[Federal Register Volume 80, Number 120 (Tuesday, June 23, 2015)]
[Notices]
[Pages 36031-36035]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-15380]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2015-0035]


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 extensions 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, 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-2015-0035].
    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 
August 24, 2015. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Physician's/Medical Officer's Statement of Patient's Capability 
to Manage Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA 
appoints a representative payee in cases where we determine 
beneficiaries are not capable of managing their own benefits. In those 
instances, we require medical evidence to determine the beneficiaries' 
capability of managing or directing their benefit payments. SSA 
collects medical evidence on Form SSA-787 to (1) determine 
beneficiaries' capability or inability to handle their own benefits, 
and (2) assist in determining the beneficiaries' need for a 
representative payee. The respondents are beneficiaries' physicians, or 
medical officers of the institution in which the beneficiary resides.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-787.........................................         120,000               1              10          20,000
----------------------------------------------------------------------------------------------------------------


[[Page 36032]]

    2. State Supplementation Provisions: Agreement; Payments--20 CFR 
416.2095-416.2098, 20 CFR 416.2099--0960-0240. Section 1618 of the 
Social Security Act (Act) requires those states administering their own 
supplementary income payment program(s) to demonstrate compliance with 
the Act by passing Federal cost-of-living increases on to individuals 
who are eligible for state supplementary payments, and informing SSA of 
their compliance. In general, states report their supplementary payment 
information annually by the maintenance-of-payment levels method. 
However, SSA may ask them to report up to four times in a year by the 
total-expenditures method. Regardless of the method, the states confirm 
their compliance with the requirements, and provide any changes to 
their optional supplementary payment rates. SSA uses the information to 
determine each state's compliance or noncompliance with the pass-along 
requirements of the Act to determine eligibility for Medicaid 
reimbursement. If a state fails to keep payments at the required level, 
it becomes ineligible for Medicaid reimbursement under Title XIX of the 
Act. Respondents are state agencies administering supplemental 
programs.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Total Expenditures..............................               7               4              60              28
Maintenance of Payment Levels...................              26               1              60              26
                                                 ---------------------------------------------------------------
    Total.......................................              33  ..............  ..............              54
----------------------------------------------------------------------------------------------------------------

    3. Surveys in Accordance with E.O. 12862 for the Social Security. 
Administration--0960-0526. Under the auspices of E. O. 12862, Setting 
Customer Service Standards, SSA conducts multiple customer satisfaction 
surveys each year. These voluntary customer satisfaction assessments 
include paper, Internet, and telephone surveys; mailed questionnaires; 
and customer comment cards. The purpose of these questionnaires is to 
assess customer satisfaction with the timeliness, appropriateness, 
access, and overall quality of existing SSA services and proposed 
modifications or new versions of services. The respondents are 
recipients of SSA services (including most members of the public), 
professionals, and individuals who work on behalf of SSA beneficiaries.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                      Burden
                                                     Number of                                      (burden for
                                                    respondents                                         all
                                                    (burden for    Frequency of      Range of       activities
                                                        all          response     response times   within  that
                                                    activities                       (minutes)         year;
                                                   within  that                                     reported in
                                                       year)                                          hours)
----------------------------------------------------------------------------------------------------------------
Year 1..........................................       7,094,640               1            3-30       1,173,904
Year 2..........................................       7,100,140               1            3-30       1,174,904
Year 3..........................................       7,105,640               1            3-30       1,176,004
                                                 ---------------------------------------------------------------
    Totals......................................      21,300,420               -               -       5,722,003
----------------------------------------------------------------------------------------------------------------

    1. Application for Circuit Court Law--20 CFR 404.985 & 416.1458--
0960-0581. Persons claiming an acquiescence ruling (AR) would change 
SSA's prior determination or decision must submit a written 
readjudication request with specific information. SSA reviews the 
information in the request to determine if the issues stated in the AR 
pertain to the claimant's case, and if the claimant is entitled to 
readjudication. If readjudication is appropriate, SSA considers the 
issues the AR covers. Any new determination or decision is subject to 
administrative or judicial review as specified in the regulations. This 
information collection request (ICR) is for the information claimants 
must provide to request readjudication. Respondents are claimants for 
Social Security benefits and Supplemental Security Income (SSI) 
payments who request readjudication.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
AR-based Readjudication.........................          10,000               1              17           2,833
Requests........................................
----------------------------------------------------------------------------------------------------------------

    2. The Ticket to Work and Self-Sufficiency Program--20 CFR 411--
0960-0644. SSA's Ticket to Work (TTW) Program transitions Social 
Security Disability Insurance and SSI recipients toward independence by 
allowing them to receive Social Security payments while maintaining 
employment under the auspices of the program. SSA uses service 
providers, called employment networks (ENs), to supervise participant 
progress through the stages of TTW Program participation, such as job 
searches and interviews, progress reviews, and changes in ticket 
status.

[[Page 36033]]

ENs can be private for-profit and nonprofit organizations, as well as 
state vocational rehabilitation agencies (VRs). SSA and the ENs utilize 
the TTW program manager to operate the TTW Program and exchange 
information about participants. For example, the ENs use the program 
manager to provide updates on tasks such as selecting a payment system 
or requesting payments for helping the beneficiary achieve certain work 
goals. Since the ENs are not PRA-exempt, the multiple information 
collections within the TTW program manager require OMB approval, and we 
clear them under this ICR. Most of the categories of information in 
this ICR are necessary for SSA to: (1) comply with the Ticket to Work 
legislation; and (2) provide proper oversight of the program. SSA 
collects this information through several modalities, including forms, 
electronic exchanges, and written documentation. The respondents are 
the ENs or state VRs, as well as SSDI beneficiaries and blind or 
disabled SSI recipients working under the auspices of the TTW Program.
    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)
----------------------------------------------------------------------------------------------------------------
a) 20 CFR 411.140(d)(2)--Interactive Voice                 6,428               1             2.5             268
 Recognition Telephone..........................
a) 20 CFR 411.140(d)(2)--Portal.................          25,713               1            1.25             536
a) 20 CFR 411.140(d)(3); 411.325(a);                         948               1              15             237
 411.150(b)(3)--SSA-1365........................
a) 20 CFR 411.140(d)(3); 411.325(a);                       3,792               1              11             695
 411.150(b)(3)--SSA-1365 Portal.................
a) 20 CFR 411.140(d)(3); 411.325(a);                       1,956               1              60           1,956
 411.150(b)(3)--SSA-1370........................
a) 20 CFR 411.140(d)(3); 411.325(a);                       5,868               1              10             978
 411.150(b)(3)--SSA-1370 Portal.................
a) 20 CFR 411.166; 411.170(b)--Electronic File            40,324               1               5           3,360
 Submission.....................................
b) 20 CFR 411.145; 411.325......................           2,494               1              15             624
b) 20 CFR 411.145; 411.325--Portal..............           7,481               1              11           1,372
b) 20 CFR 411.535(a)(1)(iii)--Data Sharing/                8,505               1               5             709
 Portal.........................................
c) 20 CFR 411.192(b)&(c)........................               6               1              30               3
c) 20 CFR 411.200(b)--SSA-1375..................         112,362               1              15          28,091
c) 20 CFR 411.200(b)--Portal....................          64,824               1               5           5,402
c) 20 CFR 411.210(b)............................              41               1              30              21
c)20 CFR 411.200(b) Wise Webinar Registration             24,000               1               3           1,200
 Page...........................................
c) 20 CFR 411.200(b) Virtual Job Fair                      9,500               1              10           1,583
 Registration...................................
d) 20 CFR 411.365; 411.505; 411.515.............               6               1              10               1
e) 20 CFR 411.325(d); 411.415...................               1               1             480               8
f) 20 CFR 411.575--SSA-1389; SSA-1391; SSA-1393;           2,805               1              40           1,870
 SSA-1396; SSA-1398; SSA-1399...................
f) 20 CFR 411.575--Portal.......................          42,075               1              22          15,428
f) 20 CFR 411.575--Automatic Payments...........          11,220               1               0               0
f) 20 CFR 411.560--SSA-1401.....................             100               1              20              33
g) 20 CFR 411.325(f)............................           1,371               1              45           1,028
h) 20 CFR 411.435; 411.615; 411.625.............               2               1             120               4
i) 20 CFR 411.320--SSA-1394.....................              52               1              10               9
i) 20 CFR 411.320--SSA-1394 Portal..............             158               1               5              13
                                                 ---------------------------------------------------------------
    Totals......................................         372,032  ..............  ..............          65,429
----------------------------------------------------------------------------------------------------------------

    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 July 23, 2015. Individuals can obtain copies of the OMB 
clearance packages by writing to [email protected].
    1. Statement of Claimant or Other Person--20 CFR 404.702 & 
416.570--0960-0045. SSA uses Form SSA-795 in special situations where 
there is no authorized form or questionnaire, yet we require a signed 
statement from the applicant, claimant, or other persons who have 
knowledge of facts, in connection with claims for Social Security 
benefits or SSI. The information we request on the SSA-795 is of 
sufficient importance that we need both a signed statement and a 
penalty clause. SSA uses this information to process, in addition to 
claims for benefits, issues about continuing eligibility; ongoing 
benefit amounts; use of funds by a representative payee; fraud 
investigation; and a myriad of other program-related matters. The most 
typical respondents are applicants for Social Security, SSI, or 
recipients of these programs. However, respondents also include friends 
and relatives of the involved parties, coworkers, neighbors, or anyone 
else in a position to provide information pertinent to the issue(s).
    Type of Request: Revision of an OMB-approved information 
collection.

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

    2. Disability Report--Adult--20 CFR 404.1512 and 416.912--0960-
0579. State Disability Determination Services (DDS) use the SSA-3368 
and its electronic versions to determine if adult disability 
applicants' impairments are

[[Page 36034]]

severe and, if so, how the impairments affect the applicants' ability 
to work. This determination dictates whether the DDSs and SSA will find 
the applicant to be disabled and entitled to SSI payments. The 
respondents are applicants for Title II disability benefits or Title 
XVI SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368........................................           7,571               1              90          11,357
(Paper form)....................................
Electronic Disability Collection System (EDCS)..       2,484,231               1              90       3,726,346
i3368 (Internet)................................       1,060,360               1              90       1,590,540
                                                 ---------------------------------------------------------------
    Totals......................................       3,552,162  ..............  ..............       5,328,243
----------------------------------------------------------------------------------------------------------------

    3. Request for Internet Services--Authentication; Automated 
Telephone Speech Technology--Knowledge-Based Authentication (RISA-
KBA)--20 CFR 401.45--0960-0596. The Request for Internet Services and 
800# Automated Telephone Services (RISA) Knowledge-Based Authentication 
(KBA) is one of the authentication methods SSA uses to allow 
individuals access to their personal information through our Internet 
and Automated Telephone Services. SSA asks individuals and third 
parties who seek personal information from SSA records, or who register 
to participate in SSA's online business services, to provide certain 
identifying information. As an extra measure of protection, SSA asks 
requestors who use the Internet and telephone services to provide 
additional identifying information unique to those individuals so SSA 
can authenticate their identities before releasing personal 
information. The respondents are current beneficiaries who are 
requesting personal information from SSA, and individuals and third 
parties who are registering for SSA's online business services.
    This is a correction notice. SSA published this information 
collection as a revision on April 9, 2015 at 80 FR 19102. 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 burden     Estimated
             Modality of completion                  Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Internet Requestors.............................      10,373,917               1             2.5         432,247
Telephone Requestors............................       1,703,367               1               4         113,558
* Change of Address (on hold)...................               1  ..............  ..............               1
                                                 ---------------------------------------------------------------
    Totals......................................      12,077,286  ..............  ..............         545,806
----------------------------------------------------------------------------------------------------------------
* Reducing the burden to a one-hour placeholder burden; Screen Splash and Change of Address applications are on
  hold.

    4. Application for Special Benefits for World War II Veterans--20 
CFR 408, Subparts B, C, and D--0960-0615. Title VIII of the Act 
(Special Benefits for Certain World War II Veterans) allows qualified 
World War II veterans residing outside the United States to receive 
monthly payments. These regulations establish the requirements 
individuals need to qualify for and become entitled to Special Veterans 
Benefits (SVB). SSA uses Form SSA-2000-F6 to elicit the information we 
need to determine entitlement to SVB. This ICR comprises the relevant 
regulations and Form SSA-2006-F6. The respondents are individuals 
applying for SVB under Title VIII of the Act.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                       Total
                                                     Number of     Frequency of   Average burden     estimated
 Regulations section and modality of completion     respondents      response      per  response   annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7...........................................              50               1              20              17
Sec.   408.420 (a), (b).........................              35               1              15               9
Sec.  Sec.   408.430 & .432.....................              33               1              30              17
Sec.   408.435 (a), (b), (c)....................              35               1              15               9
                                                 ---------------------------------------------------------------
    Totals......................................             153  ..............  ..............              52
----------------------------------------------------------------------------------------------------------------

    5. Representative Payment Policies Regulation--20 CFR 
404.2011(a)(1), 404.2025, 416.611(a)(1), 416.625--0960-0679. Per 20 CFR 
404.2011 and 20 CFR 416.611 of the Code of Federal Regulations, if SSA 
determines it may cause substantial harm for Title II or Title XVI 
recipients to receive their payments directly, recipients may dispute 
that decision. To do so, recipients provide SSA with information the 
agency uses to reevaluate its determination. In addition, our 
regulations state that after SSA selects a representative payee to

[[Page 36035]]

receive benefits on a recipient's behalf, the payees provide SSA with 
information on their continuing relationship and responsibility for the 
recipients, and explain how they use the recipients' payments. Sections 
20 CFR 404.2025 and 20 CFR 416.625 of the Code of Federal Regulations 
provide a process to follow up with the representative payee to verify 
payee performance. The respondents are Title II and Title XVI 
recipients, and their representative payees.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
                  CFR citation                       Number of     Frequency of    per  response   total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
404.2011(a)(1);.................................             250               1              15              63
416.611(a)(1)...................................
404.2025;.......................................           3,000               1               6             300
416.625.........................................
                                                 ---------------------------------------------------------------
    Totals......................................           3,250  ..............  ..............             363
----------------------------------------------------------------------------------------------------------------


Faye I. Lipsky,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2015-15380 Filed 6-22-15; 8:45 am]
 BILLING CODE 4191-02-P