[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]
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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
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Total....................................................... 1,100 .............. 196
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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:
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Annual
Form No. responses Time (minutes) Burden (hours)
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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
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Total....................................................... 36,500 .............. 10,201
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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:
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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
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Total................................................... 20,300 .............. 16,350
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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:
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Annual
Form No. responses Time (minutes) Burden (hours)
----------------------------------------------------------------------------------------------------------------
UI-41........................................................... 100 8 13
UI-41a.......................................................... 50 8 7
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Total....................................................... 150 .............. 20
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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:
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Annual
Form No. responses Time (minutes) Burden (hours)
----------------------------------------------------------------------------------------------------------------
Form G-421F (RRA) activity...................................... 360 5 30
Form G-421F (RUIA) activity..................................... 175 5 15
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Total....................................................... 535 .............. 45
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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.
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Annual
Form No. responses Time (minutes) Burden (hours)
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G-201........................................................... 50 2 2
Web-Site Survey................................................. 300 5 25
Periodic Survey................................................. 1,020 12 204
Focus Groups.................................................... 250 120 500
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Total....................................................... 1,620 .............. 731
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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