[Federal Register Volume 80, Number 83 (Thursday, April 30, 2015)]
[Notices]
[Pages 24307-24310]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-10057]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2015-0027]


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 and an extension of OMB-approved information 
collections, and one new information collection.
    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, OLCA, Attn: Reports Clearance 
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 410-966-2830, Email address: [email protected].

    Or you may submit your comments online through www.regulations.gov, 
referencing Docket ID Number [SSA-2015-0015].
    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 June 
29, 2015. Individuals can obtain copies of the collection instruments 
by writing to the above email address.
    1. Application for a Social Security Number Card, the Social 
Security Number Application Process (SSNAP), and Internet SSN 
Replacement Card (iSSNRC) Application--20 CFR 422.103-422.110--0960-
0066. SSA collects information on the SS-5 (used in the United States) 
and SS-5-FS (used outside the United States) to issue original or 
replacement Social Security cards. SSA also enters the application data 
into the Social Security Number Application Process (SSNAP) when

[[Page 24308]]

applicants request a new or replacement card via telephone or in 
person. In addition, hospitals collect the same information on SSA's 
behalf for newborn children through the Enumeration-at-Birth process. 
In this process, parents of newborns provide hospital birth 
registration clerks with information required to register these 
newborns. Hospitals send this information to State Bureaus of Vital 
Statistics (BVS), and they send the information to SSA's National 
Computer Center. SSA then uploads the data to the SSA mainframe along 
with all other enumeration data, and we assign the newborn a Social 
Security number (SSN) and issue a Social Security card. Respondents can 
also use these modalities to request a change in their SSN records. 
Additionally, the iSSNRC application will collect information similar 
to the paper SS-5 for no-change replacement SSN cards for adult U.S. 
citizens.
    A new iSSNRC modality included in the current clearance will allow 
certain applicants for an SSN replacement card to apply by completing 
an internet application and submitting the required evidence online 
rather than completing a paper Form SS-5, Application for a Social 
Security Card.
    The respondents for this collection are applicants for original and 
replacement Social Security cards, or individuals who wish to change 
information in their SSN records, who use any of the modalities 
described above.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
              Application scenario                  respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Respondents who do not have to provide parents'       10,500,000               1             8.5       1,487,500
 SSNs...........................................
* Adult U.S. Citizens requesting a replacement         1,500,000               1               5         125,000
 card with no changes through new iSSNRC
 modality.......................................
Respondents whom we ask to provide parents' SSNs         400,000               1               9          60,000
 (when applying for original SSN cards for
 children under age 18).........................
Applicants age 12 or older who need to answer          1,500,000               1             9.5         237,500
 additional questions so SSA can determine
 whether we previously assigned an SSN..........
Applicants asking for a replacement SSN card                 900               1              60             900
 beyond the new allowable limits (i.e., who must
 provide additional documentation to accompany
 the application)...............................
Authorization to SSA to obtain personal                      500               1              15             125
 information cover letter.......................
Authorization to SSA to obtain personal                      500               1              15             125
 information follow-up cover letter.............
                                                 ---------------------------------------------------------------
    Totals......................................      13,901,900  ..............  ..............       1,911,150
----------------------------------------------------------------------------------------------------------------
* The total timeline for complete national coverage of the iSSNRC application is two years from the date of
  initial implementation and is dependent on the contractor enrolling each State into the network. By FY 2018,
  we would expect to issue about 1.5 million replacement cards annually via the iSSNRC application. However, the
  estimated volume could vary based on the date of implementation, when the contractor acquires States, and our
  marketing efforts to the public.

    Cost Burden: The state BVSs incur costs of approximately $11 
million for transmitting data to SSA's mainframe. However, SSA 
reimburses the states for these costs.
    2. Third Party Liability Information Statement--42 CFR 433.136-
433.139--0960-0323. To reduce Medicaid costs, Medicaid state agencies 
must identify third party insurers liable for medical care or services 
for Medicaid beneficiaries. Regulations at 42 CFR 433.136-433.139 
require Medicaid state agencies to obtain this information on Medicaid 
applications and redeterminations as a condition of Medicaid 
eligibility. States may enter into agreements with the Commissioner of 
Social Security to make Medicaid eligibility determinations for aged, 
blind, and disabled beneficiaries in those states. Applications for and 
redeterminations of Supplemental Security Income (SSI) eligibility in 
jurisdictions with such agreements are applications and 
redeterminations of Medicaid eligibility. Under these agreements, SSA 
obtains third party liability information using Form SSA-8019, and 
provides that information to the Medicaid state agencies. The Medicaid 
state agencies use the information to bill third parties liable for 
medical care, support, or services for a beneficiary to guarantee that 
Medicaid remains the payer of last resort. The respondents are SSI 
claimants and recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8012 Paper form.............................             200               1               5              17
Modernized SSI Claims System (MSSICS)...........          51,381               1               5           4,282
                                                 ---------------------------------------------------------------
    Totals......................................          51,581  ..............  ..............           4,299
----------------------------------------------------------------------------------------------------------------

    3. Request for Deceased Individual's Social Security Record--20 CFR 
402.130--0960-0665. When a member of the public requests an 
individual's Social Security record, SSA needs the name and address of 
the requestor as well as a description of the requested record to 
process the request. SSA uses the information the respondent provides 
on Form SSA-711, or via an Internet request through SSA's electronic 
Freedom of Information Act (eFOIA) Web site, to (1) verify the wage 
earner is deceased and (2) access the correct Social Security record. 
Respondents are members of the public requesting deceased individuals' 
Social Security records.

[[Page 24309]]

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

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Internet Request through eFOIA..................          49,800               1               7           5,810
SSA-711 (paper).................................             200               1               7              23
                                                 ---------------------------------------------------------------
    Total.......................................          50,000  ..............  ..............           5,833
----------------------------------------------------------------------------------------------------------------

    Cost Burden *: In addition, SSA charges fees to the respondent for 
this information. The following chart shows the fees per transaction 
based on the information the respondent provides on the SSA-711 (or in 
eFOIA):

------------------------------------------------------------------------
                                    Information provided     Cost per
      Modality of completion          (or not provided)     transaction
------------------------------------------------------------------------
SSA-711 (paper)...................  SSN of decedent is               $29
                                     not provided.
SSA-711 (paper)...................  SSN of decedent is               $27
                                     provided.
eFOIA (Internet)..................  SSN of decedent is               $18
                                     not provided.
------------------------------------------------------------------------

    * As these costs are dependent on the respondent's provided 
information, we charge them on an as needed basis, and cannot provide a 
total annual estimate of the cost burden. We do not know whether the 
respondent provided the decedent's SSN until we manually review and 
process each SSA-711.
    4. Function Report Adult--20 CFR 404.1512 & 416.912--0960-0681. 
Individuals receiving or applying for Social Security disability 
insurance (SSDI) or SSI must provide medical evidence and other proof 
SSA requires to prove their disability. SSA, and State disability 
determinations services on our behalf, collect the information using 
Form SSA-3373. We use the information to document how claimants' 
disabilities affect their ability to function, and to determine 
eligibility for SSI and SSDI claims. The respondents are Title II and 
Title XVI applicants (or current recipients undergoing 
redeterminations) for disability payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3373........................................       2,085,721               1              61       2,120,483
----------------------------------------------------------------------------------------------------------------

    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 30 days from the date of this 
publication. To be sure we consider your comments, we must receive them 
no later than June 1, 2015. Individuals can obtain copies of the OMB 
clearance packages by writing to [email protected].
    1. Data Exchange Request Form--20 CFR 401.100--0960-NEW. SSA 
maintains approximately 3,000 data exchange agreements and regularly 
receives new requests from Federal, State, local, and foreign 
governments, as well as private organizations, to share data 
electronically. SSA engages in various forms of data exchanges from 
Social Security number verifications to computer matches for benefit 
eligibility, depending on the requestor's business needs. Section 1106 
of the Social Security Act requires we consider the requestor's legal 
authority to receive the data, our disclosure policies, systems' 
feasibility, systems' security, and costs before entering into a data 
exchange agreement. We will use Form SSA-157, Data Exchange Request 
Form, for this purpose. Requesting agencies, governments, or private 
organizations will use the form when voluntarily initiating a request 
for data exchange from SSA. Respondents are Federal, State, local, and 
foreign governments, as well as private organizations seeking to share 
data electronically with SSA.
    This is a correction notice: SSA published the incorrect burden 
information for this collection at 80 FR 9499, on February 23, 2015. We 
are correcting this error here.
    Type of Request: This is a new information collection request.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-157.........................................             121               1              30              61
----------------------------------------------------------------------------------------------------------------

    2. Statement of Self-Employment Income--20 CFR 404.101, 404.110, 
404.1096(a)-(d)--0960-0046. To qualify for insured status and thus 
collect Social Security benefits, self-employed individuals must 
demonstrate they have

[[Page 24310]]

earned the minimum amount of self-employment income (SEI) in a current 
year. SSA uses Form SSA-766, Statement of Self-Employment Income, to 
collect the information we need to determine if the individual will 
have at least the minimum amount of SEI needed for one or more quarters 
of coverage in the current year. Based on the information we obtain, we 
may credit additional quarters of coverage to give the individual 
insured status thus expediting benefit payments.
    Respondents are self-employed individuals who may be eligible for 
Social Security benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-766.........................................           2,500               1               5             208
----------------------------------------------------------------------------------------------------------------

    3. Request for Workers' Compensation/Public Disability Benefit 
Information--20 CFR 404.408(e)--0960-0098. Claimants for Social 
Security disability payments who are also receiving Worker's 
Compensation/Public Disability Benefits (WC/PDB) must notify SSA about 
their WC/PDB, so the agency can reduce claimants' Social Security 
disability payments accordingly. If claimants provide necessary 
evidence, such as a copy of their award notice, benefit check, etc., 
that is sufficient verification. In cases where claimants cannot 
provide such evidence, SSA uses Form SSA-1709. The entity paying the 
WC/PDB benefits, its agent (such as an insurance carrier), or an 
administering public agency complete this form. The respondents are 
Federal, State, and local agencies, insurance carriers, and public or 
private self-insured companies administering WC/PDB benefits to 
disability claimants.
    This is a correction notice. SSA published this information 
collection as a revision on February 23, 2015 at 80 FR 9500. Since we 
are not revising the Privacy Act Statement, this is now an extension of 
an OMB-approved information collection.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1709........................................         120,000               1              15          30,000
----------------------------------------------------------------------------------------------------------------


    Dated: April 27, 2015.
Faye I. Lipsky,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-10057 Filed 4-29-15; 8:45 am]
 BILLING CODE 4191-02-P