[Federal Register Volume 83, Number 22 (Thursday, February 1, 2018)]
[Notices]
[Pages 4722-4725]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-01947]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2018-0002]


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 an extension of an OMB-approved information collection, a new 
information collection, and 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-2018-0002].
    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 
April 2, 2018. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Request for Reconsideration--Disability Cessation--20 CFR 
404.909, 416.1409--0960-0349. When SSA determines that claimants' 
disabilities medically improved; ceased; or are no longer sufficiently 
disabling, these claimants may ask SSA to reconsider that 
determination. SSA uses Form SSA-789-U4 to arrange for a hearing or to 
prepare a decision based on the evidence of record. Specifically, 
claimants or their representatives use Form SSA-789-U4 to: (1) Ask SSA 
to reconsider a determination; (2) indicate if they wish to appear at a 
disability hearing; (3) submit any additional information or evidence 
for use in the reconsidered determination; and (4) indicate if they 
will need an interpreter for the hearing. The respondents are 
disability claimants for Social Security benefits or Supplemental 
Security Income (SSI) payments, or their representatives who wish to 
appeal an

[[Page 4723]]

unfavorable disability cessation determination.
    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-789-U4..................................          30,000                1               13            6,500
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    2. Waiver of Right to Appear--Disability Hearing--20 CFR 404.913-
404.914, 404.916(b)(5), 416.1413-416.1414, 416.1416(b)(5)--0960-0534. 
Claimants for Social Security disability payments or their 
representatives can use Form SSA-773-U4 to waive their right to appear 
at a disability hearing. The disability hearing officer uses the signed 
form as a basis for not holding a hearing, and for preparing a written 
decision on the claimant's request for disability payments based solely 
on the evidence of record. The respondents are disability claimants for 
Social Security benefits or SSI payments, or their representatives, who 
wish to waive their right to appear at a disability 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)
----------------------------------------------------------------------------------------------------------------
SSA-773-U4..................................             200                1                3               10
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    3. Social Security Number Verification Services--20 CFR 401.45--
0960-0660. Internal Revenue Service regulations require employers to 
provide wage and tax data to SSA using Form W-2, or its electronic 
equivalent. As part of this process, the employer must furnish the 
employee's name and Social Security number (SSN). In addition, the 
employee's name and SSN must match SSA's records for SSA to post 
earnings to the employee's earnings record, which SSA maintains. SSA 
offers the Social Security Number Verification Service (SSNVS), which 
allows employers to verify the reported names and SSNs of their 
employees match those in SSA's records. SSNVS is a cost-free method for 
employers to verify employee information via the internet. The 
respondents are employers who need to verify SSN data using SSA's 
records.
    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      Number of       per response    annual burden
                                                                       respondents        response        responses        (minutes)         (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSNVS..............................................................          41,387               60        2,483,220                5          206,935
--------------------------------------------------------------------------------------------------------------------------------------------------------

    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 March 5, 2018. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Statement of Interpreter--0960-NEW. SSA and the Disability 
Determination Services (DDS) will use Form SSA-4321, Statement of 
Interpreter, when a person requiring an interpreter prefers to provide 
their own interpreter during an interview or conversation between the 
person requiring an interpreter and SSA or DDS. SSA will require the 
interpreter sign Form SSA-4321, and confirm, among other things, that 
they will not knowingly give false information; they will act as an 
interpreter and witness; and they will accurately interpret the 
interview to the best of their ability. Section 205(a) of the Social 
Security Act (Act), as amended (42 U.S.C. 405(a)) authorizes SSA 
collect this information.
    Type of Request: A New Information Collection Request.

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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4321....................................       5,170,399                1                5          430,867
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    2. Application for Mother's or Father's Insurance Benefits--20 CFR 
404.339-404.342, 20 CFR 404.601-404.603--0960-0003. Section 202(g) of 
the Act provides for the payment of monthly benefits to the widow or 
widower of an insured individual if the surviving spouse is caring for 
the deceased worker's child (who is entitled to Social Security 
benefits). SSA uses the information on Form SSA-5-BK to determine an 
individual's eligibility for mother's or father's insurance benefits. 
The respondents are individuals caring for a child of the deceased 
worker who

[[Page 4724]]

is applying for mother's or father's insurance benefits under the Old 
Age, Survivors, and Disability Insurance program.
    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-5-F6 (paper)............................           6,542                1               15            1,636
Modernized Claims System....................          42,175                1               15           10,544
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    Totals..................................          48,717   ...............  ...............          12,180
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    3. Statement of Living Arrangements, In-Kind Support, and 
Maintenance--20 CFR 416.1130-416.1148--0960-0174. SSA determines SSI 
payment amounts based on applicants' and recipients' needs. We measure 
individuals' needs, in part, by the amount of income they receive, 
including in-kind support and maintenance in the form of food and 
shelter provided by other people. SSA uses Form SSA-8006-F4 to 
determine if in-kind support and maintenance exists for SSI applicants 
and recipients. This information also assists SSA in determining the 
income value of in-kind support and maintenance SSI applicants and 
recipients receive. The respondents are individuals who apply for SSI 
payments, or who complete an SSI eligibility redetermination.
    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-8006-F4.................................         173,380                1                7           20,228
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    4. Statement of Funds You Provided to Another and Statement of 
Funds You Received--20 CFR 416.1103(f)--0960-0481. SSA uses Forms SSA-
2854 (Statement of Funds You Provided to Another) and SSA-2855 
(Statement of Funds You Received) to gather information to verify if a 
loan is bona fide for SSI recipients. The SSA-2854 asks the lender for 
details on the transaction, and Form SSA-2855 asks the borrower the 
same basic questions independently. Agency personnel then compare the 
two statements; gather evidence if needed; and make a decision on the 
validity of the bona fide status of the loan.
    For SSI purposes, we consider a loan bona fide if it meets these 
requirements:
     Must be between a borrower and lender with the 
understanding that the borrower has an obligation to repay the money;
     Must be in effect at the time the cash goes to the 
borrower, that is, the agreement cannot come after the cash is paid; 
and
     Must be enforceable under State law, often there are 
additional requirements from the State.
    SSA collects this information at the time of initial application 
for SSI, or at any point when an individual alleges being party to an 
informal loan while receiving SSI. SSA collects information on the 
informal loan through both interviews and mailed forms. The agency's 
field personnel conduct the interviews and mail the form(s) for 
completion, as needed. The respondents are SSI recipients and 
applicants, and individuals who lend money to them.
    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-2854....................................          20,000                1               10            3,333
SSA-2855....................................          20,000                1               10            3,333
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    Totals..................................          40,000   ...............  ...............           6,666
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    5. Filing Claims Under the Federal Tort Claims Act--20 CFR 429.101-
429.110--0960-0667. The Federal Tort Claims Act is the legal mechanism 
for compensating persons injured by negligent or wrongful acts that 
occur during the performance of official duties by Federal employees. 
In accordance with the law, SSA accepts monetary claims filed under the 
Federal Tort Claims Act for damages against the United States, loss of 
property, personal injury, or death resulting from an SSA employee's 
wrongful act or omission. The regulation sections cleared under this 
information collection request require claimants to provide information 
SSA can use to investigate and determine whether to make an award, 
compromise, or settlement under the Federal Tort Claims Act. The 
respondents are individuals or entities making a claim under the 
Federal Tort Claims Act.
    Type of Request: Extension of an OMB-approved information 
collection.

[[Page 4725]]



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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
429.102; 429.103 \1\........................               1   ...............  ...............               1
429.104(a)..................................              11                1                5                1
429.104(b)..................................              43                1                5                4
429.104(c)..................................               1                1                5                0
429.106(b)..................................               8                1               10                1
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    Totals..................................              64   ...............  ...............               7
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\1\ The 1 hour represents a placeholder burden. We are not reporting a burden for this collection because
  respondents complete OMB-approved Form SF-95.

    6. Application for Extra Help with Medicare Prescription Drug Plan 
Costs--20 CFR 418.3101--0960-0696. The Medicare Modernization Act of 
2003 mandated the creation of the Medicare Part D prescription drug 
coverage program and the provision of subsidies for eligible Medicare 
beneficiaries. SSA uses Form SSA-1020 or the internet i1020, the 
Application for Extra Help with Medicare Prescription Drug Plan Costs, 
to obtain income and resource information from Medicare beneficiaries, 
and to make a subsidy decision. The respondents are Medicare 
beneficiaries applying for the Part D low-income subsidy.
    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-1020....................................         531,715                1               30          265,858
(paper application form)....................
i1020.......................................         346,642                1               25          144,434
(online application)........................
Field office interview......................         108,194                1               30           54,097
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    Totals..................................         986,551   ...............  ...............         464,389
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    Dated: January 26, 2018.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-01947 Filed 1-31-18; 8:45 am]
 BILLING CODE 4191-02-P