[Federal Register Volume 81, Number 141 (Friday, July 22, 2016)]
[Notices]
[Pages 47845-47848]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-17259]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2016-0033]


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 one extension of OMB-approved information 
collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information;

[[Page 47846]]

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-2016-0033].
    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 
September 20, 2016. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Request for Hearing by Administrative Law Judge--20 CFR 404.929, 
404.933, 416.1429, 404.1433, 418.1350, and 42 CFR 405.722--0960-0269. 
When SSA denies applicants' or beneficiaries' requests for new or 
continuing benefits, the Social Security Act entitles those applicants 
or beneficiaries to request a hearing to appeal the decision. To 
request a hearing, individuals complete Form HA-501, the associated 
Modernized Claims System (MCS) or Modernized Supplemental Security 
Income Claims System (MSSICS) interview, or the Internet application 
(i501). SSA uses the information to determine if the individual: (1) 
Filed the request within the prescribed time; (2) is the proper party; 
and (3) took the steps necessary to obtain the right to a hearing. SSA 
also uses the information to determine: (1) The individual's reason(s) 
for disagreeing with SSA's prior determinations in the case; (2) if the 
individual has additional evidence to submit; (3) if the individual 
wants an oral hearing or a decision on the record; and (4) whether the 
individual has (or wants to appoint) a representative. The respondents 
are Social Security benefit applicants and recipients who want to 
appeal SSA's denial of their request for new or continued benefits, and 
Medicare Part B recipients who must pay the Medicare Part B Income-
Related Monthly Adjustment Amount.
    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)
----------------------------------------------------------------------------------------------------------------
HA-501; Modernized Claims System (MCS);                   25,953               1              10           4,326
 Modernized Supplemental Security Income Claims
 System (MSSICS)................................
I501 (Internet iAppeals)........................         643,516               1               5          53,626
                                                 ---------------------------------------------------------------
    Totals......................................         669,469  ..............  ..............          57,952
----------------------------------------------------------------------------------------------------------------

    2. Travel Expense Reimbursement--20 CFR 404.999(d) and 416.1499--
0960-0434. The Social Security Act provides for travel expense 
reimbursement from Federal and State agencies for claimant travel 
incidental to medical examinations, and to parties, their 
representatives, and all reasonably necessary witnesses for travel 
exceeding 75 miles to attend medical examinations, reconsideration 
interviews and proceedings before an administrative law judge. 
Reimbursement procedures require the claimant to provide: (1) A list of 
expenses incurred, and (2) receipts of such expenses. Federal and state 
personnel review the listings and receipts to verify the reimbursable 
amount to the requestor. The respondents are claimants for Title II 
benefits and Title XVI payments, their representatives, and witnesses.
    Type of Request: Extension 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)
----------------------------------------------------------------------------------------------------------------
404.99(d) & 416.1499........................          60,000                1               10           10,000
----------------------------------------------------------------------------------------------------------------

    3. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009, and 418.1325--0960-0622. Individuals use Form SSA-
561-U2, the associated MCS interview, or the Internet application 
(i561) to initiate a request for reconsideration of a denied claim. SSA 
uses the information to document the request and to determine an 
individual's eligibility or entitlement to Social Security benefits 
(Title II), SSI payments (Title XVI), Special Veterans Benefits (Title 
VIII), Medicare (Title XVIII), and for initial determinations regarding 
Medicare Part B income-related premium subsidy reductions. The 
respondents are individuals filing for reconsideration of a denied 
claim.
    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-561 and Modernized Claims System (MCS)......         550,370               1               8          73,383

[[Page 47847]]

 
I561 (Internet iAppeals)........................         911,330               1               5          75,944
                                                 ---------------------------------------------------------------
    Totals......................................       1,461,700  ..............  ..............         149,327
----------------------------------------------------------------------------------------------------------------

    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 August 22, 2016 Individuals can obtain copies of the OMB 
clearance package by writing to [email protected].
    1. Application for Supplemental Security Income--20 CFR 416.207 and 
416.305-416.335, Subpart C--0960-0229. The Supplemental Security Income 
(SSI) program provides aged, blind, and disabled individuals who have 
little or no income, with funds for food, clothing, and shelter. 
Individuals complete Form SSA-8000-BK to apply for SSI. SSA uses the 
information from Form SSA-8000-BK and its electronic intranet 
counterpart, MSSICS, to determine: (1) Whether SSI claimants meet all 
statutory and regulatory eligibility requirements; and (2) SSI payment 
amounts. The respondents are applicants for SSI or their representative 
payees.
    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-8000-BK (Paper Version).....................          17,541               1              41          11,986
MSSICS/Signature Proxy..........................       1,373,401               1              35         801,151
                                                 ---------------------------------------------------------------
    Totals......................................       1,390,942  ..............  ..............         813,137
----------------------------------------------------------------------------------------------------------------

    2. Medical Application for Supplemental Security Income--20 CFR 
416.305-416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to 
determine an applicant's eligibility for SSI and SSI payment amounts. 
SSA employees also collect this information during interviews with 
members of the public who wish to file for SSI. SSA uses the 
information for two purposes: (1) To formally deny SSI for non-medical 
reasons when information the applicant provides results in 
ineligibility; or (2) to establish a disability claim, but defer the 
complete development of non-medical issues until SSA approves the 
disability. The respondents are applicants for SSI.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
             Modality of completion                  Number of     Frequency of    per response    total annual
                                                     responses       response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
MSSICS/Signature Proxy..........................         937,207               1              20         312,402
Non-MSSICS (Paper)..............................           1,033               1              20             344
                                                 ---------------------------------------------------------------
    Totals......................................         938,240  ..............  ..............         312,746
----------------------------------------------------------------------------------------------------------------

    3. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd 
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th 
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of 
SSA's disability determination process, we use Forms SSA-3375-BK 
through SSA-3379-BK to request information from a child's parent or 
guardian for children applying for SSI. The five different versions of 
the form contain questions about the child's day-to-day functioning 
appropriate to a particular age group; thus, respondents use only one 
version of the form for each child. The adjudicative team (disability 
examiners and medical or psychological consultants) of State disability 
determination services offices collect the information on the 
appropriate version of this form (in conjunction with medical and other 
evidence) to form a complete picture of the children's ability to 
function and their impairment-related limitations. The adjudicative 
team uses the completed profile to determine: (1) If each child's 
impairment(s) results in marked and severe functional limitations; and 
(2) whether each child is disabled. The respondents are parents and 
guardians of child applicants for SSI.
    Type of Request: Revision on 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-3375; SSA[dash]3376; SSA[dash]3377;              532,000                1               20          177,333
 SSA[dash]3378; SSA-3379....................
----------------------------------------------------------------------------------------------------------------


[[Page 47848]]

    4. Government-to-Government Services Online Web site Registration; 
Government-to-Government Services Online Web site Account Modification/
Deletion Form--20 CFR 401.45--0960-0757. The Government-to-Government 
Services Online (GSO) Web site allows various external organizations to 
submit files to a variety of SSA systems and, in some cases, receive 
files in return. The SSA systems that process data transferred via GSO 
include, but are not limited to, systems responsible for disability 
processing and benefit determination or termination. SSA uses the 
information on Form SSA-159, Government-to-Government Online Web site 
Registration Form, to register the requestor to use the GSO Web site. 
Once we receive the SSA-159, SSA provides the user with account 
information and conducts a walkthrough of the GSO Web site as 
necessary. Established organizations may submit Form SSA-159 to 
register additional users as well. The established requesting 
organizations can also complete Form SSA-160, Government-to-Government 
Online Web site Account Modification/Deletion Form, to modify their 
online accounts (e.g., address change). Respondents are State and local 
government agencies, and some private sector business entities.
    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-159.........................................           1,543               1              15             386
SSA-160.........................................             130               1              15              33
                                                 ---------------------------------------------------------------
    Totals......................................           1,673  ..............  ..............             419
----------------------------------------------------------------------------------------------------------------


    Dated: July 18, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-17259 Filed 7-21-16; 8:45 am]
BILLING CODE 4191-02-P