    Frequency of Response: 1.
    Average Burden per Response: 5 minutes.
    Estimated Annual Burden: 167 hours.
    7. 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. Forms SSA-3375-BK through SSA-3379-BK request 
information from the child's parent about the child's day-to-day 
functioning. The five different versions of the form contain questions 
about functioning appropriate to a particular age group; thus, 
respondents use only one version for each child.
    The adjudicative team (disability examiners and medical/
psychological consultants) of state Disability Determination Services 
offices collect the information on the appropriate version of this form 
(in conjunction with medical and other evidence) to form a complete 
picture of the children's ability to function and their impairment-
related limitations. The adjudicative team uses the completed profile 
to determine whether each child's impairment(s) results in marked and 
severe functional limitations and whether each child is disabled. The 
respondents are parents and/or guardians of child applicants for SSI 
payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 500,000.
    Frequency of Response: 1.
    Average Burden per Response: 20 minutes.
    Estimated Annual Burden: 166,667 hours.
    8. Registration for Appointed Representative Services and Direct 
Payment--0960-0732. SSA uses Form SSA-1699 to register appointed 
representatives of claimants before SSA who:
     Want to register for direct payment of fees;
     Registered for direct payment of fees prior to 10/31/09, 
but need to update their information;
     Registered as appointed representatives on or after 10/31/
09, but need to update their information; and/or
     Received a notice from SSA instructing them to complete 
this form.
    By registering these individuals, SSA: (1) Authenticates and 
authorizes them to do business with us; (2) allows them access to our 
records for the claimants they represent; (3) facilitates direct 
payment of authorized fees to appointed representatives; and (4) 
collects the information we will need to meet IRS requirements to issue 
specific IRS forms if we pay these representatives in excess of a 
specific amount ($600).
    In February 2010, we received emergency clearance for a new, 
simplified version of this form. We are now seeking full clearance for 
this simplified version. The respondents are appointed representatives 
who want to use Form SSA-1699 for any of the purposes cited in this 
notice.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 52,800.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 17,600 hours.
    9. Government-to-Government Services Online Web site Registration; 
Government-to-Government Services Online Web site Account Modification/
Deletion Form--20 CFR 401.45--0960-0757. The Government-to-Government 
Services Online (GSO) Web site allows various external organizations to 
submit files to a variety of SSA systems and, in some cases, receive 
return files. The users include state/local government agencies, other 
Federal agencies, and some private sector business entities. The SSA 
systems that process data transferred via GSO include, but are not 
limited to, systems responsible for disability processing and benefit 
determination or termination. A sponsor within SSA who knows the 
requestor completes the registration form, SSA-118, and submits the 
information to SSA's User Interface Team (UIT). SSA uses the 
information on Form SSA-118 (GSO Web site Registration Form) to 
maintain the identity of the requestor within GSO. Once this is 
completed, SSA provides the requestor with the new password and 
conducts a walkthrough of the GSO Web site as necessary. The 
organization can also modify its online account (e.g., address change) 
by completing Form SSA-119 (GSO Web site Account Modification/Deletion 
Form).

    Note: This is a correction notice. SSA published this 
information with the incorrect form name on May 13, 2010 at 75 FRN 
27036. We are correcting this error here.

    Also, Form SSA-118 is now Form SSA-159, and Form SSA-119 is now 
Form SSA-160.

[[Page 45194]]

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

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                                                                                  Average burden     Estimated
              Collection instrument                  Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-159.........................................             925               1              15             231
SSA-160.........................................           2,500               1              15             625
                                                 ---------------------------------------------------------------
    Totals......................................           3,425  ..............  ..............             856
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    10. Technical Updates to Applicability of the Supplemental Security 
Income (SSI) Reduced Benefit Rate for Individuals Residing in Medical 
Treatment Facilities--20 CFR 416.708(k)--0960-0758. Section 
1611(e)(1)(A) of the Social Security Act states no resident of a public 
institution is eligible for SSI payments. However, Sections 
1611(e)(1)(B) and (G) list certain exceptions to this provision that 
make it necessary for SSA to collect information about any SSI 
recipient who enters or leaves a medical treatment facility, or other 
public or private institution. SSA's regulation 20 CFR 416.708(k) 
establishes the reporting guidelines that implement this legislative 
requirement. SSA collects the information to determine eligibility for 
SSI and the payment amount. The respondents are SSI recipients who 
enter or leave an institution.

    Note: This is a correction notice: SSA published the incorrect 
CFR number for this collection at 75 FR 27036, on 5/13/10. We are 
correcting this error here.

    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 34,200.
    Frequency of Response: 1.
    Average Burden per Response: 7 minutes.
    Estimated Annual Burden: 3,990 hours.
    11. Statement for Certificate of Election for Reduced Widow(er)'s 
and Surviving Divorced Spouse's Benefits--20 CFR 404.335--0960-0759. 
Section 202(q) of the Social Security Act provides the authority to 
reduce benefits under certain conditions when a Title II beneficiary 
elects to do so. However, reduced benefits are not payable to an 
already entitled spouse (or divorced spouse) who:
     Is at least age 62 and under full retirement age in the 
month of the number holder's death; and,
     Is receiving reduced spouse's (or divorced spouse's) 
benefits, and either retirement or disability benefits in the month 
before the month of the number holder's death.
    To elect reduced widow(er) benefits, a recipient completes Form 
SSA-4111. SSA collects the information on Form SSA-4111 to pay a 
qualified dually entitled widow(er) (or surviving divorced spouse) who 
elects to receive a reduced widow(er) benefit. The respondents are 
qualified dually entitled widow(er)s (or surviving divorced spouse) who 
elect to receive a reduced widow(er) benefit.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 24,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 6,000 hours.
    12. Questionnaire about Special Veterans Benefits--0960-NEW. SSA 
will use the information collected on the SSA-2010 to determine 
continuing eligibility for Social Security Special Veterans Benefits 
(SVB), and to determine how much (if any) of a foreign pension we may 
use to reduce or increase the amount of Social Security SVB. The 
respondents will complete the SSA-2010 biannually so SSA can determine 
if we should increase, decrease, suspend, or terminate benefits based 
on the data we collect. The respondents are beneficiaries receiving 
Social Security SVB.
    Type of Request: Request for a new information collection.
    Number of Respondents: 2,500.
    Frequency of Response: 1.
    Average Burden per Response: 20 minutes.
    Estimated Annual Burden: 833 hours.

    Dated: July 28, 2010.
Faye Lipsky,
Reports Clearance Officer, Center for Reports Clearance, Social 
Security Administration.
[FR Doc. 2010-18854 Filed 7-30-10; 8:45 am]
BILLING CODE 4191-02-P