[Federal Register Volume 84, Number 107 (Tuesday, June 4, 2019)]
[Notices]
[Pages 25891-25895]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-11629]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2019-0023]
Agency Information Collection Activities: Proposed 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: 410-966-2830, Email address: [email protected]
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2019-0023].
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
August 5, 2019. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Lump Sum Death Payment--20 CFR 404.390-404.392--
0960-0013. SSA uses Form SSA-8 to collect information needed to
authorize payment of the lump sum death payment (LSDP) to a widow,
widower, or children as defined in section 202(i) of the Social
Security Act (Act). Respondents complete the application for this one-
time payment through use of the paper form, or person interview with an
SSA employee either via telephone, or in person in a field office. For
all personal interviews (either telephone or in-person), we collect the
information in our electronic Modernized Claim System (MCS).
Respondents are applicants for the LSDP.
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-8--MCS Screens.............................. 656,623 1 9 98,493
SSA-8--Paper Form............................... 5,484 1 10 914
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Totals...................................... 662,107 .............. .............. 99,407
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2. Report to United States Social Security Administration by Person
Receiving Benefits for a Child or for an Adult Unable to Handle Funds/
Report to the United States Social Security Administration--0960-0049.
Section 203(c) of the Act requires the Commissioner of SSA to make
benefit deductions, and provides for the Commissioner to impose penalty
deductions on benefits of individuals who fail to make timely reports
of events, which are cause for deductions. SSA uses Forms SSA-7161-OCR-
SM and SSA-7162-OCR-SM to: (1) Determine continuing entitlement to
Social Security benefits; (2) correct benefit amounts for beneficiaries
outside the United States; and (3) monitor the performance of
representative payees outside the United States. This collection is
mandatory as an annual (or every other year, depending on the country
of residence) review for fraud prevention. In addition, the results can
affect benefits by increasing or decreasing payment amount or by
causing SSA to suspend or terminate benefits. The respondents are
individuals living outside the United States who are receiving benefits
on their own (or on behalf of someone else) under Title II of the Act.
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-7161-OCR-SM................................. 42,314 1 15 10,579
SSA-7162-OCR-SM................................. 426,448 1 5 35,537
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[[Page 25892]]
Totals...................................... 468,762 .............. .............. 46,116
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3. Waiver of Your Right to Personal Appearance before an
Administrative Law Judge--20 CFR 404.948(b)(l)(i) and
416.1448(b)(l)(i)--0960-0284. Applicants for Social Security, Old Age,
Survivors and Disability Insurance (OASDI) benefits and Supplemental
Security Income (SSI) payments have the statutory right to appear in
person, or through a representative, and present evidence about their
claims at a hearing before an administrative law judge (ALJ). If
claimants wish to waive this right to appear before an ALJ, they must
do so in writing. Form HA-4608 serves as a written waiver for the
claimant's right to a personal appearance before an ALJ. The ALJ uses
the information we collect on Form HA-4608 to continue processing the
case, and makes the completed form a part of the documentary evidence
of record by placing it in the official record of the proceedings as an
exhibit. Respondents are applicants or claimants for OASDI and SSI, or
their representatives, who request to waive their right to appear in
person before an ALJ.
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)
----------------------------------------------------------------------------------------------------------------
HA-4608..................................... 12,000 1 2 400
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4. Statement for Determining Continuing Eligibility, Supplemental
Security Income Payment(s)--416.204--0960-0416. To determine whether
SSI recipients (1) have met and continue to meet all statutory and
regulatory requirements for SSI eligibility, and (2) are receiving the
correct SSI payment amount, SSA conducts redeterminations of
disability. Periodic collection of this information using Form SSA-
8203-BK is the only way SSA can make these redeterminations; and
collect the information as mandatory under the law. We routinely
collect the information in field offices via personal contact (face-to-
face or telephone interview) using the automated Modernized SSI Claim
System (MSSICS). The respondents are SSI recipients or their
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)
----------------------------------------------------------------------------------------------------------------
MSSICS.......................................... 1,468,220 1 19 464,936
Paper........................................... 135,357 1 20 45,119
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Totals...................................... 1,603,577 .............. .............. 510,055
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5. Request for Social Security Statement--20 CFR 404.810--0960-
0466. Section 205(c)(2)(A) of the Act requires the Commissioner of SSA
to establish and maintain records of wages paid to, and amounts of
self-employment income derived by, each individual as well as the
periods in which such wages were paid and such income derived. An
individual may complete and mail Form SSA-7004 to SSA to obtain a
Statement of Earnings or Quarters of Coverage. SSA uses the information
Form SSA-7004 collects to identify respondent's Social Security
earnings records; extract posted earnings information; calculate
potential benefit estimates; produce the resulting Social Security
statements; and mail them to the requesters. The respondents are Social
Security number holders requesting information about their Social
Security earnings records and estimates of their potential 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)
----------------------------------------------------------------------------------------------------------------
SSA-7004.................................... 60,026 1 5 5,002
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6. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of
SSA's disability determination process, we use Forms SSA-3375-BK
through SSA-3379-BK to request information from a child's parent or
guardian for children applying for SSI. The five different versions of
the form contain questions about the child's day-to-day functioning
appropriate to a particular age group; thus, respondents use only one
version of the form for each child. The adjudicative team (disability
examiners and medical or psychological consultants) of State
[[Page 25893]]
disability determination services offices collect the information on
the appropriate version of this form (in conjunction with medical and
other evidence) to form a complete picture of the children's ability to
function and their impairment-related limitations. The adjudicative
team uses the completed profile to determine: (1) If each child's
impairment(s) results in marked and severe functional limitations; and
(2) whether each child is disabled. The respondents are parents and
guardians of child applicants for SSI.
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-3375; SSA-3376; SSA-3377; SSA-3378; SSA- 579,000 1 20 193,000
3379.......................................
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7. Private Printing and Modification of Prescribed Application and
Other Forms--20 CFR 422.527--0960-0663. 20 CFR 422.527 of the Code of
Federal Regulations requires a person, institution, or organization
(third-party entities) to obtain approval from SSA prior to
reproducing, duplicating, or privately printing any application or
other form the agency owns. To obtain SSA's approval, entities must
make their requests in writing using their company letterhead,
providing the required information set forth in the regulation. SSA
uses the information to: (1) Ensure requests comply with the law and
regulations, and (2) process requests from third-party entities who
want to reproduce, duplicate, or privately print any SSA application or
other SSA form. SSA employees review the requests and provide approval
via email or mail to the third-party entities. The respondents are
third-party entities who submit a request to SSA to reproduce,
duplicate, or privately print an SSA-owned form.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated total
Regulation section Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
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20 CFR 422.527..................................................... 10 15 150 10 25
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8. Letter to Custodian of Birth Records/Letter to Custodian of
School Records--20 CFR 404.704, 404.716, 416.802, and 422.107--0960-
0693. When individuals need help in obtaining evidence of their age in
connection with Social Security number (SSN) card applications and
claims for benefits, SSA can prepare the SSA-L106, Letter to Custodian
of School Records, or SSA-L706, Letter to Custodian of Birth Records.
SSA uses the SSA-L706 to determine the existence of primary evidence of
age for SSN applicants. SSA uses both letters to verify with the
issuing entity, when necessary, the authenticity of the record
submitted by the SSN applicant or claimant. The respondents are
schools, State and local bureaus of vital statistics, and religious
entities.
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)
----------------------------------------------------------------------------------------------------------------
SSA-L106--Private Sector........................ 18 1 10 3
SSA-L106--State/Local/Tribal Government......... 14 1 10 2
SSA-L706--Private Sector........................ 429 1 10 72
SSA-L706--State/Local/Tribal Government......... 426 1 10 71
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Totals...................................... 887 .............. .............. 148
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9. Government-to-Government Services Online Website Registration
Form; Government-to-Government Services Online Website Account
Modification/Deletion Form--20 CFR 401.45--0960-0757. The Government-
to-Government Services Online (GSO) Website allows various external
organizations to submit files to a variety of SSA systems and, in some
cases, receive files in return. The SSA systems that process data
transferred via GSO include, but are not limited to, systems
responsible for disability processing and benefit determination or
termination. SSA uses the information on Form SSA-159, Government-to-
Government Online Website Registration Form, to register the requestor
to use the GSO Website. Once we receive the SSA-159, SSA provides the
user with account information and conducts a walkthrough of the GSO
Website as necessary. Established organizations may submit Form SSA-159
to register additional users as well. The established requesting
organizations can also complete Form SSA-160, Government-to-Government
Online Website Account Modification/Deletion Form, to modify their
online accounts (e.g., address change). Respondents are State and local
government agencies, and some private sector business entities.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 25894]]
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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-159......................................... 1,151 1 15 288
SSA-160......................................... 410 1 15 103
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Totals...................................... 1,561 .............. .............. 391
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10. Application Status--20 CFR 401.45--0960-0763. Application
Status provides users with the capability to check the status of their
pending Social Security claims via the National 800 Number Automated
Telephone Service. Users need their SSN and a confirmation number to
access this information. SSA systems determine the type of claim(s) the
caller filed based upon the information provided. Subsequently, the
automated telephone system provides callers with the option to choose
the claim for which they wish to obtain status. If the caller applied
for multiple claims, the automated system allows the caller to select
only one claim at a time. Once callers select the claim(s) they are
calling about, an automated voice advises them of the status of their
claim. The respondents are current Social Security claimants who wish
to check on the status of their claims. 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)
----------------------------------------------------------------------------------------------------------------
Application Status--Automated Telephone 248,485 1 3 12,424
System.....................................
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11. Statement for Determining Continuing Entitlement for Special
Veterans Benefits (SVB)--0960-0782. Title VIII of the Act provides for
the payment of Special Veterans benefits (SVB) to certain World War II
veterans who reside outside of the United States. SSA regularly reviews
individuals' claims for SVB to determine their continued eligibility
and correct payment amounts. Individuals living outside the United
States receiving SVB must report to SSA any changes that may affect
their benefits. These include changes such as: (1) A change in mailing
address or residence; (2) an increase or decrease in a pension,
annuity, or other recurring benefit; (3) a return or visit to the
United States for a calendar month or longer; or (4) an inability to
manage benefits. SSA uses Form SSA-2010, to collect this information.
Beneficiaries under age 90 receive notification of their benefit review
along with the form every two years, and beneficiaries age 90 or older
have face-face interviews with the Foreign Service Post every year who
assist them in completing this form. Currently, the average respondent
is over age 90, and very few respondents are under age 90. Respondents
are beneficiaries living outside the United States collecting SVB.
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-2010.................................... 382 1 20 127
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12. Evidence From Excluded Medical Sources of Evidence--20 CFR
404.1503b and 416.903b--0960-0803. Pursuant to its broad authority to
regulate under sections 205(a), 702(a)(5), and 1631(d)(1) of the Act,
SSA implemented section 223(d)(5)(C), as amended, through regulations
at 20 CFR 404.1503b and 416.903b. These regulations require excluded
medical sources to self-report their excluded status in writing each
time they submit evidence related to a claim for benefits under Titles
II or XVI of the Act. Excluded medical sources' duty to self-report
their excluded status apply to evidence they submit to SSA directly or
through a representative, claimant, or other individual or entity. The
respondents for this collection are medical sources that: (1) Meet one
of the exclusionary categories set forth in section 223(d)(5)(C)(i) of
the Act, as amended; and (2) furnish evidence related to a claim for
benefits under Titles II or XVI of the Act. Type of Request: Revision
of an OMB-approved information collection.
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Average burden Estimated total
Regulation section(s) Number of Frequency of Number of per response annual burden
respondents response responses (minutes) (hours)
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404.1503b(c), 416.903b(c).......................................... 50 60 3,000 20 1,000
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[[Page 25895]]
Dated: May 30, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-11629 Filed 6-3-19; 8:45 am]
BILLING CODE 4191-02-P