[Federal Register Volume 84, Number 128 (Wednesday, July 3, 2019)]
[Notices]
[Pages 31972-31976]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-14173]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2019-0026]
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 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-2019-0026].
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 3, 2019. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Child's Insurance Benefits--20 CFR 404.350-
404.368, 404.603, & 416.350--0960-0010. Title II of the Social Security
Act (Act) provides for the payment of monthly benefits to children of
an insured retired, disabled, or deceased worker. Section 202(d) of the
Act discloses the conditions and requirements the applicant must meet
when filing an application. SSA uses the information on Form SSA-4-BK
to determine entitlement for children of living and deceased workers to
monthly Social Security payments. Respondents are guardians completing
the form on behalf of the children of living or deceased workers, or
the children of living or deceased workers.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 31973]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Application for Child's Insurance Benefits/Death 1,204 1 12 241
Claim/Paper SSA-4-BK...........................
Application for Child's Insurance Benefits/Death 204,777 1 11 37,542
Claim/Modernized Claims System (MCS) and
Preliminary Claims System (PCS)................
Application for Child's Insurance Benefits/Life 3,484 1 12 697
Claim/Paper SSA-4-BK...........................
Application for Child's Insurance Benefits/Life 422,267 1 11 77,416
Claim/MCS and PCS..............................
---------------------------------------------------------------
Totals...................................... 631,732 .............. .............. 115,896
----------------------------------------------------------------------------------------------------------------
2. Request for Hearing by Administrative Law Judge--20 CFR 404.929,
404.933, 416.1429, 404.1433, 418.1350, and 42 CFR 405.722--0960-0269.
When SSA denies applicants', claimants', or beneficiaries' requests for
new or continuing disability benefits or payments, the Act entitles
those applicants, claimants, or beneficiaries to request a hearing to
appeal the decision. To request a hearing, individuals complete Form
HA-501; the associated Modernized Claims System (MCS) or Supplemental
Security Income (SSI) Claims System interview; or the internet
application (i501). SSA uses the information to determine if the
individual: (1) Filed the request within the prescribed time; (2) is
the proper party; and (3) took the steps necessary to obtain the right
to a hearing. SSA also uses the information to determine: (1) The
individual's reason(s) for disagreeing with SSA's prior determinations
in the case; (2) if the individual has additional evidence to submit;
(3) if the individual wants an oral hearing or a decision on the
record; and (4) whether the individual has (or wants to appoint) a
representative. The respondents are Social Security disability
applicants and recipients who want to appeal SSA's denial of their
request for new or continued benefits for disability and non-medical
hearing requests; and Medicare Part B recipients who must pay the
Medicare Part B Income-Related Monthly Adjustment Amount.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
HA-501; MCS; SSI Claims System.................. 10,325 1 10 1,721
i501 (Internet iAppeals)........................ 653,318 1 5 54,443
---------------------------------------------------------------
Totals...................................... 663,643 .............. .............. 56,164
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3. Travel Expense Reimbursement--20 CFR 404.999(d) and 416.1499--
0960-0434. The Act provides for travel expense reimbursement from
Federal and State agencies for claimant travel incidental to medical
examinations, and to parties, their representatives, and all reasonably
necessary witnesses for travel exceeding 75 miles to attend medical
examinations; reconsideration interviews; and proceedings before an
administrative law judge. Reimbursement procedures require the claimant
to provide: (1) A list of expenses incurred, and (2) receipts of such
expenses. Federal and state personnel review the listings and receipts
to verify the reimbursable amount to the requestor. The respondents are
claimants for Title II benefits and Title XVI payments, their
representatives, and witnesses.
Type of Request: Extension 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)
----------------------------------------------------------------------------------------------------------------
404.99(d) & 416.1499........................ 60,000 1 10 10,000
----------------------------------------------------------------------------------------------------------------
4. Certificate of Coverage Request--20 CFR 404.1913--0960-0554. The
United States (U.S.) has agreements with 30 foreign countries to
eliminate double Social Security coverage and taxation where, except
for the provisions of the agreement, a worker would be subject to
coverage and taxes in both countries. These agreements contain rules
for determining the country under whose laws the worker's period of
employment is covered, and to which country the worker will pay taxes.
The agreements further dictate that, upon the request of the worker or
employer, the country under whose system the period of work is covered
will issue a certificate of coverage. The certificate serves as proof
of exemption from coverage and taxation under the system of the other
country. The information we collect assists us in determining a
worker's coverage and in issuing a U.S. certificate of coverage as
appropriate. Per our agreements, we ask a set number of questions to
the workers and employers prior to issuing a certificate of coverage;
however, our agreements with Denmark, Netherlands, Norway, and Sweden
require us to ask more questions in those countries. Respondents are
workers and employers wishing to establish exemption from foreign
Social Security taxes.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 31974]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Requests via Letter--Individuals (minus Denmark, 5,833 1 40 3,889
Netherlands, Norway, Poland & Sweden)..........
Requests via Internet--Individuals (minus 9,761 1 40 6,507
Denmark, Netherlands, Norway, Poland & Sweden).
Requests via Letter--Individuals in Denmark, 284 1 44 208
Netherlands, Norway, & Sweden..................
Requests via Letter--Individuals in Poland...... 16 1 41 11
Requests via Internet--Individuals in Denmark, 427 1 44 313
Netherlands, Norway, & Sweden..................
Requests via Internet--Individuals in Poland.... 25 1 41 17
Requests via Letter--Employers (minus Denmark, 26,047 1 40 17,365
Netherlands, Norway, Poland & Sweden)..........
Requests via Internet--Employers (minus Denmark, 39,096 1 40 26,064
Netherlands, Norway, Poland, & Sweden).........
Requests via Letter--Employers in Denmark, 1,137 1 44 834
Netherlands, Norway, & Sweden..................
Requests via Letter--Employers in Poland........ 57 1 41 39
Requests via Internet--Employers in Denmark, 1,704 1 44 1,250
Netherlands, Norway, & Sweden..................
Requests via Internet--Employers in Poland...... 86 1 41 59
---------------------------------------------------------------
Totals...................................... 84,473 .............. .............. 56,556
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5. Privacy and Disclosure of Official Records and Information;
Availability of Information and Records to the Public--20 CFR
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566. SSA
established methods for the public to: (1) Access their SSA records;
(2) allow SSA to disclose records; (3) correct or amend their SSA
records; (4) consent for release of their records; (5) request records
under the Freedom of Information Act (FOIA); and (6) request access to
an extract of their SSN record. SSA often collects the necessary
information for these requests through a written letter, with the
exception of the consent for release of records, for which we use Form
SSA-3288. The respondents are individuals requesting access to,
correction of, or disclosure of SSA records.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records............................... 10,000 1 11 1,833
Designating a Representative for Disclosure of 3,000 1 120 6,000
Records........................................
Amendment of Records............................ 100 1 10 17
Consent of Release of Records................... 3,000,760 1 3 150,038
FOIA Requests for Records....................... 15,000 1 5 1,250
Respondents who request access to an extract of 10 1 8.5 1
their SSN record...............................
---------------------------------------------------------------
Totals...................................... 3,028,870 .............. .............. 159,139
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6. Disability Report--Child--20 CFR 416.912--0960-0577--Sections
223(d)(5)(A) and 1631(e)(1) of the Act require SSI claimants to furnish
medical and other evidence to prove they are disabled. SSA uses Form
SSA-3820 to collect various types of information about a child's
condition from treating sources or other medical sources of evidence.
The State Disability Determination Services evaluators use the
information from Form SSA-3820 to develop medical and school evidence,
and to assess the alleged disability. The information, together with
medical evidence, forms the evidentiary basis upon which SSA makes its
initial disability evaluation. The respondents are claimants seeking
SSI childhood disability payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3820........................................ 177,572 1 90 266,358
EDCS............................................ 1,000 1 120 2,000
i3820........................................... 176,572 1 120 353,144
---------------------------------------------------------------
Totals...................................... 355,144 .............. .............. 621,502
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[[Page 31975]]
7. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009, and 418.1325--0960-0622. The Act states those
individuals who are dissatisfied with the results of an initial
determination regarding their Title II disability; Tile XVI disability
(SSI); Title VIII (Special Veterans benefits); or Title XVIII (Medicare
benefits), can request a reconsideration hearing. Individuals use Form
SSA-561-U2; the associated MCS or SSI Claims System interview; or the
internet application (i561) to initiate a request for reconsideration
of a denied claim. SSA uses the information to document the request and
to determine an individual's eligibility or entitlement to Social
Security benefits (Title II); SSI payments (Title XVI); Special
Veterans Benefits (Title VIII); Medicare (Title XVIII); and for initial
determinations regarding Medicare Part B income-related premium subsidy
reductions. The respondents are applicants, claimants, beneficiaries,
or recipients filing for reconsideration of an initial determination.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-561 and Modernized Claims System (MCS)...... 330,370 1 8 40,049
I561 (Internet iAppeals)........................ 1,161,300 1 5 96,775
---------------------------------------------------------------
Totals...................................... 1,491,670 .............. .............. 136,824
----------------------------------------------------------------------------------------------------------------
8. Request to Withdraw a Hearing Request; Request to Withdraw an
Appeals Council Request for Review; and Administrative Review Process
for Adjudicating Initial Disability Claims--20 CFR parts 404, 405, and
416--0960-0710. Claimants have a statutory right under the Act and
current regulations to apply for Social Security Disability Insurance
(SSDI) benefits or SSI payments. SSA collects information at each step
of the administrative process to adjudicate claims fairly and
efficiently. SSA collects this information to establish a claimant's
right to administrative review, and determine the severity of the
claimant's alleged impairments. SSA uses the information we collect to
determine entitlement or continuing eligibility to SSDI benefits or SSI
payments, and to enable appeals of these determinations. In addition,
SSA collects information on Forms HA-85 and HA-86 to allow claimants to
withdraw a hearing request or an Appeals Council review request. The
respondents are applicants for Title II SSDI or Title XVI SSI benefits;
their appointed representatives; legal advocates; medical sources; and
schools.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
20 CFR section No. respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
404.961, 416.1461, 405.330, and 405.366......... 12,220 1 20 4,073
404.950, 416.1450, and 405.332.................. 1,040 1 20 347
404.949 and 416.1449............................ 2,868 1 60 2,868
405.334......................................... 20 1 60 20
404.957, 416.1457, and 405.380.................. 21,041 1 10 3,507
405.381......................................... 37 1 30 19
405.401......................................... 5,310 1 10 885
404.971 and 416.1471............................ 1,606 1 10 268
(HA-85; HA-86)..................................
404.982 and 416.1482............................ 1,687 1 30 844
404.987 & 404.988 and 416.1487 & 416.1488 and 12,425 1 30 6,213
405.601........................................
404.1740(b)(1).................................. 150 1 2 5
416.1540(b)(1).................................. 150 1 2 5
404.1512, 404.1740(c)(4), 416.912, and 150 1 2 5
416.1540(c)(4).................................
405.372(c)...................................... 5,310 1 10 885
405.1(b)(5)..................................... 833 1 30 417
405.372(b)......................................
405.505......................................... 833 1 30 417
405.1(c)(2)..................................... 5,310 1 10 885
405.20.......................................... 5,310 1 10 885
---------------------------------------------------------------
Totals...................................... 76,300 .............. .............. 22,548
----------------------------------------------------------------------------------------------------------------
9. Request for Accommodation in Communication Method--0960-0777.
SSA allows disabled or impaired Social Security applicants,
beneficiaries, recipients, and representative payees to choose one of
seven alternative methods of communication they want SSA to use when we
send them benefit notices and other related communications. The seven
alternative methods we offer are: (1) Standard print notice by first-
class mail; (2) standard print mail with a follow-up telephone call;
(3) certified mail; (4) Braille; (5) Microsoft Word file on data CD;
(6) large print (18-point font); or (7) audio CD. However, respondents
who want to receive notices from SSA through a communication method
other than the seven methods listed above must explain their request to
us. Those respondents use Form SSA-9000 to: (1) Describe the type of
accommodation they want; (2) disclose their condition necessitating the
need for a different type of accommodation; and (3) explain why none of
the seven methods
[[Page 31976]]
described above are sufficient for their needs. SSA uses Form SSA-9000
to determine, based on applicable law and regulation, whether to grant
the respondents' requests for an accommodation based on their
impairment or disability. SSA collects this information electronically
through either an in-person interview or a telephone interview during
which the SSA employee keys in the information on our iAccommodate
Intranet screens. The respondents are disabled or impaired Social
Security applicants, beneficiaries, recipients, and representative
payees who ask SSA to send notices and other communications in an
alternative method besides the seven modalities we currently offer.
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-9000/iAccommodate....................... 5,000 1 20 1,667
----------------------------------------------------------------------------------------------------------------
10. Report of Adult Functioning-Employer--20 CFR 404.1512 and
416.912--0960-0805. Section 205(a), 223(d)(5)(A), 1631(d)(1), and
1631(e)(1) of the Act require claimants' applying for SSDI benefits or
SSI payments to provide SSA with medical and other evidence of their
disability. 20 CFR 404.1512 and 20 CFR 416.912 of the Code of Federal
Regulations provides detailed requirements of the types of evidence
SSDI beneficiaries and SSI claimants must provide showing how their
impairment(s) affect their ability to work (e.g., evidence of age;
education and training, work experience; daily activities; efforts to
work; and any other evidence). Past employers familiar with the
claimant's ability to perform work activities complete Form SSA-385-BK,
Report of Adult Functioning-Employer to provide SSA with information
about the employees day-to-day functioning in the work setting. SSA and
Disability Determination Services use the information Form SSA-3385-BK
collects as the basis to determine eligibility or continued eligibility
for disability benefits. The respondents are claimants' past employers.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
responses response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3385-BK................................. 3,601 1 20 1,200
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Dated: June 27, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-14173 Filed 7-2-19; 8:45 am]
BILLING CODE 4191-02-P