[Federal Register Volume 76, Number 42 (Thursday, March 3, 2011)]
[Notices]
[Pages 11835-11837]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-4797]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed 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 at the following 
addresses or fax numbers.

(OMB)

    Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 
202-395-6974, Email 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].
    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 May 
2, 2011. 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. Statement Regarding Marriage--20 CFR 404.726--0960-0017. Section 
216(h)(1)(A) of the Social Security Act (the Act) directs SSA to apply 
state law to determine an individual's marital relationship. Some state 
laws recognize marriages without a ceremony (i.e., common-law 
marriages). In such cases, SSA provides the same spouse/widow(er) 
benefits to the common-law spouses as it does to ceremonially married 
spouses. To determine common-law spouses, SSA must elicit information 
from blood relatives or other persons who are knowledgeable about the 
alleged common-law relationship. SSA uses Form SSA-753, Statement 
Regarding Marriage, to collect information from third parties to verify 
the applicant's statements about intent, cohabitation, and holding out 
to the public as married, which are the basic tenets of a common-law 
marriage. SSA uses the information to determine if a valid marital 
relationship exists, and if the common-law spouse is entitled to Social 
Security spouse or widow(er) benefits. The respondents are third 
parties who can confirm or deny the alleged common-law marriage.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 40,000.
    Frequency of Response: 1.
    Average Burden per Response: 9 minutes.
    Estimated Annual Burden: 6,000 hours.
    2. Railroad Employment Questionnaire--20CFR 404.1401, 404.1406-
404.1408 --0960-0078. Railroad workers, their dependents, or survivors 
can concurrently apply for railroad retirement and Social Security 
benefits at SSA whenever the number holder, or claimant on the number 
holder's SSN, worked in the railroad industry. SSA uses the information 
from Form SSA-671 to coordinate Social Security claims processing with 
the Railroad Retirement Board and to determine benefit entitlement and 
amount. The respondents are Social Security benefit applicants employed 
by a railroad or dependents of railroad workers.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 125,000.
    Frequency of Response: 1.
    Average Burden of Response: 5 minutes.
    Estimated Annual Burden: 10,417 hours.
    3. Statement of Death by Funeral Director--20 CFR 404.715 and 
404.720--0960-0142. When a Social Security-insured worker dies, the 
funeral director or funeral home responsible for the worker's burial or 
cremation completes Form SSA-721 and sends it to SSA. SSA uses this 
information for three purposes: (1) To establish proof of death for the 
insured worker; (2) to determine if the insured worker was receiving 
any pre-death

[[Page 11836]]

benefits that SSA needs to terminate; and (3) to ascertain which 
surviving family member is eligible for the lump-sum death payment or 
other death benefits. The respondents are funeral directors who handle 
funeral arrangements for the insured individuals.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 319,811.
    Frequency of Response: 1.
    Average Burden per Response: 3.5 minutes.
    Estimated Annual Burden: 18,656 hours.
    4. Government Pension Questionnaire--20 CFR 404.408a--0960-0160. 
When someone is concurrently receiving spouse or surviving spousal 
Social Security benefits and a government pension based on non-Social 
Security earnings, SSA may reduce the benefit amount by two-thirds the 
amount of the government pension under the Act's Government Pension 
Offset (GPO) provision. We use Form SSA-3885, Government Pension 
Questionnaire, to document such cases. SSA uses the information to 
determine whether the GPO applies, to identify exceptions, and to 
determine the benefit reduction amount and effective date. The 
respondents are individuals and households.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 76,000.
    Frequency of Response: 1.
    Average Burden per Response: 12.5 minutes.
    Estimated Annual Burden: 15,833 hours.
    5. Request for Hearing by Administrative Law Judge--20 CFR 404.929, 
404.933, 416.1429, 404.1433, 405.722, 418.1350--0960-0269. When SSA 
denies applicants' or beneficiaries' requests for new or continuing 
benefits, those applicants or beneficiaries are entitled to request a 
hearing to appeal the decision. SSA uses the information from Form HA-
501 to determine if the individual filed the request within the 
prescribed time, is the proper party, and has taken the steps necessary 
to obtain the right to a hearing. SSA also uses the information to 
determine the individual's reason(s) for disagreeing with SSA's prior 
determinations in the case; if the individual has additional evidence 
to submit; if the individual wants an oral hearing or a decision on-
the-record; and whether the individual has (or wants to appoint) a 
representative. The respondents are Social Security benefit applicants 
and recipients who want to appeal SSA's denial of their request for new 
or continued benefits and Medicare Part B recipients who must pay the 
Medicare Part B Income-Related Monthly Adjustment Amount.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
                Collection method                    Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
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Paper & Modernized Claims System................         334,735               1              10          55,789
i501............................................         334,734               1              19         105,999
                                                 ---------------------------------------------------------------
    Totals......................................         669,469  ..............  ..............         161,788
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    6. Administrative Review Process for Adjudicating Initial 
Disability Claims--20 CFR 404.949, 404.950, 404.957(a), 404.961, 
404.982, 404.987-404.988, 404.1450, 404.1499, 416.1457(a), 416.1461, 
416.1482, and 416.1487-416.1488--0960-0710. Claimants have a statutory 
right under the Act and current regulations to apply for Social 
Security disability insurance benefits or Supplemental Security Income 
(SSI). SSA must collect information at each step of the administrative 
process to adjudicate claims fairly and efficiently. SSA collects this 
information to establish a claimant's right to administrative review 
and the severity of the claimant's alleged impairments. SSA uses the 
information to determine entitlement or continuing eligibility to 
disability insurance benefits or SSI payments and to enable appeals of 
these determinations. The respondents are applicants for title II 
disability insurance benefits or title XVI SSI.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
              20 CFR Section number                  Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
404.961 and 416.1461............................          12,220               1              20           4,073
404.950 and 404.1450............................           1,040               1              20             347
404.949 and 404.1449............................           2,888               1              60           2,888
404.957(a) and 416.1457(a)......................          21,078               1              10           3,513
404.982 and 416.1482............................           2,520               1              30           1,260
404.987-404.988 and 416.1487-416.1488...........          12,425               1              30           6,213
                                                 ---------------------------------------------------------------
    Totals......................................          52,171  ..............  ..............          18,294
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[[Page 11837]]

    Dated: February 28, 2011.
Faye Lipsky,
Reports Clearance Officer, Center for Reports Clearance, Social 
Security Administration.
[FR Doc. 2011-4797 Filed 3-2-11; 8:45 am]
BILLING CODE 4191-02-P