[Federal Register Volume 77, Number 92 (Friday, May 11, 2012)]
[Notices]
[Pages 27829-27831]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-11328]


=======================================================================
-----------------------------------------------------------------------

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 one new information collection, one extension of an OMB-
approved information collection, and several revisions to existing 
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, email, 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, DCRDP, Attn: Reports 
Clearance Director, 107 Altmeyer Building, 6401 Security Blvd., 
Baltimore, MD 21235, Fax: 410-966-2830, Email 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 July 
10, 2012. Individuals can obtain copies of the collection instruments 
by writing to the above email address.
    1. Automated Scheduling Application (ASA)--20 CFR 404.929, 404.936, 
404.950, 416.1429, 416.1436, and 416.1450-416.1451--0960--NEW. SSA is 
creating an online-based scheduling tool, the Automated Scheduling 
Application (ASA), to document the availability and special needs of 
participants for hearings before administrative law judges (ALJ). The 
respondents are disability applicants or recipients, ALJ staff, SSA 
Hearing Office employees, appointed representatives, medical experts, 
vocational experts, and verbatim hearing recorders who need to schedule 
or request special needs related to an ALJ hearing. All respondents 
will use the ASA system (via SSA's Intranet for SSA employees, and a 
public-facing Internet site for members of the public) to document 
their hearings availability and needs, and to view scheduled hearings 
in an electronic calendar. SSA staff will provide technical support to 
external users via our 800 number.
    Type of Request: This is a new information collection request.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                     Number of     Frequency of      Number of      burden per     total annual
         Respondent type            respondents      response        responses       response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Medical Experts, Vocational                3,300              52         171,600               8          22,880
 Experts & Hearing Reporters--
 Availability reported using the
 external ASA...................
Appointed Representatives--               16,600              52         863,200               8         115,093
 Availability reported using the
 external ASA...................
Medical Experts, Vocational                3,300               6          19,800               8           2,640
 Experts & Hearing Reporters--
 requests to HO to change
 availability using internal ASA
Appointed Representatives--               16,600               6          99,600               8          13,280
 requests to HO to change
 availability using internal ASA
                                 -------------------------------------------------------------------------------
    Totals......................          39,800  ..............       1,154,200  ..............         153,893
----------------------------------------------------------------------------------------------------------------

    2. Statement of Claimant or Other Person--20 CFR 404.702 & 
416.570--0960-0045. In cases where claimants or others want to share 
information relating to Supplemental Security Income (SSI) or Social 
Security benefits, and SSA has no standard form to document this 
information, the agency uses form SSA-795. The agency documents 
whatever information the claimant or other member of the public 
provides, and considers it when processing benefits claims or when 
making decisions on ongoing issues relating to the above programs. The 
respondents are applicants or recipients of SSI or Social Security 
benefits, or others who are in a position to provide relevant 
information on an existing claim or case.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
            Collection instrument                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-795.....................................         305,500                1               15           76,375
----------------------------------------------------------------------------------------------------------------

    3. Authorization for the Social Security Administration to Obtain 
Account Records from a Financial Institution and Request for Records 
(Medicare)--0960-0729. Under the aegis of the Medicare Modernization 
Act of 2003, Medicare beneficiaries can apply for a Medicare 
Prescription Drug Plan (Part D) program subsidy. In some cases, SSA 
will verify the details of applicants' accounts at financial 
institutions to determine if they are eligible for the

[[Page 27830]]

subsidy. Form SSA-4640 provides the applicant authorization SSA needs 
to contact financial institutions about applicants' accounts. Financial 
institutions use the form to verify the information SSA requests. The 
respondents are applicants for the Medicare Part D program subsidy, and 
the financial institutions where these applicants are account holders.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total annual
               Type of respondent                   respondents      Response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Medicare Part D Subsidy Applicants..............           5,000               1               1              83
Financial Institutions..........................           5,000               1               4             333
                                                 ---------------------------------------------------------------
    Totals......................................          10,000  ..............  ..............             416
----------------------------------------------------------------------------------------------------------------

    4. Statement of Reclamation Action--31 CFR Part 210--0960-0734.
    Regulations governing the Federal Government Participation in the 
Automated Clearing House (1) allow SSA to send Social Security payments 
to Canada and (2) mandate the reclamation of funds paid erroneously to 
a Canadian bank or financial institution after the death of a Social 
Security beneficiary. SSA uses Form SSA-1713, Notice of Reclamation 
Action, to collect information to determine if, how, and when the 
Canadian bank or financial institution is going to return erroneous 
payments after the death of a Social Security beneficiary who elected 
to have payments sent to Canada. Form SSA-1712 (or SSA-1712 CN), Notice 
of Reclamation-Canada Payment Made in the United States, is the cover 
sheet SSA prepares to request return of the payment. The respondents 
are Canadian banks and financial institutions who erroneously received 
Social Security payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
            Collection instrument                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1713....................................              15                1                5                1
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding 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 11, 2012. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Request for Reconsideration--Disability Cessation--20 CFR 
404.909, 416.1409--0960-0349. SSA uses Form SSA-789-U4 to arrange for a 
hearing or to prepare a decision based on the evidence of record. 
Specifically, claimants or their representatives use Form SSA-789-U4 to 
(1) ask SSA to reconsider a determination; (2) indicate if they wish to 
appear at a disability hearing; (3) submit any additional information 
or evidence for use in the reconsidered determination; and (4) indicate 
if they will need an interpreter for the hearing. The respondents are 
applicants or claimants for Social Security benefits or SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
            Collection instrument                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-789-U4..................................          30,000                1               13            6,500
----------------------------------------------------------------------------------------------------------------

    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 applying for or 
receiving SSI benefits to report to SSA that (1) they are fleeing to 
avoid prosecution for a crime; (2) they are fleeing to avoid custody or 
confinement after conviction of a crime; or (3) they are violating a 
condition of probation or parole. SSA uses the information we receive 
to deny eligibility, or to suspend recipients' SSI payments. The 
respondents are SSI applicants and recipients, or representative payees 
of SSI applicants and recipients, who are reporting their status as a 
fugitive felons or probation/parole violators.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
            Collection instrument                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
Modernized SSI Claims System Screens........           1,000                1                1               17
----------------------------------------------------------------------------------------------------------------



[[Page 27831]]

    Dated: May 7, 2012.
Naomi Sipple,
Reports Clearance Analyst, Office of Regulations and Reports Clearance, 
Social Security Administration.
[FR Doc. 2012-11328 Filed 5-10-12; 8:45 am]
BILLING CODE 4191-02-P