[Federal Register Volume 84, Number 138 (Thursday, July 18, 2019)]
[Notices]
[Pages 34469-34472]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-15249]


=======================================================================
-----------------------------------------------------------------------

SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2019-0030]


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes one extension, 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,

[[Page 34470]]

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-2019-0030].
    I. The information collection below is pending at SSA. SSA will 
submit it 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 16, 2019. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    Work Incentives Planning and Assistance Program--0960-0629. As part 
of SSA's strategy to assist Social Security Disability Insurance (SSDI) 
beneficiaries and Supplemental Security Income (SSI) recipients who 
wish to return to work and achieve self-sufficiency, SSA established 
the Work Incentives Planning and Assistance (WIPA) program. This 
community based, work incentive, planning and assistance project 
collects identifying claimant information via project sites and 
community work incentives coordinators (CWIC). SSA uses this 
information to ensure proper management of the project, with particular 
emphasis on administration, budgeting, and training. In addition, 
project sites and CWIC's collect data from SSDI beneficiaries and SSI 
recipients on background employment, training, benefits, and work 
incentives. SSA is interested in identifying SSDI beneficiary and SSI 
recipient outcomes under the WIPA program, to determine the extent to 
which beneficiaries with disabilities and SSI recipients achieve their 
employment, financial, and healthcare goals. SSA will also use the data 
in its analysis and future planning for SSDI and SSI programs. 
Respondents are SSDI beneficiaries, SSI recipients, community project 
sites, and employment advisors.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
             Modality of completion                 respondents      response        response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Small Site (Under 150 beneficiaries served) (SSA-          4,800               1              20           1,600
 4565; SSA-4566; SSA-4567)......................
Medium Site (150-599 beneficiaries served) (SSA-           7,500               1              20           2,500
 4565; SSA-4566; SSA-4567)......................
Large Site (600 or more beneficiaries served)             17,700               1              20           5,900
 (SSA-4565; SSA-4566; SSA-4567).................
                                                 ---------------------------------------------------------------
    Total Sites.................................          30,000  ..............  ..............          10,000
SSDI & SSI Beneficiaries........................          30,000               1              25          12,500
Help Line.......................................          30,000               1               5           2,500
                                                 ---------------------------------------------------------------
    Total.......................................          90,000  ..............  ..............          25,000
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these information collections would 
be most useful if OMB and SSA receive them 30 days from the date of 
this publication. To be sure we consider your comments, we must receive 
them no later than August 19, 2019. Individuals can obtain copies of 
the OMB clearance packages by writing to [email protected].
    1. Real Property Current Market Value Estimate--0960-0471. SSA 
considers an individual's resources when evaluating eligibility for 
Supplemental Security Income (SSI) payments. The value of an 
individual's resources, including non-home real property, is one of the 
eligibility requirements for SSI payments. SSA obtains current market 
value estimates of the claimant's real property through Form SSA-L2794. 
We allow respondents to use readily available records to complete the 
form, or we can accept their best estimates. We use this form as part 
of initial applications and in post-entitlement situations. The 
respondents are small business operators in real estate; state and 
local government employees tasked with assessing real property values; 
and other individuals knowledgeable about local real estate values.
    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)
----------------------------------------------------------------------------------------------------------------
SSA-L2794...................................             300                1               20              100
----------------------------------------------------------------------------------------------------------------

    2. Child Care Dropout Questionnaire--20 CFR 404.211(e)(4) --0960-
0474. If individuals applying for Title II disability benefits care for 
their own or their spouse's children under age 3, and have no steady 
earnings during the time they care for those children, they may exclude 
that period of care from the disability computation period. We call 
this the child-care dropout exclusion. SSA uses the information from 
Form SSA-4162 to determine if an individual qualifies for this 
exclusion. Respondents are applicants for Title II disability benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 34471]]



----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of    per  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4162....................................           2,000                1                5              167
----------------------------------------------------------------------------------------------------------------

    3. Medical Report on Adult with Allegation of Human 
Immunodeficiency Virus Infection; Medical Report on Child with 
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.933--
20 CFR 416.934--0960-0500. Section 1631(e)(i) of the Social Security 
Act authorizes the Commissioner of SSA to gather information to make a 
determination about an applicant's claim for SSI payments; this 
procedure is the Presumptive Disability (PD). SSA uses Forms SSA-4814-
F5 and SSA-4815-F6 to collect information necessary to determine if an 
individual with human immunodeficiency virus infection, who is applying 
for SSI disability benefits, meets the requirements for PD. The 
respondents are the medical sources of the applicants for SSI 
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-4814-F5.....................................           9,600               1               8           1,280
SSA-4815-F6.....................................              80               1              10              13
                                                 ---------------------------------------------------------------
    Totals......................................           9,680  ..............  ..............           1,293
----------------------------------------------------------------------------------------------------------------

    4. Beneficiary Recontact Report--20 CFR 404.703 & 404.705--0960-
0502. SSA investigates recipients of disability payments to determine 
their continuing eligibility for payments. Research indicates 
recipients may fail to report circumstances that affect their 
eligibility. Two such cases are: (1) When parents receiving disability 
benefits for their child marry; and (2) the removal of an entitled 
child from parents' care. SSA uses Form SSA-1588-SM to ask mothers or 
fathers about both their marital status and children under their care, 
to detect overpayments and avoid continuing payment to those are no 
longer entitled. Respondents are recipients of mothers' or fathers' 
Social Security benefits.
    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-1588-SM.................................          76,944                1                5            6,412
----------------------------------------------------------------------------------------------------------------

    5. Certification of Contents of Document(s) or Record(s)--20 CFR 
404.715--0960-0689. SSA established procedures for individuals to 
provide the evidence necessary to establish their rights to Social 
Security benefits. Examples of such evidence categories include age, 
relationship, citizenship, marriage, death, and military service. Form 
SSA-704 allows SSA employees; State record custodians; and other 
custodians of evidentiary documents to certify and record information 
from original documents and records under their custodial ownership to 
establish these types of evidence. SSA uses Form SSA-704 in situations 
where individuals cannot produce the original evidentiary documentation 
required to establish benefits eligibility. The respondents are State 
record custodians and other custodians of evidentiary documents.
    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-704.....................................             293                1               10               49
----------------------------------------------------------------------------------------------------------------

    6. Registration for Appointed Representative Services and Direct 
Payment--0960-0732. SSA uses Form SSA-1699 to register appointed 
representatives of claimants before SSA who:
     Want to register for direct payment of fees;
     Registered for direct payment of fees prior to 10/31/09, 
but need to update their information;
     Registered as appointed representatives on or after 10/31/
09, but need to update their information; or
     Received a notice from SSA instructing them to complete 
this form.
    By registering these individuals, SSA: (1) Authenticates and 
authorizes them to do business with us; (2) allows them to access our 
records for the claimants they represent; (3) facilitates direct 
payment of authorized fees to appointed representatives; and, (4) 
collects the information we need to meet Internal Revenue Service (IRS) 
requirements to

[[Page 34472]]

issue specific IRS forms if we pay an appointed representative in 
excess of a specific amount ($600). The respondents are appointed 
representatives who want to use Form SSA-1699 for any of the purposes 
cited in this Notice.
    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-1699....................................          17,700                1               20            5,900
----------------------------------------------------------------------------------------------------------------

    7. Certificate of Incapacity--5 CFR 890.302(d)--0960-0739. Rules 
governing the Federal Employee Health Benefits (FEHB) plan require a 
physician to verify the disability of Federal employees' children ages 
26 and over for these children to retain health benefits under their 
employed parents' plans. The physician must verify the adult child's 
disability: (1) Pre-dates the child's 26th birthday; (2) is very 
serious; and (3) will continue for at least one year. Physicians use 
Form SSA-604, the Certificate of Incapacity, to document and certify 
this information, and the Social Security Administration uses the 
information provided to determine the eligibility for these children, 
ages 26 and over, for coverage under a parent's FEHB plan. The 
respondents are physicians of SSA employees' children ages 26 or over 
who are seeking to retain health benefits under their parent's FEHB 
coverage.
    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-604.....................................              50                1               45               38
----------------------------------------------------------------------------------------------------------------


    Dated: July 12, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-15249 Filed 7-17-19; 8:45 am]
 BILLING CODE 4191-02-P