[Federal Register Volume 81, Number 81 (Wednesday, April 27, 2016)]
[Notices]
[Pages 24927-24928]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-09828]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0018]


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 a new information collection and a revision of an OMB-approved 
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-2016-0018].
    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 
27, 2016. Individuals can obtain copies of the collection instruments 
by writing to the above email address.
    1. Report of Adult Functioning-Employer--20 CFR 404.1512 and 20 CFR 
416.912--0960--NEW. Section 205(a), 223(d)(5)(A), 1631(d)(1), and 
1631(e)(1) of the Social Security Act (Act) require claimants applying 
for Social Security Disability Insurance (SSDI) or Supplemental 
Security Income (SSI) benefits to provide SSA with medical and other 
evidence of their disability. 20 CFR 404.1512 and 20 CFR 416.912 of the 
Code of Federal Regulations provides detailed requirements of the types 
of evidence Social Security disability claimants and beneficiaries must 
provide showing how their impairment(s) affects their ability to work 
(e.g., evidence of age, education and training, work experience, daily 
activities, efforts to work, and any other evidence). Past employers 
familiar with the claimant's ability to perform work activities 
complete Form SSA-385-BK, Report of Adult Functioning-Employer to 
provide SSA with information about the employees day-to-day functioning 
in the work setting. SSA and Disability Determination Services use the 
information Form SSA-3385-BK collects as the basis to determine 
eligibility or continued eligibility for disability benefits. The 
respondents are claimants' past employers.
    Type of Request: This is a new information collection.

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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
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SSA-3385-BK.................................           3,900                1               20            1,300
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    2. Work Incentives Planning and Assistance Program--0960-0629. As 
part of SSA's strategy to assist SSDI beneficiaries and SSI recipients 
who wish to return to work and achieve self-sufficiency, SSA 
established the Work Incentives Planning and Assistance (WIPA) program. 
This community based, work incentive, planning and assistance project 
collects identifying claimant information via project sites and 
community work incentives coordinators (CWIC). SSA uses this 
information to ensure proper management of the project, with particular 
emphasis on administration, budgeting, and training. In addition, 
project sites and CWIC's collect data from SSDI beneficiaries and SSI 
recipients on background employment, training, benefits, and work 
incentives. SSA is interested in identifying SSDI beneficiary and SSI 
recipient outcomes under the WIPA program, to determine the extent to 
which beneficiaries with disabilities and SSI recipients achieve their 
employment, financial, and healthcare goals. SSA will also use the data 
in its analysis for future planning for SSDI and SSI programs. 
Respondents are SSDI beneficiaries, SSI recipients, community project 
sites, and employment advisors.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
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Small WIPA Site (under 150 beneficiaries served)           4,800               1              20           1,600
Medium WIPA Site (150-599 beneficiaries served).           7,500               1              20           2,500

[[Page 24928]]

 
Large WIPA Site (600 or more beneficiaries                17,700               1              20           5,900
 served)........................................
                                                 ---------------------------------------------------------------
    Total WIPA Sites............................          30,000  ..............  ..............          10,000
 
SSDI & SSI Beneficiaries........................          30,000               1              25          12,500
Help Line.......................................          30,000               1               5           2,500
                                                 ---------------------------------------------------------------
    Total.......................................          60,000  ..............  ..............          15,000
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        Grand Total.............................          90,000  ..............  ..............          25,000
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    Dated: April 22, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-09828 Filed 4-26-16; 8:45 am]
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