[Federal Register Volume 84, Number 227 (Monday, November 25, 2019)]
[Notices]
[Pages 64938-64942]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-25497]


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

RAILROAD RETIREMENT BOARD


Agency Forms Submitted for OMB Review, Request for Comments

    In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 
chapter 35), the Railroad Retirement Board (RRB) is forwarding an 
Information Collection Request (ICR) to the Office of Information and 
Regulatory Affairs (OIRA), Office of Management and Budget (OMB). Our 
ICR describes the information we seek to collect from the public. 
Review and approval by OIRA ensures that we impose appropriate 
paperwork burdens.
    The RRB invites comments on the proposed collections of information 
to determine (1) the practical utility of the collections; (2) the 
accuracy of the estimated burden of the collections; (3) ways to 
enhance the quality, utility, and clarity of the information that is 
the subject of collection; and (4) ways to minimize the burden of 
collections on respondents, including the use of automated collection 
techniques or other forms of information technology. Comments to the 
RRB or OIRA must contain the OMB control number of the ICR. For proper 
consideration of your comments, it is best if the RRB and OIRA receive 
them within 30 days of the publication date.
    1. Title and purpose of information collection: Evidence of Marital 
Relationship--Living with Requirements; OMB 3220-0021.
    Under Sections 2(c) or 2(d) (45 U.S.C. 231a) of the Railroad 
Retirement Act, an applicant must submit proof of a valid marriage to a 
railroad employee. In some cases, the existence of a marital 
relationship is not formalized by a civil or religious ceremony. In 
other cases, questions may arise about the legal termination of a prior 
marriage of the employee, spouse, or widow(er). In these instances, the 
RRB must secure

[[Page 64939]]

additional information to resolve questionable marital relationships. 
The circumstances requiring an applicant to submit documentary evidence 
of marriage are prescribed in 20 CFR 219.30.
    The RRB utilizes Forms G-124, Individual Statement of Marital 
Relationship; G-124a, Certification of Marriage Information; G-237, 
Statement Regarding Marital Status; G-238, Statement of Residence; and 
G-238a, Statement Regarding Divorce or Annulment, to secure the needed 
information. Forms G-124, G-237, G-238, and G-238a can be completed 
either with assistance from RRB personnel during an in-office interview 
or by mail. One response is requested of each respondent. Completion is 
required to obtain benefits.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (84 FR 48381 on September 13, 2019) required by 
44 U.S.C 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Evidence of Martial Relationship--Living with Requirements.
    OMB Control Number: 3220-0021.
    Forms submitted: G-124, G-124a, G-237, G-238 and G-238a.
    Type of request: Revision of a currently approved collection.
    Affected public: Individuals or Households; Business or other for 
Profit.
    Abstract: Under the RRA, to obtain a benefit as a spouse of an 
employee annuitant or as the widow(er) of the deceased employee, an 
applicant must submit information to be used to determine if the 
marriage requirements for such benefits have been met. The collection 
obtains information supporting claimed common-law marriage, termination 
of previous marriages, and residency requirements.
    Changes proposed: The RRB proposes minor non-burden impacting 
changes to the forms in the collection.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-124 (in person)...............................................             125              15              31
G-124 (by mail).................................................              75              20              25
G-124a..........................................................             300              10              50
G-237 (in person)...............................................              75              15              19
G-237 (by mail).................................................              75              20              25
G-238 (in person)...............................................             150               3               8
G-238 (by mail).................................................             150               5              13
G-238a..........................................................             150              10              25
                                                                 -----------------------------------------------
    Total.......................................................           1,100  ..............             196
----------------------------------------------------------------------------------------------------------------

    2. Title and Purpose of information collection: Medical Reports; 
OMB 3220-0038.
    Under sections 2(a)(1)(iv) and 2(a)(1)(v) of the Railroad 
Retirement Act (RRA) (45 U.S.C.231a), annuities are payable to 
qualified railroad employees whose physical or mental condition makes 
them unable to (1) work in their regular occupation (occupational 
disability) or (2) work at all (total disability). The requirements for 
establishing disability and proof of continuing disability under the 
RRA are prescribed in 20 CFR 220.
    Annuities are also payable to (1) qualified spouses and widow(ers) 
under sections 2(c)(1)(ii)(C) and 2(d)(1)(ii) of the RRA who have a 
qualifying child who became disabled before age 22; (2) surviving 
children on the basis of disability under section 2(d)(1)(iii)(C), if 
the child's disability began before age 22; and (3) widow(er)s on the 
basis of disability under section 2(d)(1)(i)(B). To meet the disability 
standard, the RRA provides that individuals must have a permanent 
physical or mental condition that makes them unable to engage in any 
regular employment.
    Under section 2(d)(1)(v) of the RRA, annuities are also payable to 
remarried widow(er)s and surviving divorced spouses on the basis of, 
among other things, disability or having a qualifying disabled child in 
care. However, the disability standard in these cases is that found in 
the Social Security Act. That is, individuals must be unable to engage 
in any substantial gainful activity by reason of any medically 
determinable physical or mental impairment. The RRB also determines 
entitlement to a Period of Disability and entitlement to early Medicare 
based on disability for qualified claimants in accordance with Section 
216 of the Social Security Act.
    When making disability determinations, the RRB needs evidence from 
acceptable medical sources. The RRB currently utilizes Forms G-3EMP, 
Report of Medical Condition by Employer; G-197, Authorization to 
Disclose Information to the Railroad Retirement Board; G-250, Medical 
Assessment; G-250A, Medical Assessment of Residual Functional Capacity; 
G-260, Report of Seizure Disorder; RL-11B, Disclosure of Hospital 
Medical Records; RL-11D, Disclosure of Medical Records from a State 
Agency; RL-11D1, Request for Medical Evidence from Employers, and RL-
250, Request for Medical Assessment, to obtain the necessary medical 
evidence. One response is requested of each respondent. Completion is 
required for all forms to obtain benefits except Form RL-11D1, which is 
voluntary.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (84 FR on September 18, 2019) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Medical Reports.
    OMB Control Number: 3220-0038.
    Form(s) submitted: G-3EMP, G-197, G-250, G-250a, G-260, RL-11B, RL-
11D, RL-11D1, and RL-250.
    Type of request: Revision of a currently approved collection of 
information.
    Affected public: Individuals or households; Private Sector; State, 
Local and Tribal Government.
    Abstract: The Railroad Retirement Act provides disability annuities 
for qualified railroad employees whose physical or mental condition 
renders them incapable of working in their regular occupation 
(occupational disability) or any occupation (total disability). The 
medical reports obtain information needed for determining the nature 
and severity of the impairment.
    Changes proposed: In support of the RRB's Disability Program 
Improvement Project to enhance/improve disability case processing and 
overall program integrity, the RRB proposes the addition of proposed 
Form RL-11D1, Request for Medical Evidence from Employers, to

[[Page 64940]]

the information collection. Form RL-11D1 will be mailed by an RRB field 
office to railroad employers to obtain any medical evidence regarding 
the employee's disability that they may have acquired within the last 
18 months. A copy of the employee signed Form G-197 will be enclosed 
with the RL-11D1. The employer will return the RL-11D1 to RRB 
Headquarters certifying that they either have submitted the requested 
medical evidence or that they have no medical evidence to submit.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-3EMP..........................................................             600              10             100
G-197...........................................................           6,000              10           1,000
G-250...........................................................          11,950              30           5,975
G-250A..........................................................              50              20              17
G-260...........................................................             100              25              42
RL-11B..........................................................           5,000              10             833
RL-11D..........................................................             250              10              42
RL-11D1.........................................................             600              20             200
RL-250..........................................................          11,950              10           1,992
                                                                 -----------------------------------------------
    Total.......................................................          36,500  ..............          10,201
----------------------------------------------------------------------------------------------------------------

    3. Title and purpose of information collection: Application to Act 
as Representative Payee; OMB 3220-0052.
    Under Section 12 of the Railroad Retirement Act, the Railroad 
Retirement Board (RRB) may pay benefits to a representative payee when 
an employee, spouse or survivor annuitant is incompetent or is a minor. 
A representative payee may be a court-appointed guardian, a statutory 
conservator or an individual selected by the RRB. The procedures 
pertaining to the appointment and responsibilities of a representative 
payee are prescribed in 20 CFR 266. The forms furnished by the RRB to 
apply for representative payee status, and for securing the information 
needed to support the application follow. RRB Form AA-5, Application 
for Substitution of Payee, obtains information needed to determine the 
selection of a representative payee who will serve in the best interest 
of the beneficiary. RRB Form G-478, Statement Regarding Patient's 
Capability to Manage Benefits, obtains information about an annuitant's 
capability to manage their own benefits. The form is completed by the 
annuitant's personal physician or by a medical officer, if the 
annuitant is in an institution. It is not required when a court has 
appointed an individual or institution to manage the annuitant's funds 
or, in the absence of such appointment, when the annuitant is a minor. 
The RRB also provides representative payees with a booklet at the time 
of their appointment. The booklet, RRB Form RB-5, Your Duties as 
Representative Payee-Representative Payee's Record, advises 
representative payees of their responsibilities under 20 CFR 266.9 and 
provides a means for the representative payee to maintain records 
pertaining to the receipt and use of RRB benefits. The booklet is 
provided for the representative payee's convenience. The RRB also 
accepts records that are kept by representative payees as part of a 
common business practice. Completion is voluntary. One response is 
requested of each respondent.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (84 FR 48381 on September 13, 2019) required by 
44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Application to Act as Representative Payee.
    OMB Control Number: 3220-0052.
    Forms submitted: AA-5, G-478, and RB-5.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households; Business or other for 
Profit.
    Abstract: Under Section 12 of the Railroad Retirement Act, the 
Railroad Retirement Board (RRB) may pay benefits to a representative 
payee when an employee, spouse or survivor annuitant is incompetent or 
is a minor. The collection obtains information related to the 
representative payee application, supporting documentation and the 
maintenance of records pertaining to the receipt and use of benefits.
    Changes proposed: The RRB is proposing no changes to Forms AA-5, G-
478, and the RB-5 booklet.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
AA-5............................................................           3,000              18           900.0
    Individuals.................................................           2,250  ..............           675.0
    Institutions................................................             750  ..............           225.0
G-478...........................................................           2,000               6           200.0
RB-5............................................................          15,300              60          15,300
    Individuals.................................................          11,475  ..............          11,475
    Institutions................................................           3,825  ..............           3,825
                                                                 -----------------------------------------------
        Total...................................................          20,300  ..............          16,350
----------------------------------------------------------------------------------------------------------------

    4. Title and purpose of information collection: Employer Service 
and Compensation Reports; OMB 3220-0070.
    Section 2(c) of the Railroad Unemployment Insurance Act (RUIA) 
specifies the maximum normal

[[Page 64941]]

unemployment and sickness benefits that may be paid in a benefit year. 
Section 2(c) further provides for extended benefits for certain 
employees and for beginning a benefit year early for other employees. 
The conditions for these actions are prescribed in 20 CFR 302.
    All information about creditable railroad service and compensation 
needed by the RRB to administer Section 2(c) is not always available 
from annual reports filed by railroad employers with the RRB (OMB 3220-
0008). When this occurs, the RRB must obtain supplemental information 
about service and compensation.
    The RRB utilizes Form UI-41, Supplemental Report of Service and 
Compensation, and Form UI-41a, Supplemental Report of Compensation, to 
obtain the additional information about service and compensation from 
railroad employers. Completion of the forms is mandatory. One response 
is required of each respondent.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (84 FR 48381 on September 13, 2019) required by 
44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Employer Service and Compensation Reports.
    OMB Control Number: 3220-0070.
    Forms submitted: UI-41 and UI-41a.
    Type of request: Revision of a currently approved collection.
    Affected public: Private Sector; Businesses or other for profits.
    Abstract: The reports obtain the employee's service and 
compensation for a period subsequent to those already on file and the 
employee's base year compensation. The information is used to determine 
the entitlement to and the amount of benefits payable.
    Changes proposed: The RRB proposes minor non-burden impacting 
changes to Form UI-41a.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
UI-41...........................................................             100               8              13
UI-41a..........................................................              50               8               7
                                                                 -----------------------------------------------
    Total.......................................................             150  ..............              20
----------------------------------------------------------------------------------------------------------------

    5. Title and purpose of information collection: Repayment of Debt; 
OMB 3220-0169. When the Railroad Retirement Board (RRB) determines that 
an overpayment of Railroad Retirement Act or Railroad Unemployment 
Insurance Act benefits has occurred, it initiates prompt action to 
notify the annuitant of the overpayment and to recover the money owed 
the RRB. To effect payment of a debt by credit card, the RRB utilizes 
Form G-421F, Repayment by Credit Card. The RRB's procedures pertaining 
to benefit overpayment determinations and the recovery of such benefits 
are prescribed in 20 CFR 255 and 340.One form is completed by each 
respondent. Completion is voluntary.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (84 FR 48381 on September 13, 2019) required by 
44 U.S.C. 3506(c)(2). That request elicited no comments.

Information Collection Request (ICR)

    Title: Repayment of Debt.
    OMB Control Number: 3220-0169.
    Form(s) submitted: G-421F.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households.
    Abstract: When the RRB determines that an overpayment of benefits 
under the Railroad Retirement Act or Railroad Unemployment Insurance 
Act has occurred, it initiates action to notify the claimant of the 
overpayment and to recover the amount owed. The collection obtains 
information needed to allow for repayment by the claimant by credit 
card, in addition to the customary form of payment by check or money 
order.
    Changes proposed: The RRB proposes no changes to Form G-421F.
    The burden estimate for the ICR is as follows:

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
Form G-421F (RRA) activity......................................             360               5              30
Form G-421F (RUIA) activity.....................................             175               5              15
                                                                 -----------------------------------------------
    Total.......................................................             535  ..............              45
----------------------------------------------------------------------------------------------------------------

    6. Title and purpose of information collection: Customer 
Satisfaction Monitoring; OMB 3220-0192.
    In accordance with Executive Order 12862, the Railroad Retirement 
Board (RRB) conducts a number of customer surveys designed to determine 
the kinds and quality of services our beneficiaries, claimants, 
employers and members of the public want and expect, as well as their 
satisfaction with existing RRB services. The information collected is 
used by RRB management to monitor customer satisfaction by determining 
to what extent services are satisfactory and where and to what extent 
services can be improved. The surveys are limited to data collections 
that solicit strictly voluntary opinions, and do not collect 
information which is required or regulated. The information collection, 
which was first approved by the Office of Management and Budget (OMB) 
in 1997, provides the RRB with a generic clearance authority. This 
generic authority allows the RRB to submit a variety of new or revised 
customer survey instruments (needed to timely implement customer 
monitoring activities) to the Office of Management and Budget (OMB) for 
expedited review and approval.
    Previous Requests for Comments: The RRB has already published the 
initial 60-day notice (84 FR 48381 September 13, 2019) required by 44 
U.S.C. 3506(c)(2). That request elicited no comments.

[[Page 64942]]

Information Collection Request (ICR)

    Title: Customer Satisfaction Monitoring.
    OMB Control Number: 3220-0192.
    Form(s) submitted: G-201.
    Type of request: Extension without change of a currently approved 
collection.
    Affected public: Individuals or Households.
    Abstract: The Railroad Retirement Board (RRB) utilizes voluntary 
customer surveys to ascertain customer satisfaction with the RRB in 
terms of timeliness, appropriateness, access, and other measures of 
quality service. Surveys involve individuals that are direct or 
indirect beneficiaries of RRB services as well as railroad employers 
who must report earnings.
    Changes proposed: The RRB proposes no changes to Form G-201.

----------------------------------------------------------------------------------------------------------------
                                                                      Annual
                            Form No.                                 responses    Time (minutes)  Burden (hours)
----------------------------------------------------------------------------------------------------------------
G-201...........................................................              50               2               2
Web-Site Survey.................................................             300               5              25
Periodic Survey.................................................           1,020              12             204
Focus Groups....................................................             250             120             500
                                                                 -----------------------------------------------
    Total.......................................................           1,620  ..............             731
----------------------------------------------------------------------------------------------------------------

    Additional Information or Comments: Copies of the forms and 
supporting documents can be obtained from Kennisha Tucker at (312) 469-
2591 or [email protected].
    Comments regarding the information collection should be addressed 
to Brian Foster, Railroad Retirement Board, 844 North Rush Street, 
Chicago, Illinois 60611-1275 or [email protected] and to the OMB 
Desk Officer for the RRB, Fax: 202-395-6974, Email address: 
[email protected].

Stephanie Hillyard,
Secretary to the Board.
[FR Doc. 2019-25497 Filed 11-22-19; 8:45 am]
 BILLING CODE 7905-01-P