[Federal Register Volume 84, Number 17 (Friday, January 25, 2019)]
[Notices]
[Pages 371-377]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-00194]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2018-0072]
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
[[Page 372]]
1, 1995. This notice includes revisions of OMB-approved information
collections, and one new information collection.
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-2018-0072].
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
March 26, 2019. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Tribal Council Coverage Agreement--0960-NEW. Section 218A of the
Social Security Act (Act) grants voluntary Social Security coverage to
Indian tribal council members. The coverage is voluntary for tribal
council members; however, if the tribe wishes to obtain Social Security
coverage, they must complete the agreement. Each tribe requesting
coverage fills out one agreement. SSA employees collect this
information via the paper form. The respondents are Indian tribal
councils who wish to receive Social Security coverage for their
members.
Type of Request: Request for a new 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)
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Tribal Council Coverage Agreement Form...... 100 1 10 17
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2. Request to be Selected as a Payee--20 CFR 404.2010-404.2055,
416.601-416.665--0960-0014. SSA requires an individual applying to be a
representative payee for a Social Security beneficiary or Supplemental
Security Income (SSI) recipient to complete Form SSA-11-BK, or supply
the same information to a field office technician through a personal
ingerview. SSA obtains information from applicant payees regarding
their relationship to the beneficiary; personal qualifications; concern
for the beneficiary's well-being; and intended use of benefits if
appointed as payee. The respondents are individuals; private sector
businesses and institutions; and State and local government
institutions and agencies applying to become representative payees.
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)
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Individuals/Households (90%)
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Representative Payee System (RPS)............... 1,710,000 1 12 342,000
Paper Version................................... 68,400 1 12 13,680
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Total....................................... 1,778,400 .............. .............. 355,680
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Private Sector (9%)
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Representative Payee System (RPS)............... 171,000 1 12 34,200
Paper Version................................... 6,840 1 12 1,368
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Total....................................... 177,840 .............. .............. 35,568
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State/Local/Tribal Government (1%)
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Representative Payee System (RPS)............... 19,000 1 12 3,800
Paper Version................................... 340 1 12 68
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Total....................................... 19,340 .............. .............. 3,868
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Grand Total............................. 1,975,580 .............. .............. 395,116
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3. Statement for Determining Continuing Eligibility for
Supplemental Security Income Payment--20 CFR 416.204--0960-0145. SSA
uses Form SSA-8202-BK to conduct low and middle-error profile (LEP/MEP)
telephone, or face-to-face redetermination interviews with SSI
recipients and representative payees, if applicable. SSA conducts LEP
redeterminations interviews on a 6-year cycle, and MEP redeterminations
annually. SSA requires the information we collect during the interview
to determine whether: (1) SSI recipients
[[Page 373]]
met, and continue to meet, all statutory and regulatory requirements
for SSI eligibility; and (2) the SSI recipients received, and are still
receiving, the correct payment amounts. This information includes non-
medical eligibility factors such as income, resources, and living
arrangements. To complete Form SSA-8202, the respondents may need to
obtain information from employers or financial institutions. The
respondents are SSI recipients and their representatives, if
applicable.
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)
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SSA-8202-BK..................................... 9,954 1 21 3,484
SSI Claims System............................... 2,021,883 1 20 673,944
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Totals...................................... 2,031,787 .............. .............. 677,428
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4. Internet Direct Deposit Application--31 CFR part 210--0960-0634.
SSA requires all applicants and recipients of Social Security Old Age,
Survivors, and Disability Insurance (OASDI) benefits, or SSI payments,
to receive these benefits and payments via direct deposit at a
financial institution. SSA receives Direct Deposit/Electronic Funds
Transfer (DD/EFT) enrollment information from OASDI beneficiaries and
SSI recipients to facilitate DD/EFT of their funds with their chosen
financial institution. We also use this information when an enrolled
individual wishes to change their DD/EFT information. For the
convenience of the respondents, we collect this information through
several modalities, including an internet application; in-office or
telephone interviews; and our automated telephone system. In addition
to using the direct deposit information to enable DD/EFT of funds to
the recipient's chosen financial institution, we also use the
information through our Direct Deposit Fraud Indicator to ensure the
correct recipient receives the funds. Respondents are OASDI
beneficiaries and SSI recipients requesting that we enroll them in the
Direct Deposit program, or change their direct deposit banking
information.
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)
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Internet DD..................................... 432,482 1 10 72,080
Non-Electronic Services (FO, 800#- ePath, SSI 3,227,426 1 12 645,485
Claims System, SPS, MACADE, POS, RPS)..........
Direct Deposit Fraud Indicator.................. 33,238 1 2 1,108
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Totals...................................... 3,693,146 .............. .............. 718,673
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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 February 25, 2019. Individuals can obtain copies of
the OMB clearance packages by writing to [email protected].
1. Certificate of Responsibility for Welfare and Care of Child Not
in Applicant's Custody--20 CFR 404.330, 404.339-404.341 and 404.348-
404.349--0960-0019. SSA uses Form SSA-781 to determine if non-custodial
parents who file for spouse, mother's, father's, or surviving divorced
mother's or father's benefits based on having a child in their care
meet the in-care requirements. The in-care provision requires claimants
to have an entitled child under age 16 or disabled in their care. The
respondents are applicants for spouse, mother's, father's, or surviving
divorced mother or father Social Security benefits.
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)
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SSA-781..................................... 14,000 1 10 2,333
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2. Farm Self-Employment Questionnaire--20 CFR 404.1082(c) &
404.1095--0960-0061. SSA collects the information on Form SSA-7156 on a
voluntary and as-needed basis to determine the existence of an
agriculture trade or business which may affect the monthly benefit, or
insured status, of the applicant. SSA requires the existence of a trade
or business before determining if an individual or partnership has net
earnings from self-employment. When an applicant indicates self-
employment as a farmer, SSA uses the SSA-7165 to obtain the information
we need to determine the existence of an agricultural trade or
business, and subsequent covered earnings for Social Security
entitlement purposes. As part of the application process, we conduct a
personal
[[Page 374]]
interview, either face-to-face or via telephone, and document the
interview using Form SSA-7165. We also allow applicants to complete a
fillable version of the form available on our website, which they can
complete, print, and sign. The respondents are applicants for Social
Security benefits whose entitlement depends on whether the worker
received covered earnings from self-employment as a farmer.
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)
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SSA-7156.................................... 47,500 1 10 7,917
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3. Child Relationship Statement--20 CFR 404.355 & 404.731--0960-
0116. To help determine a child's entitlement to Social Security
benefits, SSA uses criteria under section 216(h)(3) of the Act, deemed
child provision. SSA may deem a child to an insured individual if: (1)
The insured individual presents SSA with satisfactory evidence of
parenthood, and was living with or contributing to the child's support
at certain specified times; or (2) the insured individual: (a)
Acknowledged the child in writing; (b) was court decreed as the child's
parent; or (c) was court ordered to support the child. To obtain this
information, SSA uses Form SSA-2519, Child Relationship Statement. The
respondents are people with knowledge of the relationship between
certain individuals filing for Social Security benefits and their
alleged biological children.
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)
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SSA-2519.................................... 50,000 1 15 12,500
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4. Pre-1957 Military Service Federal Benefit Questionnaire--20 CFR
404.1301 -404.1371--0960-0120. SSA may grant gratuitous military wage
credits for active military or naval service (under certain conditions)
during the period September 16, 1940 through December 31, 1956, if no
other Federal agency (other than the Veterans Administration) credited
the service for benefit eligibility or computation purposes. We use
Form SSA-2512 to collect specific information about other Federal,
military, or civilian benefits the wage earner may receive when the
applicant indicates both pre-1957 military service and the receipt of a
Federal benefit. SSA uses the data in the claims adjudication process
to grant gratuitous military wage credits when applicable, and to
solicit sufficient information to determine eligibility. Respondents
are applicants for Social Security benefits on a record where the wage
earner claims pre-1957 military service.
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)
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SSA-2512.................................... 5,000 1 10 833
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5. Authorization for the Social Security Administration to Obtain
Account Records from a Financial Institution--20 CFR 416.200, 416.203,
404.508, & 416.553--0960-0293. SSA collects and verifies financial
information from individuals applying for Title II and Title XVI waiver
determinations, as well as those who apply for, or currently receive
(in the case of redetermination), SSI payments. We require the
financial information from these applicants to: (1) Determine the
eligibility of the applicant or recipient for SSI benefits; or (2)
determine if a request to waive a Social Security overpayment defeats
the purpose of the Act. If the Title II and Title XVI waiver
applicants, or the SSI claimants, provide incomplete, unavailable, or
seemingly altered records, SSA contacts their financial institutions to
verify the existence, ownership, and value of accounts owned. Financial
institutions need individuals to sign Form SSA-4641-F4, or work with
SSA staff to complete one of SSA's electronic applications, e4641 or
the Access to Financial Institutions (AFI) screens, to authorize the
individual's financial institution to disclose records to SSA. The
respondents are Title II and Title XVI recipients applying for waivers,
or SSI applicants, recipients, and their to determine SSI eligibility.
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)
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SSA-4641 (paper)................................ 140,000 1 6 14,000
[[Page 375]]
e4641 and AFI (Internet)........................ 15,860,000 1 2 528,667
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Totals...................................... 16,000,000 .............. .............. 542,667
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6. Vocational Rehabilitation Provider Claim--20 CFR 404.2108(b),
404.2117(c)(1)&(2), 404.2101(b)&(c), 404.2121(a), 416.2208(b),
416.2217(c)(1) & (2), 416.2201(b)&(c), 416.2221(a)--0960-0310. State
vocational rehabilitation (VR) agencies submit Form SSA-199 to SSA to
obtain reimbursement of costs incurred for providing VR services. SSA
requires state VR agencies to submit reimbursement claims for the
following categories: (1) Claiming reimbursement for VR services
provided; (2) certifying adherence to cost containment policies and
procedures; and (3) preparing causality statements. The respondents
provide the information requested through a web-based Secure Ticket
Portal, in lieu of submitting forms. This Portal allows VRs to retrieve
reports, and enter and submit information electronically, minimizing
the use of the paper form to SSA for consideration and approval of the
claim for reimbursement of costs incurred for SSA beneficiaries. SSA
uses the information on the SSA-199, along with the written
documentation, to determine whether, and how much, to pay State VR
agencies under SSA's VR program. Respondents are State VR agencies
offering vocational and employment services to Social Security and SSI
recipients.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated
Modality of completion (type of Number of Frequency of Number of per response total annual
response as indicated below) respondents response responses (minutes) burden (hours)
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SSA-199 CFR 404.2108 & 416.2208. 80 160 12,800 23 4,907
CFR 404.2117 & 416.2217 Written 80 1 80 60 80
requests.......................
CFR 404.2121 & 416.2221 Written 80 2.5 200 100 333
requests.......................
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Total....................... 80 .............. 13,080 .............. 5,320
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7. 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.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-765..................................... 1,925 1 30 963
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8. Request for Change in Time/Place of Disability Hearing--20 CFR
404.914(c)(2) and 416.1414(c)(2)--0960-0348. At the request of the
claimants or their representatives, SSA schedules evidentiary hearings
at the reconsideration level for claimants of Title II benefits or
Title XVI payments when we deny their claims for disability. When
claimants or their representatives find they are unable to attend the
scheduled hearing, they complete Form SSA-769 to request a change in
time or place of the hearing. SSA uses the information as a basis for
granting or denying requests for changes and for rescheduling
disability hearings. Respondents are claimants or their representatives
who wish to request a change in the time or place of their hearing.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 376]]
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-769..................................... 7,483 1 8 998
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9. Application for Supplemental Security Income--20 CFR 416.305-
416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to determine
an applicant's eligibility for SSI and SSI payment amounts. SSA
employees also collect this information during interviews with members
of the public who wish to file for SSI. SSA uses the information for
two purposes: (1) To formally deny SSI for nonmedical reasons when
information the applicant provides results in ineligibility; or (2) to
establish a disability claim, but defer the complete development of
non-medical issues until SSA approves the disability. The respondents
are applicants for SSI 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)
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SSI Claims System............................... 802,368 1 20 267,456
iClaim/SSI Claims System........................ 168,661 1 20 56,220
SSA-8001-BK (Paper Version)..................... 2,588 1 20 863
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Totals...................................... 973,617 .............. .............. 324,539
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10. Wage Reports and Pension Information--20 CFR 422.122(b)--0960-
0547. Pension plan administrators annually file plan information with
the Internal Revenue Service, which then forwards the information to
SSA. SSA maintains and organizes this information by plan number, plan
participant's name, and Social Security number. Under Section 1131(a)
of the Act, pension plan participants are entitled to request this
information from SSA. The Wage Reports and Pension Information
regulation, 20 CFR 422.122(b) of the Code of Federal Regulations,
requires requestors submit a written request with identifying
information to SSA, before SSA disseminates this information. The
respondents are requestors of pension plan information.
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)
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Requests for pension plan information....... 580 1 30 290
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11. International Direct Deposit--31 CFR part 210--0960-0686. SSA's
International Direct Deposit (IDD) Program allows beneficiaries living
abroad to receive their payments via direct deposit to an account at a
financial institution outside the United States. SSA uses Form SSA-
1199-(Country) to enroll Title II beneficiaries residing abroad in IDD,
and to obtain the direct deposit information for foreign accounts.
Routing account number information varies slightly for each foreign
country, so we use a variation of the Treasury Department's Form SF-
1199A for each country. The respondents are Social Security
beneficiaries residing abroad who want SSA to deposit their Title II
benefit payments directly to a foreign financial institution.
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)
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SSA-1199-(Country).......................... 13,750 1 5 1,146
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12. Representative Payment Policies and Administrative Procedures
for Imposing Penalties for False or Misleading Statements or
Withholding of Information--0960-0740. This information collection
request comprises several regulation sections that provide additional
safeguards for Social Security beneficiaries' whose representative
payees receive their payment. SSA requires representative payees to
notify them of any event or change in circumstances that would affect
receipt of benefits or performance of payee duties. SSA uses the
information to determine continued eligibility for benefits, the amount
of benefits due and if the payee is suitable to continue servicing as
payee. The respondents are representative payees who receive and use
benefits on behalf of Social Security beneficiaries.
Type of Collection: Revision of an OMB-approved information
collection.
[[Page 377]]
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Average burden Estimated
Regulation section Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
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404.2035(d)--Paper/Mail......................... 29,601 1 5 2,467
404.2035(d)--Office interview/Intranet.......... 562,419 1 5 46,868
404.2035(f)--Paper/Mail......................... 296 1 5 25
404.2035(f)--Office interview/Intranet.......... 5,624 1 5 469
416.635(d)--Paper/Mail.......................... 16,146 1 5 1,346
416.635(d)--Office interview/Intranet........... 296,424 1 5 24,702
416.635(f)--Paper/Mail.......................... 162 1 5 14
416.635(f)--Office interview/Intranet........... 3,067 1 5 256
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Totals...................................... 913,739 .............. .............. 76,147
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Dated: January 22, 2019.
Faye I. Lipsky,
Director, Office of Regulations and Reports Clearance, Social Security
Administration.
[FR Doc. 2019-00194 Filed 1-24-19; 8:45 am]
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