[Federal Register Volume 82, Number 157 (Wednesday, August 16, 2017)]
[Notices]
[Pages 38982-38984]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-17269]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2017-0041]


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

[[Page 38983]]

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-2017-0041].
    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 
October 16, 2017. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Application to Collect a Fee for Payee Service--20 CFR 404.2040a 
& 20 CFR 416.640a--0960-0719. Sections 205(j)(4)(A)&(B), and 1631(a)(2) 
of the Social Security Act (Act) allow SSA to authorize certain 
organizational representative payees to collect a fee for providing 
payee services. Before an organization may collect this fee, they 
complete and submit Form SSA-445. SSA uses the information to determine 
whether to authorize or deny permission to collect fees for payee 
services. The respondents are private sector businesses or State and 
local government offices applying to become fee-for-service 
organizational representative payees.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-445--Private sector business................              90               1              10              15
SSA-445--State/local government offices.........              10               1              10               2
                                                 ---------------------------------------------------------------
    Totals......................................             100  ..............  ..............              17
----------------------------------------------------------------------------------------------------------------

    2. Redetermination of Eligibility for Help with Medicare 
Prescription Drug Plan Costs--20 CFR 418.3125--0960-0723. As per the 
requirements of the Medicare Modernization Act of 2003, SSA conducts 
low-income subsidy eligibility redeterminations for Medicare 
beneficiaries who currently receive the Medicare Part D subsidy and who 
meet certain criteria. Respondents complete Form SSA-1026-REDE under 
the following circumstances: (1) When individuals became entitled to 
the Medicare Part D subsidy during the past 12 months; (2) if they were 
eligible for the Part D subsidy for more than 12 months; or (3) if they 
reported a change in income, resources, or household size. Part D 
beneficiaries complete the SSA-1026-SCE when they need to report a 
potentially subsidy-changing event, including the following: (1) 
Marriage; (2) spousal separation; (3) divorce; (4) annulment of a 
marriage; (5) spousal death; or (6) moving back in with one's spouse 
following a separation. The respondents are current recipients of the 
Medicare Part D low-income subsidy who will undergo an eligibility 
redetermination for one of the reasons mentioned above.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of     burden per     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1026-REDE...................................          98,990               1              18          29,697
SSA-1026-SCE....................................           4,267               1              18           1,280
SSA-1026-REDE--Field Office Interview...........          50,529               1              18          15,159
SSA-1026-SCE--Field Office Interview............           3,468               1              18           1,040
                                                 ---------------------------------------------------------------
    Total.......................................         157,254  ..............  ..............          47,176
----------------------------------------------------------------------------------------------------------------

    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 September 15, 2017. Individuals can obtain copies of 
the OMB clearance packages by writing to [email protected].
    1. Statement Regarding Date of Birth and Citizenship--20CFR 
404.716--0960-0016. Section 205(a) of the Act gives the Commissioner of 
SSA the authority to make rules and regulations and to establish 
procedures for collecting evidence from individuals applying for Social 
Security benefits. When individuals apply for Social Security benefits 
and cannot provide preferred methods of proving age or citizenship, SSA 
uses Form SSA-702 to establish these facts. Specifically, SSA uses the 
SSA-702 to establish age as a factor of entitlement to Social Security 
benefits, or U.S. citizenship as a payment factor. Respondents are 
individuals with knowledge about the date of birth or citizenship of 
applicants filing for one or more Social Security benefits who need to 
establish age or citizenship.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 38984]]



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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-702.....................................           1,200                1               10              200
----------------------------------------------------------------------------------------------------------------

    2. Marital Relationship Questionnaire--20 CFR 416.1826--0960-0460. 
SSA uses Form SSA-4178, Marital Relationship Questionnaire, to 
determine if unrelated individuals of the opposite sex who live 
together are misrepresenting themselves as husband and wife. SSA needs 
this information to determine whether we are making correct payments to 
couples and individuals applying for or currently receiving 
Supplemental Security Income (SSI) payments. The respondents are 
applicants for and recipients of 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-4178--Modernized SSI Claims System..........           1,200               1              10             200
SSA-4178........................................           3,825               1               5             319
                                                 ---------------------------------------------------------------
    Totals......................................           5,100  ..............  ..............             425
----------------------------------------------------------------------------------------------------------------

    3. Medical Source Statement of Ability To Do Work Related 
Activities (Physical and Mental)--20 CFR 404.1512-404.1513, 416.912-
416.913, 404.1517, and 416.917--0960-0662. In some instances when a 
claimant appeals a denied disability claim, SSA may ask the claimant to 
have a consultative examination at the agency's expense, if the 
claimant's medical sources cannot or will not give the agency 
sufficient evidence to determine whether the claimant is disabled. The 
medical providers who perform these consultative examinations provide a 
statement about the claimant's state of disability. Specifically, these 
medical source statements determine the work-related capabilities of 
these claimants. SSA collects the medical data on the HA-1151 and HA-
1152 to assess the work-related physical and mental capabilities of 
claimants who appeal SSA's previous determination on their issue of 
disability. The respondents are medical sources who provide reports 
based either on existing medical evidence or on consultative 
examinations.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                                     Estimated
                                     Number of     Frequency of      Number of    Average burden   total annual
     Modality of completion         respondents      response        responses     per response       burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
HA-1151.........................           5,000              30         150,000              15          37,500
HA-1152.........................           5,000              30         150,000              15          37,500
                                 -------------------------------------------------------------------------------
    Totals......................          10,000  ..............         300,000  ..............          75,000
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    Dated: August 10, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-17269 Filed 8-15-17; 8:45 am]
 BILLING CODE 4191-02-P