[Federal Register Volume 69, Number 210 (Monday, November 1, 2004)]
[Notices]
[Pages 63429-63432]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-24312]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages that will require clearance by the 
Office of Management and Budget (OMB) in compliance with Pub. L. 104-
13, the Paperwork Reduction Act of 1995, effective October 1, 1995. The 
information collection packages that may be included in this notice are 
for revisions to OMB-approved information collections and extensions 
(no change) 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 on ways to minimize 
burden on respondents, including the use of automated collection 
techniques or other forms of information technology. Written comments 
and recommendations regarding the information collection(s) should be 
submitted to the OMB Desk Officer and the SSA Reports Clearance 
Officer. The information can be mailed and/or faxed to the individuals 
at the addresses and fax numbers listed below:

(OMB), Office of Management and Budget, Fax: (202) 395-6974
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance 
Officer, 1338 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, 
Fax: (410) 965-6400

    I. The information collections listed below are pending at SSA and 
will be submitted to OMB within 60 days from the date of this notice. 
Therefore, your comments should be submitted to SSA within 60 days from 
the date of this publication. You can obtain copies of the collection 
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
    1. Reporting Events--SSI--20 CFR 416.701-.732-0960-0128. SSA 
administers Federal Supplemental Security Income (SSI) benefits under 
Title XVI of the Social Security Act. SSI is a public assistance 
program that provides benefits to individuals who are disabled, blind, 
or aged and who have limited income and resources. To assure proper 
administration of SSI benefits, SSA periodically requests information 
from individuals to reevaluate their continuing SSI eligibility and 
payment amount using Form SSA-8150-EV. The form serves as a reminder to 
individuals as to what they need to report in order to retain their 
benefits. Form SSA-8150-EV provides individuals with a way to report 
changes in their circumstances in writing. SSA uses the reported 
changes to determine SSI eligibility and correct payment amounts.
    Type of Request: Extension of an approved OMB information 
collection.
    Number of Respondents: 30,180.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 2,515 hours.
    2. Cessation or Continuance of Disability or Blindness 
Determination and Transmittal--20 CFR 404.1615, 20 CFR 404.1512, and 20 
CFR 404.1588-1599--0960-0442. Form SSA-833-C3/U3 is used by Disability 
Determination Services (DDS) to prepare continuance and cessation 
determinations of disability or blindness on Title II claims. The 
information is used in the course of the Federal SSA quality review of 
the determination. Form SSA-833-C3/U3 is also used to provide for SSA 
input on automated systems controls, e.g. establish and or cancel diary 
controls, to establish a permanent longitudinal history of the claim, 
and to supply a statistical base to provide aggregate program 
information to SSA administrators, Congress, and the President.
    Type of Request: Extension of an approved OMB information 
collection.
    Number of Respondents: 303,564.

[[Page 63430]]

    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 151,782 hours.
    3. Application to Collect a Fee for Payee Services--0960-NEW. 
Information requested on Form SSA-445 will be provided by the fee for 
payee services applicant. SSA will be the only user of this 
information. By using Form SSA-445, SSA will be able to determine 
whether the applicant meets the requirements to become a fee for 
service organizational payee, and if the applicant has provided all the 
information and documentation required. Based on the information 
provided on Form SSA-445, SSA will issue a determination authorizing or 
denying permission to collect fees for payee services.
    Type of Request: New information collection.
    Number of Respondents: 100.
    Frequency of Response: 1.
    Average Burden Per Response: 3 minutes.
    Estimated Annual Burden: 5 hours.
    4. Agreement to Sell Property--20 CFR 416.1240-1245--0960-0127. 
Individuals or couples who are otherwise eligible for SSI benefits, but 
who's resources exceed the allowable limit, may receive conditional 
payments if they agree to dispose of the excess non-liquid resources 
and make repayment. Form SSA-8060-U3 is used to document this agreement 
and to ensure that the individuals understand their obligations. 
Respondents are applicants and recipients of SSI benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden Per Response: 10 Minutes.
    Estimated Annual Burden: 3,333 Hours.
    5. Epidemiological Research Request--20 CFR 401.165--0960-NEW. 
Section 311 of the Social Security Independence and Program 
Improvements Act of 1994 directed SSA to provide support to health 
researchers involved in epidemiological research. Specifically, when 
the study is determined to contribute to a national health interest, 
SSA will furnish information regarding whether a study subject is shown 
on the SSA administrative records as being alive or deceased (vital 
status). SSA will recoup all expenses incurred in providing this 
information. SSA collects information from health researchers in order 
to provide the data required and to collect fees. Respondents are 
applicants for vital status information.
    Type of Request: Collection in use without OMB number.
    Number of Respondents: 25.
    Frequency of Response: 1.
    Average Burden Per Response: 120 minutes.
    Estimated Annual Burden: 50 hours.
    6. Student Reporting Form--20 CFR 404.367, 404.368, 404.415, 
404.434, 404.452(b)(2)--0960-0088. Form SSA-1383 is used by Social 
Security student beneficiaries to report events or changes that may 
affect continuing entitlement to these benefits. The respondents are 
Social Security student beneficiaries.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 75,000.
    Frequency of Response: 1.
    Average Burden Per Response: 6 minutes.
    Estimated Annual Burden: 7,500 hours.
    7. Electronic Benefit Verification Information--20 CFR 401.40--
0960-0595. SSA provides verification of benefits, when requested, to 
individuals receiving Title II and/or Title XVI benefits. In order to 
provide to the public an easy and convenient means of requesting 
benefit information, SSA has developed an electronic request form that 
will allow persons to request the information through the Internet. The 
information collected on the electronic screens will be used by SSA to 
process the request for a benefit verification statement. To ensure 
appropriate confidentiality, the statement will be mailed to the 
recipient/beneficiary address shown in SSA's records. The respondents 
are Title II and XVI recipients/beneficiaries who request benefit 
verification information using the Internet.
    Type of Request; Extension of an approved OMB information 
collection
    Number of Respondents: 133,920.
    Frequency of Response: 1.
    Average Burden Per Response: \1/2\ minute.
    Estimated Annual Burden: 1,116 hours.
    8. Listing of Impairments--Part 404, Subpart P, Appendix I--0960-
0642.

Background

    The Listing of Impairments (the listings), Part 404, Subpart P, 
Appendix I, describes for each of the major body systems, impairments 
which are severe enough to prevent an individual from doing any gainful 
activity. As part of the listings, we provide an introductory text, 
which identifies specific requirements that affect the body system, 
such as documentation requirements and other factors that must be 
considered when evaluating impairments within that body system. These 
can include requirements for medical and other evidence. This clearance 
request covers sections in the following listings that contain 
information collection requirements: The regulations for the 
musculoskeletal body system contain reporting requirements at sections 
1.00B, 1.00C, 1.00D, 1.00E, 1.00H, 1.00I, 1.00J, 1.00K, 1.00P, 14.09A, 
101.00B, 101.00C, 101.00D, 101.00E, 101.00H, 101.00I, 101.00J, 101.00P, 
and 114.09A. The regulations for the cardiovascular body system contain 
reporting requirements at sections 4.00B, 4.00C, 4.00D, 4.00E, 4.00F, 
4.00G, 4.02A, 104.00B, 104.00C, 104.00E, and 104.06. The regulations 
for the genitourinary body system contain reporting requirements at 
sections 6.00C, 6.00E, 6.00G, 106.00C, 106.00E, and 106.00G. The 
regulations for the skin body system contain reporting requirements at 
sections 8.00C, 8.00D, 108.00B, 108.00C, and 108.00D. The regulations 
for the multiple body system contain reporting requirements at sections 
10.00B, 10.00C, 110.00B, and 110.00C. The regulations for Amyotrophic 
Lateral Sclerosis (ALS) contain reporting requirements at sections 
11.00G and 11.10. The regulations for the malignant neoplastic diseases 
contain reporting requirements at 13.00B, 13.00D, 13.00E, 13.00G, 
13.00K, 113.00B, 113.00D, 113.00E, 113.00G, and 113.00K.

The Information Collection

    The medical evidence documentation described in the listings is 
used by State DDSs to assess the alleged disability. The information, 
together with other evidence, is used to determine if an individual 
claiming disability benefits has an impairment that meets severity and 
duration requirements. The respondents are disability applicants and 
other sources of evidence. SSA uses various forms to collect the 
information specified in the regulations. The public reporting burden 
is accounted for in the Information Collection Requests for these 
forms. Consequently, we are assigning a placeholder of 1-hour to the 
specific reporting requirements in theses listings so that we do 
duplicate the burden assigned to the forms.
    Type of Request: Extension of an approved OMB information 
collection.
    9. Social Security Disability Report--20 CFR 404.1512 & 416.912--
0960-0579. SSA requires applicants for disability payments to furnish 
medical, work history, and other evidence or information indicating 
they have an impairment which is disabling. This

[[Page 63431]]

information is collected by form SSA-3368, the Adult Disability Report, 
and is used by State DDSs to make disability determinations for SSA.
    The respondents are applicants for Title II and Title XVI 
disability benefits. These applicants may complete the form using any 
of the following modalities: (1) The traditional paper form; (2) an 
interview with an SSA field office representative, using the Electronic 
Disability Collection System (EDCS); (3) the Internet (i3368); and (4) 
a new modality, the i3368-PRO, an Internet form designed to be 
completed by representatives of applicants for disability payments. The 
latter three versions of the form collect the same information as the 
paper form, but may be formatted differently and include certain 
enhancements (ex: self-help screens) to guide the claimant or 
interviewer through the application process.
    Type of Request: Revision to an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                Collection format                   respondents      response        response     annual  burden
                                                                                      (hours)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper version)........................          10,000               1               1          10,000
Field office/Electronic Disability Collection          1,956,667               1               1       1,956,667
 System (EDCS)..................................
i3368 (Internet version; Hour burden varies from          66,000               1          2\1/2\         165,000
 1\1/2\-3 hours, depending on information
 required)......................................
i3368-PRO.......................................          84,000               1          1\1/2\         126,000
                                                 -----------------
      Totals....................................       2,116,667  ..............  ..............       2,257,667
----------------------------------------------------------------------------------------------------------------

    II. The information collections listed below have been submitted to 
OMB for clearance. Your comments on the information collections would 
be most useful if received by OMB and SSA within 30 days from the date 
of this publication. You can obtain a copy of the OMB clearance 
packages by calling the SSA Reports Clearance Officer at 410-965-0454, 
or by writing to the address listed above.
    1. The Census Bureau Survey of Income and Program Participation 
(SIPP) on Behalf of the Social Security Administration (SSA)--0960-NEW. 
SSA has requested the Census Bureau to include in its SIPP interviews 
scheduled for January 2005 a sample of social security disabled 
insurance beneficiaries and SSI recipients. SSA will use these data to 
conduct statistical research of recipients of SSA-administered 
programs. The SIPP for SSA Beneficiaries is a household-based survey 
molded around a central ``core'' of labor force and income questions. 
The core is supplemented with questions designed to address specific 
needs, such as obtaining information about assets and liabilities, as 
well as expenses related to work, health care, child support and real 
estate/dependent care. These supplemental questions are included with 
the core and are referred to as ``topical modules.''
    The topical modules for the SIPP for SSA Beneficiaries collect 
information about:
    <bullet> Medical Expenses and Utilization of Health Care (Adults 
and Children).
    <bullet> Work-Related Expenses, Child Support Paid and Child Care 
Poverty.
    <bullet> Assets, Liabilities, and Eligibility.
    <bullet> Dependent Care.
    The survey will include approximately 2,000 households. We estimate 
that each household will average 2.1 people, yielding 4,200 interviews. 
On average interviews take 45 minutes. The survey interviews will be 
conducted from January 1, 2005 through January 31, 2005.
    Type of Request: New Information Collection.
    Number of Respondents: 4,200.
    Frequency of Response: 1.
    Average Burden per Response: 45 minutes.
    Estimated Annual Burden: 3,150 hours.
    2. Employee Identification Statement--20 CFR 404.702--0960-0473. 
The information collected on Form SSA-4156 is needed in scrambled 
earnings situations when two or more individuals have used the same 
social security number (SSN), or when an employer (or employers) have 
reported earnings for two or more employees under the same SSN. The 
information on the form is used to help identify the individual (and 
the SSN) to whom the earnings belong. The respondents are employers who 
have reported erroneous wages.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 4,750.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Average Burden: 792 hours.
    III. Agency Information Collection Activities: Emergency 
Consideration Request SSA is requesting emergency consideration from 
OMB two weeks from the date of publication of the information 
collection listed below. Therefore, please submit your comments prior 
to this date.
    1. Public Understanding Measurement System (PUMS) 0960-NEW. As 
required by Section 2(b) of the Government Performance and Results Act 
(GPRA), which provides that Agencies establish the means for measuring 
their progress in achieving agency-level goals, SSA established the 
PUMS in 1998 as a tool for measuring its performance in meeting its 
strategic objectives in the area of public knowledge about and 
understanding of the Social Security program. The instrument used in 
PUMS is a national phone survey of adult Americans (age 18 and over) 
conducted annually for SSA by a professional polling organization.
    SSA has recently revised its strategic performance objective to 
``measure the percent of adult Americans who are knowledgeable about 
the current Social Security program and related issues, including long-
range financing.'' For 2004, SSA has adjusted its PUMS process to 
collect data on this revised measure. Once this data is collected, then 
SSA will set a strategic performance goal with yearly performance 
targets as required by the GPRA.
    The survey instrument is designed to collect knowledge data at the 
national level via 1,400 national surveys. Additionally, the survey is 
designed to assure a valid knowledge measure for key populations toward 
which SSA has targeted education and outreach programs. This 
information is a crucial step in making SSA more focused and effective 
in its communication programs. The respondents will be randomly 
selected adults residing in the United States.
    Type of Request: Emergency.
    Number of Respondents: 1,400.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.

[[Page 63432]]

    Estimated Annual Burden: 350 hours.

    Dated: October 25, 2004.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 04-24312 Filed 10-29-04; 8:45 am]
BILLING CODE 4191-02-P