[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]
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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.
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Average
Number of Frequency of burden per Estimated
Modality of completion respondents response response total annual
(minutes) burden (hours)
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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
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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 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.
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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
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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]]
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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
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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.
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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
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Totals...................................... 9,680 .............. .............. 1,293
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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.
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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
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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.
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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-704..................................... 293 1 10 49
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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.
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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
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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.
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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
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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