[Federal Register Volume 83, Number 132 (Tuesday, July 10, 2018)]
[Notices]
[Pages 31987-31990]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-14689]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2018-0030]


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-

[[Page 31988]]

966-2830, Email address: [email protected].
    Or you may submit your comments online through www.regulations.gov, 
referencing Docket ID Number [SSA-2018-0030].
    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 10, 2018. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Medical Source Opinion of Patient's Capability to Manage 
Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA appoints a 
representative payee in cases where we determine beneficiaries are not 
capable of managing their own benefits. In these instances, we require 
medical evidence to determine the beneficiaries' capability of managing 
or directing their benefit payments. SSA collects medical evidence on 
Form SSA-787 to: (1) Determine beneficiaries' capability or inability 
to handle their own benefits; and (2) assist in determining the 
beneficiaries' need for a representative payee. The respondents are the 
beneficiary's physicians, or medical officers of the institution in 
which the beneficiary resides.
    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-787.....................................         131,556                1               20           43,852
----------------------------------------------------------------------------------------------------------------

    2. Work Activity Report--Employee--20 CFR 404.1520(b), 404.1571-
404.1576, 404.1584-404.1593, and 416.971-404.976--0960-0059. SSA uses 
Form SA-821-BK to collect recipient employment information to determine 
whether recipients worked after becoming disabled and, if so, whether 
the work is substantial gainful activity. SSA uses Form SSA-821-BK to 
obtain work information during the initial claims process, the 
continuing disability review process, post-adjudicative work issue 
actions, and for Supplemental Security Income (SSI) claims involving 
work issues. SSA reviews and evaluates the data to determine if the 
applicant or recipient meets the disability requirements of the law. 
The respondents are applicants and recipients of Title II Social 
Security and Title XVI SSI 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-821-BK..................................         300,000                1               30          150,000
----------------------------------------------------------------------------------------------------------------

    3. Appointment of Representative--20 CFR 404.1707, 404.1720, 
408.1101, 416.1507, and 416.1520--0960-0527. Individuals claiming 
rights or benefits under the Social Security Act (Act) must notify SSA 
in writing when they appoint an individual to represent them in dealing 
with SSA. In addition, SSA requires representatives to sign the notice 
of appointment, or submit the equivalent in writing, if the 
representative is not an attorney. Recipients use Form SSA-1696-U4 to 
appoint a representative to handle their claim before SSA, and their 
appointed representative uses the SSA-1696-U4 to indicate whether they 
will charge a fee, and to show their eligibility for direct fee 
payment. In addition, representatives also use the SSA-1696-U4 to 
inform SSA of their disbarment; suspension from a court or bar in which 
they previously admitted to practice; or their disqualification from 
participating in or appearing before a Federal program or agency. 
Finally, SSA requires non-attorney appointed representatives to sign 
the SSA-1696-U4, or an equivalent written statement. SSA uses the 
information on the SSA-1696-U4 to document the appointment of the 
representative. Respondents are applicants for, or recipients of, 
Social Security disability benefits (SSDI) or SSI payments who are 
notifying SSA they have appointed a person to represent them in their 
dealings with SSA, and their non-attorney representatives who need to 
sign the form.
    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-1696-U4.................................         800,000                1               13          173,333
----------------------------------------------------------------------------------------------------------------

    4. Representative Payee Report of Benefits and Dedicated Account--
20 CFR 416.546, 416.635, 416.640, and 416.665--0960-0576. SSA requires 
representative payees (RPs) to submit a written report accounting for 
the use of money paid to Social Security or SSI recipients, and to 
establish and maintain a dedicated account for these payments. SSA uses 
Form SSA-6233 to: (1) Ensure the RPs use the payments for the 
recipient's current maintenance and personal needs; and (2) confirm the 
expenditures of funds from the dedicated account remain in compliance 
with the law. Respondents are RPs for SSI and Social Security 
recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 31989]]



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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-6233....................................          36,228                1               20           12,076
----------------------------------------------------------------------------------------------------------------

    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 August 9, 2018. Individuals can obtain copies of the 
OMB clearance packages by writing to [email protected].
    1. Claimant's Medication--20 CFR 404.1512, 416.912--0960-0289. In 
cases where claimants request a hearing after denial of their 
disability claim for Social Security, SSA uses Form HA-4632 to request 
information from the claimant regarding the medications they use. This 
information helps the administrative law judge overseeing the case to 
fully investigate: (1) The claimant's medical treatment and (2) the 
effects of the medications on the claimant's medical impairments and 
functional capacity. The respondents are applicants (or their 
representatives) for Old Age, Survivors, and Disability Insurance 
(OASDI) benefits or SSI payments who request a hearing to contest an 
agency denial of their claim.
    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)
----------------------------------------------------------------------------------------------------------------
HA-4632 (paper).................................          20,000               1              15           5,000
Electronic Records Express......................         180,000               1              15          45,000
                                                 ---------------------------------------------------------------
    Total.......................................         200,000  ..............  ..............          50,000
----------------------------------------------------------------------------------------------------------------

    2. Representative Payee Report--Special Veterans Benefits--20 CFR 
408.665--0960-0621. Title VIII of the Act allows for payment of monthly 
Social Security benefits to qualified World War II veterans residing 
outside the United States. An SSA-appointed representative payee may 
receive and manage the monthly payment for the beneficiary's use and 
benefit. SSA uses the information on Form SSA-2001-F6 to determine 
whether the representative payee used the certified payments properly, 
and continues to demonstrate strong concern for the beneficiary's best 
interests.
    Representative payees who receive Special Veterans Benefits (SVB) 
on behalf of beneficiaries residing outside the United States must 
complete the SSA-2001-F6 annually. We also require these representative 
payees to complete the form any time we have reason to believe they 
could be misusing the benefit payments. The respondents are individuals 
or organizations serving as representative payees who receive SVB on 
behalf of beneficiaries living outside the United States.
    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-2001-F6.................................              16                1               20                5
----------------------------------------------------------------------------------------------------------------

    3. Data Exchange Request Form--20 CFR 401.100--0960-0802. SSA 
maintains approximately 3,000 data exchange agreements and regularly 
receives new requests from Federal, State, local, and foreign 
governments, as well as private organizations, to share data 
electronically. SSA engages in various forms of data exchanges from 
Social Security number verifications to computer matches for benefit 
eligibility, depending on the requestor's business needs. Section 1106 
of the Act requires we consider the requestor's legal authority to 
receive the data, our disclosure policies, systems' feasibility, 
systems' security, and costs before entering into a data exchange 
agreement. We use Form SSA-157, Data Exchange Request Form, for this 
purpose. Requesting agencies, governments, or private organizations use 
the SSA-157 when voluntarily initiating a request for data exchange 
from SSA. Respondents are Federal, State, local, and foreign 
governments, as well as private organizations seeking to share data 
electronically with SSA.
    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)
----------------------------------------------------------------------------------------------------------------
State, local, and tribal governments............             114               1              30              57
Private sector organizations....................              32               1              30              16
                                                 ---------------------------------------------------------------

[[Page 31990]]

 
    Totals......................................             146  ..............  ..............              73
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    Dated: July 3, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-14689 Filed 7-9-18; 8:45 am]
 BILLING CODE 4191-02-P