[Federal Register Volume 82, Number 73 (Tuesday, April 18, 2017)]
[Notices]
[Pages 18335-18340]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-07796]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2017-0019]


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-2017-
0019].
    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 
19, 2017. Individuals can obtain copies of the collection instruments 
by writing to the above email address.
    1. Promoting Opportunity Demonstration--0960-NEW. Section 823 of 
the Bipartisan Budget Act of 2015 requires SSA to carry out the 
Promoting Opportunity Demonstration (POD) to test a new benefit offset 
formula for Social Security Disability Insurance (SSDI) beneficiaries. 
Therefore, SSA is undertaking POD, a demonstration to evaluate the 
affect the new policy will have on SSDI beneficiaries and their 
families in several critical areas: (1) Employment, (2) benefits, (3) 
earnings, and (4) income (earnings plus benefits). Under current law, 
Social Security beneficiaries lose their SSDI benefit if they have 
earnings or work activity above the threshold of Substantial Gainful 
Activity (SGA). The POD evaluation will draw on previous lessons from 
related work incentive experiences, especially SSA's Benefit Offset 
National Demonstration (BOND), 0960-0785, which tested a different 
offset formula. POD tests a different policy than BOND in two important 
ways: (1) A lower threshold at which point the offset is applied--
increasing the likelihood of reducing benefit expenditures relative to 
current law expenditures; and (2) A more immediate adjustment to the 
benefits--to increase the salience and clarity of the offset policy for 
beneficiaries. The POD will test a benefit offset that will reduce 
benefits by $1 for every $2 in participants' earnings above the POD 
threshold, gradually reducing benefits as earnings increase. The POD 
threshold will equal the greater of (1) an inflation-adjusted trial 
work period level ($840 in 2017); or (2) the amount of the 
participant's itemized impairment-related work expenses up to SGA. The 
new rules we will test in POD also simplify work incentives and we 
intend them to promote employment and reduce dependency on benefits.
    The design for POD will include implementation and evaluation 
activities designed to answer seven central research questions:
     What are the impacts of the two POD benefit designs on 
beneficiaries' earnings, SSDI benefits, and total earnings and benefit 
income?
     Is POD attractive to beneficiaries? Do they remain engaged 
over time?
     How were the POD offset policies implemented, and what 
operational,

[[Page 18336]]

systemic, or contextual factors facilitated or posed challenges to 
administering the offset?
     How successful were POD and SSA in making timely benefit 
adjustments, and what factors affected timeliness positively or 
negatively?
     How do the impacts of the POD offset policies vary with 
beneficiary characteristics?
     What are the costs and benefits of the POD benefit designs 
relative to current law, and what are the implications for the SSDI 
trust fund?
     What are the implications of the POD findings for national 
policy proposals that would include a SSDI benefit offset?
The public survey data collections have four components--a process 
analysis, a participation analysis, an impact analysis, and a cost-
benefit analysis. The data collections are the primary source for data 
to measure the effects the benefit offset on SSDI beneficiaries' work 
efforts and earnings. Ultimately, these data will benefit researchers, 
policy analysts, policy makers, SSA, and the state vocational 
rehabilitation agencies in a wide range of program areas. There are 
four targeted outcomes for SSDI beneficiaries under POD: (1) Increased 
employment and earnings; (2) decreased benefits payments; (3) increased 
total income; and (4) impacts on other related outcomes (for example, 
health status and quality of life).
     Additionally, four outcomes of interest for system changes 
include: (1) Reduction in overpayments; (2) enhanced program integrity; 
(3) stronger culture of self-sufficiency; and (4) improved SSDI trust 
fund balance. Respondents are SSDI beneficiaries, who will provide 
written consent before agreeing to participate in the study and before 
we randomly assign them to one of the study treatment groups.
    Type of Request: Request for a new information collection.

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                                                                                  Average burden     Estimated
     Modality of completion          Number of     Frequency of      Number of     per response    total annual
                                    respondents      response        responses       (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Informed Consent Form...........          16,500               1          16,500              15           4,125
Baseline Survey.................          16,500               1          16,500              20           5,500
12-Month Follow Up Survey.......           6,000               1           6,000              30           3,000
24-Month Follow Up Survey.......          12,000               1          12,000              30           6,000
Interviews with Site Staff......              40               4             160              66             176
Onsite Audit of Sample of Case                 8               2              16              20               5
 Files..........................
Semi-Structured Interviews with              144               1             144              60             144
 Treatment Group Subjects.......
Monthly Earnings and Impairment-           1,820              12          21,840              10           3,640
 Related Expenses Reporting Form
 (paper)........................
Monthly Earnings and Impairment-             780              12           9,360               5             780
 Related Expenses Reporting Form
 (Internet).....................
End of Year Reporting Form                   945               1             945              15             236
 (paper)........................
End of Year Reporting Form                   405               1             405              10              68
 (Internet).....................
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
    Totals......................          55,142  ..............          83,870  ..............          23,674
----------------------------------------------------------------------------------------------------------------

    2. Statement Regarding Contributions--20 CFR 404.360-404.366 and 
404.736--0960-0020. SSA uses the SSA-783 to collect information 
regarding a child's current sources of support when determining the 
child's entitlement to Social Security benefits. We request this 
information from adults acting on behalf of the child claimants who can 
provide SSA with any sources of support or substantial contributions 
for the child. These adults inform the claims representative of these 
sources as part of the initial benefits process. If the individual 
capable of providing the information does not accompany the child 
claimant, we mail the SSA-783 to the individual for completion; or if 
the person has access to a computer, we will refer them to SSA's Web 
site. The respondents are individuals providing information about a 
child's sources of support.
    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-783.....................................          30,000                1               17            8,500
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    3. Disability Report--Appeal--20 CFR 404.1512, 416.912, 404.916(c), 
416.1416(c), 422.140, 404.1713, 416.1513, 404.1740(b)(4), 
416.1540(b)(4), and 405 Subpart C--0960-0144. SSA requires disability 
applicants who wish to appeal an unfavorable disability determination 
to complete Form SSA-3441-BK; the associated Electronic Disability 
Collect System (EDCS) interview; or the Internet application, i3441. 
This allows claimants to disclose any changes to their disability, or 
resources, which might influence SSA's unfavorable determination. We 
may use the information to: (1) Reconsider and review an initial 
disability determination; (2) review a continuing disability; and (3) 
evaluate a request for a hearing. This information assists the State 
Disability Determination Services (DDS) and administrative law judges 
(ALJ) in preparing for the appeals and hearings, and in issuing a 
determination or decision on an individual's entitlement (initial or 
continuing) to disability benefits. In addition, the information we 
collect on the SSA-3441-BK, or related modalities, facilitates SSA's 
collection of medical information to support the applicant's request 
for reconsideration; request for benefits cessation appeal; and request 
for a hearing before an ALJ. Respondents are individuals who appeal 
denial, reduction, or cessation of Social Security disability benefits 
and Supplemental Security Income (SSI)

[[Page 18337]]

payments; individuals who wish to request a hearing before an ALJ; or 
their representatives.
    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-3441-BK.....................................           2,396               1              45           1,797
Electronic Disability Collect System (EDCS).....         476,771               1              45         357,578
i3441 (Internet)................................       1,046,938               1              28         488,571
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
    Totals......................................       1,526,105  ..............  ..............         847,946
----------------------------------------------------------------------------------------------------------------

    4. Authorization to Disclose Information to SSA--20 CFR 404.1512 
and 416.912, 45 CFR 160 and 164--0960-0623. Sections 223(d)(5)(A) and 
1614(a)(3)(H)(i) of the Social Security Act require claimants to 
provide medical and other evidence the Commissioner of Social Security 
may require to prove they are disabled. SSA must obtain sufficient 
evidence to make eligibility determinations for Title II and Title XVI 
payments. Therefore, the applicant must authorize release of 
information from various sources to SSA. The applicants use Form SSA-
827, or the Internet counterpart, i827, to provide consent for the 
release of medical records, education records, and other information 
related to their ability to perform tasks. Once the applicant completes 
Form SSA-827, or the i827, SSA or the State DDS sends the form to the 
designated source(s) to obtain pertinent records. The respondents are 
applicants for Title II and Title XVI disability payments.
    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)
----------------------------------------------------------------------------------------------------------------
i827 with electronic signature (eAuthorization).       4,189,270               1               9         628,391
SSA-827 with wet signature (paper version)......       1,055,807               1              10         175,968
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
    Totals......................................       5,245,077  ..............  ..............         804,359
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these 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 May 18, 2017. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Supported Employment Demonstration (SED)--0960-NEW. Sponsored by 
SSA, the SED builds on the success of the intervention designed for the 
Mental Health Treatment Study (MHTS) previously funded by SSA. The MHTS 
provides integrated mental health and vocational services to disability 
beneficiaries with mental illness. The SED will offer these same 
services to individuals with mental illness to whom SSA denied Social 
Security disability benefits. SSA seeks to determine whether offering 
this evidence-based package of integrated vocational and mental health 
services to denied disability applicants fosters employment that leads 
to self-sufficiency, improved mental health and quality of life, and 
reduced demand for disability benefits. The SED will use a randomized 
controlled trial to compare the outcomes of two treatment groups and a 
control group. Study participation spans 36 months beginning on the day 
following the date of randomization to one of the three study groups. 
The SED study population consists of individuals aged 18 to 50 who 
apply for disability benefits alleging a mental illness and the initial 
decision is a denial of benefits in the past 60 days. The SED will 
enroll up to 1,000 participants in each of the three study arms for a 
total of 3,000 participants: 40 participants in each of three study 
arms for the 20 urban sites equaling an n of 2,400 urban site 
participants, and 20 participants in each of three arms for the 10 
rural sites equaling an n of 600 rural site participants. We randomly 
select and assign each enrolled participant to one of three study arms:
     Full-Service Treatment (n=1,000). The multi-component 
service model from the MHTS comprises the Full-Service Treatment. At 
its core are an Individual Placement and Support (IPS) supported 
employment specialist and behavioral health specialist providing IPS 
supported employment services integrated with behavioral health care. 
Participants in the full-service treatment group will also receive the 
services of a Nurse Care Coordinator who coordinates Systematic 
Medication Management services, as well assistance with: Out-of-pocket 
expenses associated with prescription behavioral health medications; 
work-related expenses; and services and treatment not covered by the 
participant's health insurance.
     Basic-Service Treatment (n=1,000). The Basic-Service 
Treatment model leaves intact IPS supported employment integrated with 
behavioral health services as the centerpiece of the intervention arm. 
The Basic-Service Treatment is essentially the Full-Service model 
without the services of the Nurse Care Coordinator, Systematic 
Medication Management, and the funds associated with out-of-pocket 
expenses for prescription behavioral health medications.
     Usual Services (n=1,000). This study arm represents a 
control group against which the two treatment groups we can compare. 
Participants assigned to this group seek services as they normally 
would (or would not) in their community. However, at the time of 
randomization, each Usual Service participant will receive a

[[Page 18338]]

comprehensive manual describing mental health and vocational services 
in their locale, along with state and national resources.

This study will test the two treatment conditions against each other 
and against the control group on multiple outcomes of policy interest 
to SSA. The key outcomes of interest include: (1) Employment; (2) 
earnings; (3) income; (4) mental status; (5) quality of life; (6) 
health services utilization; and (7) SSA disability benefit receipt and 
amount. SSA is also interested in the study take up rate 
(participation), knowing who enrolls (and who does not), and fidelity 
to evidence-based treatments, among other aspects of implementation. 
Data collection for the evaluation of the SED will consist of the 
following activities: Baseline in-person participant interviews; 
quarterly participant telephone interviews; receipt of SSA 
administrative record data; and collection of site-level program data. 
Evaluation team members will also conduct site visits involving: (1) 
Pre-visit environmental scans in order to understand the local context 
in which SED services are embedded; (2) independent fidelity 
assessments in conjunction with those carried out by state Mental 
Health/Vocational Rehabilitation staff; (3) key informant interviews 
with the IPS specialist, the nurse care coordinator, the case manager, 
and facility director; (4) focus groups with participants in the Full-
Service and Basic-Service Treatment groups; and (5) ethnographic data 
collection consisting of observations in the natural environment and 
person-centered interviews with participants and non-participants. The 
respondents are study participants and non-participants, family 
members, IPS specialists, nurse care coordinators, case managers, and 
facility directors.
    Type of Request: Request for a new information collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
     Modality of completion          Number of     Frequency of      Number of     per response    total annual
                                    respondents      response        responses       (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Competency and CIDI Screener....           3,000               1           3,000              40           2,000
Baseline Interview..............           3,000               1           3,000              45           2,250
Quarterly Interview (Quarters 1,           3,000               9          27,000              20           9,000
 2, 3, 5, 6, 7, 9, 10, and 11)..
Annual Interview (Quarters 4, 8,           3,000               3           9,000              30           4,500
 and 11)........................
Fidelity Assessment Participant              180               4             720              60             720
 Interview......................
Fidelity Assessment Family                    90               4             360              60             360
 Member Interview...............
Key Informant Interview.........             120               4             480              60             480
Participant Focus Groups........             600               2           1,200              60           1,200
Person-Centered Interview.......             180               4             720              60             720
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
    Totals......................          13,170  ..............          45,480  ..............          21,230
----------------------------------------------------------------------------------------------------------------

    2. Student Reporting Form--20 CFR 404.352(b)(2); 404.367; 404.368; 
404.415; 404.434; 422.135--0960-0088. To qualify for Social Security 
Title II student benefits, student beneficiaries must be in full-time 
attendance status at an educational institution. In addition, SSA 
requires these beneficiaries to report events that may cause a 
reduction, termination, or suspension of their benefits. SSA collects 
such information on Forms SSA-1383 and SSA-1383-FC to determine if the 
changes or events the student beneficiaries report will affect their 
continuing entitlement to SSA benefits. SSA also uses the SSA-1383 and 
SSA-1383-FC to calculate the correct benefit amounts for student 
beneficiaries. The respondents are Social Security Title II student 
beneficiaries.
    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-1383..........................          74,887               1               6           7,489
SSA-1383-FC.......................           1,247               1               6             125
                                   -----------------------------------------------------------------------------
    Totals........................          76,134  ..............  ..............           7,614
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    3. Advanced Notice of Termination of Child's Benefits & Student's 
Statement Regarding School Attendance--20 CFR 404.350-404.352, 404.367-
404.368--0960-0105. SSA collects information on Forms SSA-1372-BK and 
SSA-1372-BK-FC to determine whether children of an insured worked meet 
the eligibility requirements for student benefits. The data we collect 
allows SSA to determine student entitlement and whether to terminate 
benefits. The respondents are student claimants for Social Security 
benefits, their respective schools and, in some cases, their 
representative payees.
    Type of Request: Revision of an OMB-approved information 
collection.
SSA-1372-BK:

----------------------------------------------------------------------------------------------------------------
                                                                    Average burden     Estimated
        Type of respondent             Number of     Frequency of    per response    total annual
                                      respondents      response        (minutes)    burden (hours)
--------------------------------------------------------------------------------------------------
Individuals/Households............          99,850               1               8          13,313

[[Page 18339]]

 
State/Local/Tribal Government.....          99,850               1               3           4,993
                                   -----------------------------------------------------------------------------
    Totals........................         199,700  ..............  ..............          18,306
----------------------------------------------------------------------------------------------------------------

SSA-1372-BK:

----------------------------------------------------------------------------------------------------------------
                                                                    Average burden     Estimated
        Type of respondent             Number of     Frequency of    per response    total annual
                                      respondents      response        (minutes)    burden (hours)
--------------------------------------------------------------------------------------------------
Individuals/Households............           1,198               1               8             160
State/Local/Tribal Government.....           1,198               1               3              60
                                   -----------------------------------------------------------------------------
    Totals........................           2,396  ..............  ..............             220
                                   -----------------------------------------------------------------------------
        Grand Total...............         200,096  ..............  ..............          18,526
----------------------------------------------------------------------------------------------------------------

    4. Request for Review of Hearing Decision/Order--20 CFR 404.967-
404.981, 416.1467-416.1481--0960-0277. Claimants have a statutory right 
under the Social Security Act and current regulations to request review 
of an ALJ's hearing decision or dismissal of a hearing request on Title 
II and Title XVI claims. Claimants may request Appeals Council review 
by filing a written request using Form HA-520. SSA uses the information 
to establish the claimant filed the request for review within the 
prescribed time and to ensure the claimant completed the requisite 
steps permitting the Appeals Council review. The Appeals Council uses 
the information to: (1) Document the claimant's reason(s) for 
disagreeing with the ALJ's decision or dismissal; (2) determine whether 
the claimant has additional evidence to submit; and (3) determine 
whether the claimant has a representative or wants to appoint one. The 
respondents are claimants requesting review of an ALJ's decision or 
dismissal of hearing.
    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)
----------------------------------------------------------------------------------------------------------------
HA-520......................................         175,000                1               10           29,167
----------------------------------------------------------------------------------------------------------------

    5. Disability Update Report--20 CFR 404.1589-404.1595 and 416.988-
416.996--0960-0511. As part of our statutory requirements, SSA 
periodically uses Form SSA-455, the Disability Update Report, to 
evaluate current Title II disability beneficiaries' and Title XVI 
disability payment recipients' continued eligibility for Social 
Security disability payments. Specifically, SSA uses the form to 
determine if: (1) There is enough evidence to warrant referring the 
respondent for a full medical Continuing Disability Review (CDR); (2) 
the respondent's impairments are still present and indicative of no 
medical improvement, precluding the need for a CDR; or (3) the 
respondent has unresolved work-related issues. SSA mails Form SSA-455 
to specific disability recipients, whom we select as possibly 
qualifying for the CDR process. SSA pre-fills the form with data 
specific to the disability recipient, except for the sections we ask 
the recipients to complete. When SSA receives the completed form, we 
scan it into SSA's system. This allows us to gather the information 
electronically, and enables SSA to process the returned forms through 
automated decision logic to decide the proper course of action to take. 
The respondents are recipients of Title II and Title XVI Social 
Security disability payments.
    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-455.....................................       1,500,000                1               15          375,000
----------------------------------------------------------------------------------------------------------------



[[Page 18340]]

    Dated: April 13, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-07796 Filed 4-17-17; 8:45 am]
 BILLING CODE 4191-02-P