[Federal Register Volume 81, Number 118 (Monday, June 20, 2016)]
[Notices]
[Pages 39990-39992]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-14443]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0027]


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 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-2016-0027].

    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 19, 2016. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Request for Earnings and Benefit Estimate Statement--20 CFR 
404.810--0960-0466. Section 205(c)(2)(A) of the Social Security Act 
(Act) requires the Commissioner of SSA establish and maintain records 
of wages paid to, and amounts of self-employment income derived by, 
each individual as well as the periods in which such wages were paid 
and such income derived. An individual may complete and mail Form SSA-
7004 to SSA's Data Operations Center in Wilkes-Barre, PA, to obtain a 
Statement of Earnings or Quarters of Coverage. SSA uses the information 
Form SSA-7004 collects to identify respondent's Social Security 
earnings records; extract posted earnings information; calculate 
potential benefit estimates; produce the resulting Social Security 
statements; and mail them to the requesters. The respondents are Social 
Security number holders requesting information about their Social 
Security earnings records and estimates of their potential benefits.
    Type of Request: Revision of an OMB-approved 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)
----------------------------------------------------------------------------------------------------------------
SSA-7004....................................          40,090                1                5            3,341
----------------------------------------------------------------------------------------------------------------

    2. National Beneficiary Survey--0960-0800. SSA is continuing the 
National Beneficiary Survey (NBS), a survey which gathers data from 
Supplemental Security Income (SSI) recipients and Social Security 
Disability Insurance (SSDI) beneficiaries about their characteristics, 
their well-being, and other factors that promote or hinder employment. 
In particular, the survey seeks to uncover important information about 
the factors promoting beneficiary self-sufficiency and, conversely, 
factors impeding beneficiary efforts to maintain employment. We use 
this data to improve the administration and effectiveness of the SSDI 
and SSI programs. These results are valuable as SSA and other 
policymakers continue efforts to improve programs and services that 
help SSDI beneficiaries and SSI recipients become more self-sufficient.

Background

    SSDI and SSI programs provide a crucial and necessary safety net 
for working-age people with disabilities. By improving employment 
outcomes for SSDI beneficiaries and SSI recipients, SSA supports the 
effort to reduce the reliance of people with disabilities on these 
programs. SSA conducted the prior NBS in 2004, 2005, 2006, and 2010, 
which was an important first step in understanding the work interest 
and experiences of SSI recipients and SSDI beneficiaries, and in 
gaining information about their impairments, health, living 
arrangements, family structure, pre-disability occupation, and use of 
non-SSA programs (e.g., the Supplemental Nutrition Assistance Program). 
The prior NBS data is available to researchers and the public.

The National Beneficiary Survey (NBS)

    The primary purpose of the new NBS-General Waves is to assess 
beneficiary well-being and interest in work, learn about beneficiary 
work experiences (successful and unsuccessful), and identify factors 
that promote or restrict long-term work success. Information collected 
in the survey includes factors such as health; living arrangements; 
family structure; current occupation; use of non-SSA programs; 
knowledge of SSDI and SSI work incentive programs; obstacles to work; 
and beneficiary interest and motivation to return to work.
    We propose to conduct the first wave of the NBS-General Waves in 
2015. We will further conduct subsequent rounds in 2017 (round 2) and 
2019 (round 3). The information we will collect is not available from 
SSA administrative data or other sources. In the NBS-General Waves, the 
sample design is similar to what we used for the prior NBS. Enhancement 
of the prior questionnaire includes additional questions on the factors 
that promote or hinder employment success. In 2015 we conducted semi-
structured qualitative interviews to provide SSA an in-depth 
understanding of factors that aid or inhibit individuals in their 
efforts to obtain and retain employment and advance in the workplace. 
We use the qualitative data to add context and

[[Page 39991]]

understanding when interpreting survey results, and to inform the 
sample and survey design of rounds 2 and 3.
    Respondent participation in the NBS is voluntary and the decision 
to participate or not has no impact on current or future receipt of 
payments or benefits. Respondents are current SSDI beneficiaries and 
SSI recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total  annual
               Administration year                  respondents      response        response         burden
                                                                                      (hours)         (hours)
----------------------------------------------------------------------------------------------------------------
                                                      2017
----------------------------------------------------------------------------------------------------------------
Cross-Sectional Samples:
    Representative Beneficiary Sample...........           4,000               1              50           3,333
    Successful Workers..........................           4,500               1              70           5,250
                                                 ---------------------------------------------------------------
        Subtotal................................  ..............  ..............  ..............           8,583
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                                                      2019
----------------------------------------------------------------------------------------------------------------
Cross-Sectional Samples:
    Representative Beneficiary Sample...........           4,000               1              50           3,333
    Successful Workers..........................           3,000               1              70           3,500
Longitudinal Samples:
    Successful Workers..........................           2,250               1              70           2,625
                                                 ---------------------------------------------------------------
        Subtotal................................  ..............  ..............  ..............           9,458
                                                 ---------------------------------------------------------------
            Total Burden........................          17,750  ..............  ..............          18,041
----------------------------------------------------------------------------------------------------------------

    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 20, 2016. Individuals can obtain copies of the OMB 
clearance package by writing to [email protected].
    1. Application for Lump Sum Death Payment--20 CFR 404.390-404.392--
0960-0013. SSA uses Form SSA-8-F4 to collect information needed to 
authorize payment of the lump sum death payment (LSDP) to a widow, 
widower, or children as defined in section 202(i) of the Act. 
Respondents complete the application for this one-time payment via 
paper form, telephone, or an in-person interview with SSA employees. 
Respondents are applicants for the LSDP.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total annual
             Modality of completion                 respondents      response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
MCS.............................................         662,084               1               9          99,313
Paper...........................................           8,164               1              10           1,361
                                                 ---------------------------------------------------------------
    Total.......................................         670,248  ..............  ..............         100,674
----------------------------------------------------------------------------------------------------------------

    2. Representative Payee Evaluation Report--20 CFR 404.2065 & 
416.665--0960-0069. Sections 205(j) and 1631(a)(2) of the Social 
Security Act (Act) state SSA may appoint a representative payee to 
receive Title II benefits or Title XVI payments on behalf of 
individuals unable to manage or direct the management of those funds 
themselves. SSA requires appointed representative payees to report once 
each year on how they used or conserved those funds. When a 
representative payee fails to adequately report to SSA as required, SSA 
conducts a face-to-face interview with the payee and completes Form 
SSA-624, Representative Payee Evaluation Report, to determine the 
continued suitability of the representative payee to serve as a payee. 
The respondents are individuals or organizations serving as 
representative payees for individuals receiving Title II benefits or 
Title XVI payments, and who fail to comply with SSA's statutory annual 
reporting requirement.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-624.....................................         267,000                1               30          133,500
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[[Page 39992]]

    3. Medical Report on Adult with Allegation of Human 
Immunodeficiency Virus Infection; Medical Report on Child with 
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.933-20 
CFR 416.934--0960-0500. Section 1631(e)(i) of the Act authorizes the 
Commissioner of SSA to gather information to make a determination about 
an applicant's claim for SSI payments; this procedure is the 
Presumptive Disability (PD). SSA uses Forms SSA-4814-F5 and SSA-4815-F6 
to collect information necessary to determine if an individual with 
human immunodeficiency virus infection, who is applying for SSI 
disability benefits, meets the requirements for PD. The respondents are 
the medical sources of the applicants for SSI disability payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                                     Number of     Frequency of   Average burden   total annual
             Modality of completion                 respondents      response      per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4814-F5.....................................          18,750               1               8           2,500
SSA-4815-F6.....................................             120               1              10              20
                                                 ---------------------------------------------------------------
    Totals......................................          18,870  ..............  ..............           2,520
----------------------------------------------------------------------------------------------------------------

    4. Complaint Form for Allegations of Discrimination in Programs or 
Activities Conducted by the Social Security Administration--0960-0585. 
SSA uses Form SSA-437 to investigate and formally resolve complaints of 
discrimination based on disability, race, color, national origin 
(including limited English language proficiency), sex (including sexual 
orientation and gender identity), age, religion, or retaliation for 
having participated in a proceeding under this administrative complaint 
process in connection with an SSA program or activity. Individuals who 
believe SSA discriminated against them on any of the above bases may 
file a written complaint of discrimination. SSA uses the information 
to: (1) Identify the complaint; (2) identify the alleged discriminatory 
act; (3) establish the date of such alleged action; (4) establish the 
identity of any individual(s) with information about the alleged 
discrimination; and (5) establish other relevant information that would 
assist in the investigation and resolution of the complaint. 
Respondents are individuals who believe an SSA program or activity, or 
SSA employees, contractors or agents discriminated against them.
    Type of Request: Revision on an OMB-approved 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)
----------------------------------------------------------------------------------------------------------------
SSA-437.....................................             255                1               60              255
----------------------------------------------------------------------------------------------------------------

    5. Statement for Determining Continuing Entitlement for Special 
Veterans Benefits (SVB)--0960-0782. SSA regularly reviews individuals' 
claims for Special Veterans Benefits (SVB) to determine their continued 
eligibility and correct payment amounts. Individuals living outside the 
United States receiving SVB must report to SSA any changes that may 
affect their benefits, such as: (1) A change in mailing address or 
residence; (2) an increase or decrease in a pension, annuity, or other 
recurring benefit; (3) a return or visit to the United States for a 
calendar month or longer; or (4) an inability to manage benefits. SSA 
uses Form SSA-2010, to collect this information. Respondents are 
beneficiaries living outside the United States collecting SVB.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response     annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-2010....................................           1,799                1               20              600
----------------------------------------------------------------------------------------------------------------


    Dated: June 14, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-14443 Filed 6-17-16; 8:45 am]
 BILLING CODE 4191-02-P