[Federal Register Volume 83, Number 192 (Wednesday, October 3, 2018)]
[Notices]
[Pages 49965-49969]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-21539]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2018-0053]


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 extensions 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-2018-0053].
    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 
December 3, 2018. Individuals can obtain copies of the collection 
instruments by writing to the above email address.

[[Page 49966]]

    1. Response to Notice of Revised Determination--20 CFR 404.913-
404.914, 404.992(b), 416.1413-416.1414, and 416.1492(d)--0960-0347. 
When SSA determines: (1) Claimants for initial disability benefits do 
not actually have a disability; or (2) current disability recipients' 
records show their disability ceased, SSA notifies the disability 
claimants, or recipients of this decision. In response to this notice, 
the affected claimants and disability recipients have the following 
recourse: (1) They may request a disability hearing to contest SSA's 
decision; and (2) they may submit additional information or evidence 
for SSA to consider. Disability claimants, recipients, and their 
representatives use Form SSA-765 to accomplish these two actions. If 
respondents request the first option, SSA's Disability Hearings Unit 
uses the form to schedule a hearing; ensure an interpreter is present, 
if required; and ensure the disability recipients or claimants, and 
their representatives, receive a notice about the place and time of the 
hearing. If respondents choose the second option, SSA uses the form and 
other evidence to reevaluate the claimant's or recipients' case, and 
determine if the new information or evidence will change SSA's 
decision. The respondents are disability claimants, current disability 
recipients, or their representatives.
    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-765.....................................           1,925                1               30              963
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    2. Site Review Questionnaire for Volume and Fee-for-Service Payees 
and Beneficiary Interview Form--20 CFR 404.2035, 404.2065, 416.665, 
416.701, and 416.708--0960-0633. SSA asks organizational representative 
payees to complete Form SSA-637, the Site Review Questionnaire for 
Volume and Fee-for-Service Payees, to provide information on how they 
carry out their responsibilities, including how they manage beneficiary 
funds. SSA then obtains information from the beneficiaries these 
organizations represent via Form SSA-639, Beneficiary Interview Form, 
to corroborate the payees' statements. Due to the sensitivity of the 
information, SSA employees always complete the forms based on the 
answers respondents give during the interview. The respondents are 
individuals; State and local governments; non-profit and for-profit 
organizations serving as representative payees; and the beneficiaries 
they serve.
    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-637.........................................           4,924               1             120           9,848
SSA-639.........................................          21,772               1              10           3,629
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
    Totals......................................          26,696  ..............  ..............          13,477
----------------------------------------------------------------------------------------------------------------

    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 November 2, 2018. Individuals can obtain copies of 
the OMB clearance packages by writing to [email protected].
    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.

----------------------------------------------------------------------------------------------------------------
                                                                                 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 
the SSA-821-BK to obtain work information during the initial claims 
process; the continuing disability review process; post-adjudicative 
work issue actions; and for the 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

[[Page 49967]]

recipients of Title II Social Security and Title XVI SSI disability 
payments.
    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-821-BK..................................         300,000                1               30          150,000
----------------------------------------------------------------------------------------------------------------

    3. State Supplementation Provisions: Agreement; Payments--20 CFR 
416.2095-416.2099--0960-0240. Section 1618 of the Social Security Act 
(Act) requires those states administering their own supplementary 
income payment program(s) to demonstrate compliance with the Act by 
passing Federal cost-of-living increases on to individuals who are 
eligible for state supplementary payments, and informing SSA of their 
compliance. In general, states report their supplementary payment 
information annually by the maintenance-of-payment levels method. 
However, SSA may ask them to report up to four times in a year by the 
total-expenditures method. Regardless of the method, the states confirm 
their compliance with the requirements, and provide any changes to 
their optional supplementary payment rates. SSA uses the information to 
determine each state's compliance or noncompliance with the pass-along 
requirements of the Act to determine eligibility for Medicaid 
reimbursement. If a state fails to keep payments at the required level, 
it becomes ineligible for Medicaid reimbursement under Title XIX of the 
Act. Respondents are state agencies administering supplemental 
programs.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
     Modality of completion          Number of     Frequency of      Number of     per response    total annual
                                    respondents      response       respondents      (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Total Expenditures..............               7               4              28              60              28
Maintenance of Payment Levels...              26               1              26              60              26
                                 -------------------------------------------------------------------------------
    Total.......................              33  ..............              54  ..............              54
----------------------------------------------------------------------------------------------------------------

    4. 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 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.

----------------------------------------------------------------------------------------------------------------
                                                                                 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
----------------------------------------------------------------------------------------------------------------

    5. 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 49968]]



----------------------------------------------------------------------------------------------------------------
                                                                                 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
----------------------------------------------------------------------------------------------------------------

    6. Testimony by Employees and the Production of Records and 
Information in Legal Proceedings--20 CFR 403.100-403.155 --0960-0619. 
Regulations at 20 CFR 403.100-403.155 of the Code of Federal 
Regulations establish SSA's policies and procedures for an individual; 
organization; or government entity to request official agency 
information, records, or testimony of an agency employee in a legal 
proceeding when the agency is not a party. The request, which 
respondents submit in writing to SSA, must: (1) Fully set out the 
nature and relevance of the sought testimony; (2) explain why the 
information is not available by other means; (3) explain why it is in 
SSA's interest to provide the testimony; and (4) provide the date, 
time, and place for the testimony. Respondents are individuals or 
entities who request testimony from SSA employees in connection with a 
legal proceeding.
    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)
----------------------------------------------------------------------------------------------------------------
20 CFR 403.100-403.155......................             100                1               60              100
----------------------------------------------------------------------------------------------------------------

    7. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. Inmates of Federal, State, or local prisons may need a 
Social Security card as verification of their Social Security Number 
(SSN) for school or work programs, or as proof of employment 
eligibility upon release from incarceration. Before SSA can issue a 
replacement Social Security card, applicants must show SSA proof of 
their identity. People who are in prison for an extended period 
typically do not have current identity documents. Therefore, under 
formal written agreement with the correctional institution, SSA allows 
prison officials to verify the identity of certain incarcerated U.S. 
citizens who need replacement Social Security cards. Information prison 
officials provide comes from the official prison files, sent on 
correctional facility letterhead. SSA uses this information to 
establish the applicant's identity in the replacement Social Security 
card process. The respondents are prison officials who certify the 
identity of prisoners applying for replacement Social Security cards.
    Type of Request: Extension of an OMB-approved Information 
Collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                         Average burden  Estimated total
                       Modality of completion                           Number of       Frequency of      Number of       per response    annual burden
                                                                       respondents        response        responses        (minutes)         (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Verification of Prisoner Identity Statements.......................           1,000              200          200,000                3           10,000
--------------------------------------------------------------------------------------------------------------------------------------------------------

    8. Notification of a Social Security Number (SSN) to an Employer 
for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying 
for employment must provide a SSN, or indicate they have applied for 
one. However, when an individual applies for an initial SSN, there is a 
delay between the assignment of the number and the delivery of the SSN 
card. At an individual's request, SSA uses Form SSA-132 to send the 
individual's SSN to an employer. Mailing this information to the 
employer: (1) Ensures the employer has the correct SSN for the 
individual; (2) allows SSA to receive correct earnings information for 
wage reporting purposes; and (3) reduces the delay in the initial SSN 
assignment and delivery of the SSN information directly to the 
employer. It also enables SSA to verify the employer as a safeguard for 
the applicant's personally identifiable information. The majority of 
individuals who take advantage of this option are in the United States 
with exchange visitor and student visas; however, we allow any 
applicant for an SSN to use the SSA-132. The respondents are 
individuals applying for an initial SSN who ask SSA to mail 
confirmation of their application or the SSN to their employers.
    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-132.....................................         326,000                1                2           10,867
----------------------------------------------------------------------------------------------------------------



[[Page 49969]]

    Dated: September 28, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-21539 Filed 10-2-18; 8:45 am]
 BILLING CODE 4191-02-P