[Federal Register Volume 79, Number 57 (Tuesday, March 25, 2014)]
[Notices]
[Pages 16381-16384]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-06500]


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RAILROAD RETIREMENT BOARD


Agency Forms Submitted for OMB Review, Request for Comments

    SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 
U.S.C. Chapter 35), the Railroad Retirement Board (RRB) is forwarding 
an Information Collection Request (ICR) to the Office of Information 
and Regulatory Affairs (OIRA), Office of Management and Budget (OMB). 
Our ICR describes the information we seek to collect from the public. 
Review and approval by OIRA ensures that we impose appropriate 
paperwork burdens.
    The RRB invites comments on the proposed collection of information 
to determine (1) the practical utility of the collection; (2) the 
accuracy of the estimated burden of the collection; (3) ways to enhance 
the quality, utility, and clarity of the information that is the 
subject of collection; and (4) ways to minimize the burden of 
collections on respondents, including the use of automated collection 
techniques or other forms of information technology. Comments to the 
RRB or OIRA must contain the OMB control number of the ICR. For proper 
consideration of your comments, it is best if the RRB and OIRA receive 
them within 30 days of the publication date.
    1. Title and purpose of information collection: Application and 
Claim for Unemployment Benefits and Employment Service; OMB 3220-0022.
    Section 2 of the Railroad Unemployment Insurance Act (RUIA), 
provides unemployment benefits for qualified railroad employees. These 
benefits are generally payable for each day of unemployment in excess 
of four during a registration period (normally a period of 14 days).
    Section 12 of the RUIA provides that the RRB establish, maintain 
and operate free employment facilities directed toward the reemployment 
of railroad employees. The procedures for applying for the unemployment 
benefits and employment service and for registering and claiming the 
benefits are prescribed in 20 CFR 325.
    The RRB utilizes the following forms to collect the information 
necessary to pay unemployment benefits: Form UI-1 (or its Internet 
equivalent, Form UI-1 (Internet)), Application for Unemployment 
Benefits and Employment Service, is completed by a claimant for 
unemployment benefits once in a benefit year, at the time of first 
registration. Completion of Form UI-1 or UI-1 (Internet) also registers 
an unemployment claimant for the RRB's employment service.
    The RRB also utilizes Form UI-3, (or its Internet equivalent Form 
UI-3 (Internet)) Claim for Unemployment Benefits for use in claiming 
unemployment benefits for days of unemployment in a particular 
registration period, normally a period of 14 days.
    Completion of Forms UI-1, UI-1 (Internet), UI-3 and UI-3 (Internet) 
is required to obtain or retain benefits. The number of responses 
required of each claimant varies, depending on their period of 
unemployment.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (79 FR 415 on January 3, 2014) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Application and Claim for Unemployment Benefits and 
Employment Service.
    OMB Control Number: 3220-0022.
    Forms submitted: UI-1, UI-1 (Internet), UI-3, UI-3 (Internet).
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households.
    Abstract: Under Section 2 of the Railroad Unemployment Insurance 
Act, unemployment benefits are provided for qualified railroad 
employees. The collection obtains the information needed to determine 
the eligibility to and amount of such benefits for railroad employees.
    Changes proposed: The RRB proposes no changes to the forms in the 
collection.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
UI-1............................................................           6,817              10           1,136
UI-1 (Internet).................................................           3,490              10             582
UI-3............................................................          51,996               6           5,200

[[Page 16382]]

 
UI-3 (Internet).................................................          36,286               6           3,629
                                                                 -----------------------------------------------
    Total.......................................................          98,589  ..............          10,547
----------------------------------------------------------------------------------------------------------------

    2. Title and purpose of information collection: Railroad 
Unemployment Insurance Act Applications; OMB 3220-0039.
    Under Section 2 of the Railroad Unemployment Insurance Act (RUIA), 
sickness benefits are payable to qualified railroad employees who are 
unable to work because of illness or injury. In addition, sickness 
benefits are payable to qualified female employees if they are unable 
to work, or if working would be injurious, because of pregnancy, 
miscarriage, or childbirth. Under Section 1(k) of the RUIA, a statement 
of sickness for the days the employee was sick and not able to work, is 
to be filed with the RRB within a 10-day period from the first day 
claimed as a day of sickness. The RRB's authority for requesting 
supplemental medical information is Sections 12(i) and 12(n) of the 
RUIA. The procedures for claiming sickness benefits and for the RRB to 
obtain supplemental medical information needed to determine a 
claimant's eligibility for such benefits are prescribed in 20 CFR Part 
335.
    The forms currently used by the RRB to obtain information needed to 
determine eligibility for and the amount of sickness benefits due a 
claimant are as follows: Form SI-1A, Application for Sickness Benefits; 
Form SI-1b, Statement of Sickness; Form SI-3, Claim for Sickness 
Benefits; Form SI-7, Supplemental Doctor's Statement; Form SI-8, 
Verification of Medical Information; Form ID-7H, Non-Entitlement to 
Sickness Benefits and Information on Unemployment Benefits; Form ID-
11A, Notice of Late Filing; and Form ID-11B, Notice of Insufficient 
Medical and Late Filing. Completion is required to obtain or retain 
benefits. One response is requested of each respondent.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (78 57421 on September 18, 2013) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Railroad Unemployment Insurance Act Applications.
    OMB Control Number: 3220-0039.
    Form(s) submitted: SI-1a, SI-1b, SI-3, SI-3 (Internet), SI-7, SI-8, 
ID-7H, ID-11A and ID-11B.
    Type of request: Revision of a currently approved collection.
    Affected public: Individuals or Households.
    Abstract: Under Section 2 of the Railroad Unemployment Insurance 
Act, sickness benefits are payable to qualified railroad employees who 
are unable to work because of illness or injury. The collection obtains 
information from railroad employees and physicians needed to determine 
eligibility to and the amount of such benefits.
    Changes proposed: The RRB proposes to delete Forms ID-7H and ID-11B 
from the information collection due to less than ten responses per 
year.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                        Annual
                     Form No.                          responses    Time (minutes)  Burden (hours)
--------------------------------------------------------------------------------------------------
SI-1a (Employee)..................................          16,000              10           2,667
SI-1b (Doctor)....................................          16,000               8           2,133
SI-3 (Manual).....................................         126,490               5          10,541
SI-3 (Internet)...................................          33,443               5           2,787
SI-7..............................................          21,472               8           2,863
SI-8..............................................              26               5               2
ID-11A............................................             518               4              35
                                                   -------------------------------------------------------------
    Total.........................................         213,949  ..............          21,028
----------------------------------------------------------------------------------------------------------------

    3. Title and purpose of information collection: Public Service 
Pension Questionnaires; OMB 3220-0136.
    Public Law 95-216 amended the Social Security Act of 1977 by 
providing, in part, that spouse or survivor benefits may be reduced 
when the beneficiary is in receipt of a pension based on employment 
with a Federal, State, or local governmental unit. Initially, the 
reduction was equal to the full amount of the government pension.
    Public Law 98-21 changed the reduction to two-thirds of the amount 
of the government pension. Public Law 108-203 amended the Social 
Security Act by changing the requirement for exemption to public 
service offset, that Federal Insurance Contributions Act (FICA) taxes 
be deducted from the public service wages for the last 60 months of 
public service employment, rather than just the last day of public 
service employment.
    Sections 4(a)(1) and 4(f)(1) of the Railroad Retirement Act (RRA) 
provides that a spouse or survivor annuity should be equal in amount to 
what the annuitant would receive if entitled to a like benefit from the 
Social Security Administration. Therefore, the public service pension 
(PSP) provisions apply to RRA annuities. RRB regulations pertaining to 
the collection of evidence relating to public service pensions or 
worker's compensation paid to spouse or survivor applicants or 
annuitants are found in 20 CFR 219.64c.
    The RRB utilizes Form G-208, Public Service Pension Questionnaire, 
and Form G-212, Public Service Monitoring Questionnaire, to obtain 
information used to determine whether an annuity reduction is in order. 
Completion of the forms is voluntary. However, failure to complete the 
forms could result in the nonpayment of benefits. One response is 
requested of each respondent.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (79 FR 676 on January 6, 2014) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Public Service Pension Questionnaires.

[[Page 16383]]

    OMB Control Number: 3220-0136.
    Forms submitted: G-208 and G-212.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households.
    Abstract: A spouse or survivor annuity under the Railroad 
Retirement Act may be subjected to a reduction for a public service 
pension. The questionnaires obtain information needed to determine if 
the reduction applies and the amount of such reduction.
    Changes proposed: The RRB proposes no changes to the forms in the 
collection.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-208...........................................................              70              16            19.0
G-212...........................................................           1,100              15           275.0
                                                                 -----------------------------------------------
    Total.......................................................           1,170  ..............           294.0
----------------------------------------------------------------------------------------------------------------

    4. Title and purpose of information collection: Representative 
Payee Monitoring; OMB 3220-0151.
    Under Section 12 of the Railroad Retirement Act (RRA), the RRB may 
pay annuity benefits to a representative payee when an employee, 
spouse, or survivor annuitant is incompetent or a minor. The RRB is 
responsible for determining if direct payment to an annuitant or a 
representative payee would best serve the annuitant's best interest. 
The accountability requirements authorizing the RRB to conduct periodic 
monitoring of representative payees, including a written accounting of 
benefit payments received, are prescribed in 20 CFR 266.7. The RRB 
utilizes the following forms to conduct its representative payee 
monitoring program.
    Form G-99a, Representative Payee Report, is used to obtain 
information needed to determine whether the benefit payments certified 
to the representative payee have been used for the annuitant's current 
maintenance and personal needs and whether the representative payee 
continues to be concerned with the annuitant's welfare. RRB Form G-99c, 
Representative Payee Evaluation Report, is used to obtain more detailed 
information from a representative payee who fails to complete and 
return Form G-99a or in situations when the returned Form G-99a 
indicates the possible misuse of funds by the representative payee. 
Form G-99c contains specific questions concerning the representative 
payee's performance and is used by the RRB to determine whether or not 
the representative payee should continue in that capacity. Completion 
of the forms in this collection is required to retain benefits.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (79 FR 416 on January 3, 2014) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Representative Payee Monitoring.
    OMB Control Number: 3220-0151.
    Forms submitted: G-99a and G-99c.
    Type of request: Revision of a currently approved collection.
    Affected public: Individuals or Households.
    Abstract: Under Section 12(a) of the Railroad Retirement Act, the 
RRB is authorized to select, make payments to, and conduct transactions 
with an annuitant's relative or some other person willing to act on 
behalf of the annuitant as representative payee. The collection obtains 
information needed to determine if a representative payee is handling 
benefit payments in the best interest of the annuitant.
    Changes proposed: Consistent with 20 CFR 266.4(g), which states 
that ``the RRB may consider whether a representative payee has ever 
been convicted of a felony or a misdemeanor under the statutes of the 
Board or the Social Security Act, or convicted of a felony under any 
other Federal or state law'' the RRB proposes the deletion of the 
limiting phrase ``within the past 15 years'' from Forms G-99a and G-
99c. Other minor editorial changes are also proposed to both forms.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-99a (legal and all other, excepting parent for child).........           5,400              18           1,620
G-99c (Parts I and II)..........................................             300              24             120
G-99c (Parts I, II, and III)....................................             120              31              62
                                                                 -----------------------------------------------
    Total.......................................................           5,820  ..............           1,802
----------------------------------------------------------------------------------------------------------------

    5. Title and purpose of information collection: Report of Medicaid 
State Office on Beneficiary's Buy-In Status; OMB 3220-0185.
    Under Section 7(d) of the Railroad Retirement Act, the RRB 
administers the Medicare program for persons covered by the railroad 
retirement system. Under Section 1843 of the Social Security Act, 
states may enter into ``buy-in agreements'' with the Secretary of 
Health and Human Services for the purpose of enrolling certain groups 
of low-income individuals under the Medicare medical insurance (Part B) 
program and paying the premiums for their insurance coverage. 
Generally, these individuals are categorically needy under Medicaid and 
meet the eligibility requirements for Medicare Part B. States can also 
include in their buy-in agreements, individuals who are eligible for 
medical assistance only. The RRB uses Form RL-380-F, Report to State 
Medicaid Office, to obtain information needed to determine if certain 
railroad beneficiaries are entitled to receive Supplementary Medical 
Insurance program coverage under a state buy-in agreement in states in 
which they reside. Completion of Form RL-380-F is voluntary. One 
response is received from each respondent.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (79 FR 676 on January 6,

[[Page 16384]]

2014) required by 44 U.S.C. 3506(c)(2). That request elicited no 
comments.

Information Collection Request (ICR)

    Title: Report of Medicaid State Office on Beneficiary's Buy-In 
Status.
    OMB Control Number: 3220-0185.
    Forms submitted: RL-380-F.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: State, Local, and Tribal Governments.
    Abstract: Under the Railroad Retirement Act, the Railroad 
Retirement Board administers the Medicare program for persons covered 
by the railroad retirement system. The collection obtains the 
information needed to determine if certain railroad beneficiaries are 
entitled to receive Supplemental Medical Insurance program coverage 
under a state buy-in agreement in states in which they reside.
    Changes proposed: The RRB proposes no changes to Form RL-380-F.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                    Annual
                           Form No.                               responses      Time (minutes)   Burden (hours)
----------------------------------------------------------------------------------------------------------------
RL-380-F.....................................................             600               10              100
----------------------------------------------------------------------------------------------------------------

    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Dana Hickman at (312) 751-
4981 or [email protected].
    Comments regarding the information collection should be addressed 
to Charles Mierzwa, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois 60611-2092 or [email protected] and to the OMB 
Desk Officer for the RRB, Fax: 202-395-6974, Email address: [email protected].

Charles Mierzwa,
Chief of Information Resources Management.
[FR Doc. 2014-06500 Filed 3-24-14; 8:45 am]
BILLING CODE 7905-01-P