[Federal Register Volume 72, Number 50 (Thursday, March 15, 2007)]
[Notices]
[Pages 12244-12248]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-4654]


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

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 new information collections, approval of existing information 
collections, 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, faxed or e-mailed to the 
individuals at the addresses and fax numbers listed below:

(OMB), Office of Management and Budget, Attn: Desk Officer for SSA, 
Fax: 202-395-6974, E-mail address: <a href="/cdn-cgi/l/email-protection#5b1412091a04082e39363228283234351b343639753e342b753c342d"><span class="__cf_email__" data-cfemail="511e1803100e0224333c382222383e3f113e3c337f343e217f363e27">[email protected]</span></a>.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance 
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235, 
Fax: 410-965-6400, E-mail address: <a href="/cdn-cgi/l/email-protection#e5aab5a9a8cbb7a6aaa5969684cb828a93"><span class="__cf_email__" data-cfemail="4807180405661a0b07083b3b29662f273e">[email protected]</span></a>.

    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. Work History Report--20 CFR 404.1512 and 416.912--0960-0578. The 
information collected by form SSA-3369 is needed to determine 
disability by the State Disability Determination Services (DDS). The 
information will be used to document an individual's past work history. 
The respondents are applicants for Supplemental Security

[[Page 12245]]

Income (SSI) disability payments and Social Security disability 
benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 500,000 hours.
    2. Beneficiary Interview and Auditor's Observations Form--0960-
0630. The information collected through the Beneficiary Interview and 
Auditor's Observation Form, SSA-322, will be used by SSA's Office of 
the Inspector General to interview beneficiaries and/or their payees to 
determine whether representative payees are complying with their duties 
and responsibilities under SSA's regulations at 20 CFR 404.2035 and 
416.635. Respondents to this collection will be randomly selected SSI 
recipients and Social Security beneficiaries who have representative 
payees.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 2,550.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 638 hours.
    3. Report to U.S. SSA by Person Receiving Benefits for a Child or 
Adult Unable to Handle Funds & Report to U.S. SSA--0960-0049. SSA needs 
the information on Form SSA-7161-OCR-SM to monitor the performance of 
representative payees outside the U.S. and the information on Form SSA-
7162-OCR-SM to determine continuing entitlement to Social Security 
benefits and correct benefit amounts for beneficiaries outside the U.S. 
The respondents are individuals outside the U.S. who are receiving 
benefits either for someone else, or on their own behalf, under title 
II of the Social Security Act.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Form number                      respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7161-OCR-SM.................................          30,000               1              15           7,500
SSA-7162-OCR-SM.................................         236,500               1               5          19,708
                                                 ---------------------------------------------------------------
    Totals......................................         257,000  ..............  ..............          27,208
----------------------------------------------------------------------------------------------------------------

    4. Real Property Current Market Value Estimate--0960-0471. The SSA-
L2794 is used to obtain current market value estimates of real property 
owned by applicants for, or beneficiaries of, Supplemental Security 
Income payments (or a person whose resources are deemed to such an 
individual). The value of an individual's resources, including non-home 
real property is one of the eligibility requirements for SSI payments. 
The respondents are individuals with knowledge of local real property 
values.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 5,438.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 1,813 hours.
    5. Requests for Self-Employment Information, Employee Information, 
Employer Information--20 CFR 422.120--0960-0508. SSA uses forms SSA-
L2765, SSA-L3365 and SSA-L4002 to request correct information when an 
employer, employee or self-employed person reports an individual's 
earnings without a Social Security Number (SSN) or with an incorrect 
name or SSN. The respondents are employers, employees or self-employed 
individuals who are requested to furnish additional identifying 
information.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                   Form number                      respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L2765.......................................          15,400               1              10           2,567
SSA-L3365.......................................         173,100               1              10          28,850
SSA-L4002.......................................         656,000               1              10         109,333
                                                 ---------------------------------------------------------------
    Total.......................................         844,500  ..............  ..............         140,750
----------------------------------------------------------------------------------------------------------------

    6. Cost Reimbursable Research Request--0960-NEW.

Background

    The Social Security Administration (SSA) is responsible for 
administrating two cash benefit programs, notably the Old-Age, 
Survivors, and Disability Insurance (OASDI) and SSI programs. To carry 
out this task, SSA maintains a number of files with detailed 
information on individuals and their characteristics, such as 
demographics, employment, earnings, assets, disability diagnosis, 
location, and other information. While designed for SSA to carry out 
its administrative tasks, the data files offer great informational 
depth to researchers interested in SSA's programs and other research 
areas. As a result, SSA provides qualified researchers needing agency 
administrative data for a variety of projects.
    SSA's data files are governed by strict confidentiality 
restrictions and are not publicly accessible. Therefore, SSA has 
charged the Office of Research, Evaluation, and Statistics (ORES) as 
the primary interface for researchers, either within SSA or outside of 
it, who seek access to SSA's program files. To safeguard the 
information and the public trust, ORES has established comprehensive 
unified application process procedures for obtaining program data for 
research use.

The Cost Reimbursable Research Request

    To request SSA program data for research, the researcher must 
submit a

[[Page 12246]]

completed research application for SSA's evaluation. In the 
application, the requesting researcher must provide required basic 
project information and describe the way in which the proposed project 
will further SSA's mission to promote the economic security of the 
nation's people through its administration of the OASDI programs, and/
or the SSI program. Depending on the type of research data needed, the 
requesting researchers may be required to provide SSA with up to 14 \1\ 
prescribed project information elements to properly assess their data 
request.
---------------------------------------------------------------------------

    \1\ The complete application process is described in SSA's 
Program Data User Manual.
---------------------------------------------------------------------------

    Once the application is reviewed and approved by ORES a 
Reimbursable Conditions of Use Agreement is signed with the requestor 
which outlines the conditions and safeguards agreed to for the research 
project data exchange. The requestor may use the data for research and 
statistical purposes only. This is a reimbursable service and SSA 
recovers all expenses incurred in providing this information. The 
respondents to this information collection are the qualified 
researchers that request SSA administrative data for a variety of 
projects. These applicants include but are not limited to Federal and 
State government agencies and/or their contractors, private entities, 
and colleges/universities.
    Type of Request: Collection in use without OMB Control Number.
    Number of Respondents: 15.
    Frequency of Response: 1.
    Average Burden per Response: 240 minutes.
    Estimated Annual Burden: 60 hours.
    The total average annual cost for all respondents to use this 
service is approximately $112,500 or an average of $7,500 to complete a 
single request. This cost projection is an estimate of SSA's 
administrative and systems costs to analyze and provide the requested 
research data. Since this is a reimbursable, service all associated 
cost are borne by the requesters.
    7. Notice Regarding Substitution of Party On Death of Claimant-
Reconsideration of Disability Cessation--20 CFR 404.917-404.921 and 
416.1407-416.1421--0960-0351. Form SSA-770 is used when a claimant dies 
before a determination is made on that person's request for 
reconsideration on his/her disability cessation. SSA seeks a qualified 
substitute party to pursue the appeal. If the qualified substitute 
party is located, the SSA-770 is used to collect information regarding 
whether to pursue or withdraw the reconsideration request. The 
information collected on the SSA-770 forms the basis of the decision to 
continue or discontinue the appeals process. Respondents are substitute 
applicants who are pursuing a reconsideration request for a deceased 
claimant.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,200.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 100 hours.
    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. Response to Notice of Revised Determination--20 CFR 404.913-.914 
and 992(b), 416.1413-.1414 and 1492--0960-0347. Form SSA-765 is used by 
claimants to request a disability hearing and/or to submit additional 
evidence before a revised reconsideration determination is issued. The 
respondents are claimants who file for a disability hearing in response 
to a notice of revised determination for disability under the OASDI and 
SSI programs.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,925.
    Frequency of Response: 1.
    Average Burden Per Response: 30 minutes.
    Estimated Annual Burden: 963 hours.
    2. Questionnaire about Employment or Self-Employment Outside the 
United States--20 CFR 404.401(b)(1), 404.415, 404.417--0960-0050. The 
information collected on the SSA-7163 is needed to determine whether 
work performed by beneficiaries outside the United States is cause for 
deductions from their monthly Social Security Title II benefits; to 
determine which of two work tests (foreign test or regular test) is 
applicable; and to determine the months, if any, for which deductions 
should be imposed. The respondents are Title II beneficiaries living 
and working outside the United States.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 20,000.
    Frequency of Response: 1.
    Average Burden Per Response: 12 minutes.
    Estimated Annual Burden: 4,000 hours.
    3. Medical Permit Parking Application--41 CFR 101-20.104-2--0960-
0624. SSA issues medical parking assignments at SSA-owned and -leased 
facilities to individuals who have a medical condition which meets the 
criteria for medical parking. In order to issue a medical parking 
permit, SSA must obtain medical evidence from the applicant's 
physician. Form SSA-3192-F4 is used to collect this information. SSA 
then uses the information to determine whether the individual qualifies 
for a medical parking permit and whether or not to issue the permit. 
The respondents are physicians of applicants for medical parking 
permits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 800.
    Frequency of Response: 1.
    Average Burden Per Response: 60 minutes.
    Estimated Annual Burden: 800 hours.
    4. Reporting Changes that Affect Your Social Security Payment--20 
CFR 404.301-305, .310-311, .330-.333, .335-.341, .350-.352, .370-.371, 
401-.402, .408(a), .421-.425, .428-.430, .434-.437, .439-.441, 
446-.447, .450-.455, .468--0960-0073. SSA uses the information 
collected on Form SSA-1425 to determine continuing entitlement to Title 
II Social Security benefits and to determine the proper benefit amount. 
The respondents are Social Security beneficiaries receiving SSA 
retirement, disability or survivor's auxiliary benefits who need to 
report an event that could affect payments.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 70,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 5,833 hours.
    5. Disability Hearing Officer's Decision--20 CFR 404.917 and 
416.1417--0960-0441. The Social Security Act requires that SSA provide 
an evidentiary hearing at the reconsideration level of appeal for 
claimants who have received an initial or revised determination that a 
disability did not exist or has ceased. Based on the hearing, the 
disability hearing officer (DHO) completes form SSA-1207 and all 
applicable supplementary forms (which vary depending on the type of 
claim). The DHO uses the information in documenting and preparing the 
disability decision. The form will aid the DHO in addressing the 
crucial elements of the case in a sequential and logical fashion. The 
respondents are DHOs in the State DDSs.

[[Page 12247]]

    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 65,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 48,750 hours.
    6. Statement for Determining Continuing Eligibility, Supplemental 
Security Income Payment(s)--20 CFR Subpart B, 416.204--0960-0416. SSA 
uses the information collected on form SSA-8203-BK for high-error-
profile (HEP) redeterminations of disability to determine whether SSI 
recipients have met and continue to meet all statutory and regulatory 
requirements for SSI eligibility and whether they have been, and are 
still receiving, the correct payment amount. The information is 
normally completed in field offices by personal contact (face-to-face 
or telephone interview) using the automated Modernized SSI Claim System 
(MSSICS). The respondents are recipients of Title XVI benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                Collection method                   respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
MISSICS.........................................         109,012               1              20          36,337
MISSICS/Signature Proxy.........................          36,338               1              19          11,507
Paper...........................................          25,650               1              20           8,550
                                                 =================
    Totals:.....................................         171,000  ..............  ..............          56,394
----------------------------------------------------------------------------------------------------------------

    7. Information Collections Conducted by State DDSs on Behalf of 
SSA--20 CFR 404.1503a, 404.1512, 404.1513404.1512, 404.1513, 404.1514 
404.1517, 404.1519; 20 CFR subpart Q, 404.1613, 404.1614, 404.1624; 20 
CFR subpart I, 416.903a, 416.912, 416.913, 416.914, 416.917, 416.919 
and 20 CFR subpart J, 416.1013, 416.1024, 416.1014--0960-0555. The 
State DDSs collect certain information that SSA needs to correctly 
administer its disability program. This information is divided into the 
Consultative Examination (CE) and Medical Evidence of Record (MER) 
categories. There are three types of CE evidence: (a) Medical evidence 
from CE providers, in which DDSs use CE medical evidence to make 
disability determinations when the claimant's own medical sources 
cannot or will not provide the required information, (b) CE claimant 
completion of a response form where claimants indicate if they intend 
to keep their CE appointment, and (c) CE claimant completion of a form 
indicating whether they want the CE report to be sent to their doctor. 
In the MER category, the DDSs use MER information to determine a 
person's physical and/or mental status prior to making a disability 
determination. Please note that for the first time, some of the 
information included in this collection can be submitted electronically 
through the new Electronic Records Express (ERE) systems. The 
respondents are medical providers, other sources of MER, and disability 
claimants.
    Type of Collection: Revision to an existing OMB-approved 
collection.

CE

a. Medical Evidence From CE Providers

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                                                    respondents      response        response      Annual Burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper Submissions...............................       1,215,000               1              30         607,500
ERE Submisions..................................         285,000               1              15          71,250
                                                 ---------------------------------------------------------------
    Totals......................................       1,500,000  ..............  ..............         678,750
----------------------------------------------------------------------------------------------------------------

b. Claimants re Appointment Letter
    Number of Respondents: 750,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 62,500 hours.
c. Claimants re Report to Medical Provider
    Number of Respondents: 1,500,000.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 125,000 hours.

MER:

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                                     Number of     Frequency of     burden per       Estimated
                                                    respondents      response        response      annual burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Paper submissions...............................       2,480,800               1              15         620,200
C/D (Connect Direct, commercially available              218,400               1              15          54,600
 software used for electronically transferring
 medical records)...............................
ERE.............................................         100,800  ..............               7          11,760
                                                 ---------------------------------------------------------------
    Totals......................................       2,800,000  ..............  ..............         686,560
----------------------------------------------------------------------------------------------------------------



[[Page 12248]]

    Dated: March 8, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-4654 Filed 3-14-07; 8:45 am]
BILLING CODE 4191-02-P


</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>