[Federal Register Volume 83, Number 111 (Friday, June 8, 2018)]
[Notices]
[Pages 26732-26736]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-12391]


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SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2018-0025]


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 revisions, and extensions, 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, 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: <a href="/cdn-cgi/l/email-protection#743b3d26352b270116191d07071d1b1a341b19165a111b045a131b02"><span class="__cf_email__" data-cfemail="c6898f94879995b3a4abafb5b5afa9a886a9aba4e8a3a9b6e8a1a9b0">[email protected]</span></a>

[[Page 26733]]

(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: <a href="/cdn-cgi/l/email-protection#1c534e324e796c736e686f325f70797d6e7d727f795c6f6f7d327b736a"><span class="__cf_email__" data-cfemail="f8b7aad6aa9d88978a8c8bd6bb949d998a99969b9db88b8b99d69f978e">[email protected]</span></a>
    Or you may submit your comments online through www.regulations.gov, 
referencing Docket ID Number [SSA-2018-0025].
    I. The information collections below are pending at SSA. SSA will 
submit them 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 
August 7, 2018. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Fee Agreement for Representation before the Social Security 
Administration--0960--NEW. Under the Social Security Act (Act), SSA 
requires individuals who represent a claimant before the agency and 
want to receive a fee for their services to obtain SSA's authorization 
of the fee. One way to obtain the authorization is to submit the fee 
agreement. To facilitate this process, individuals can use Form SSA-
1693. SSA uses the information from the SSA-1693 to review the request 
and authorize any fee to representatives who seek to charge and collect 
a fee from a claimant. The respondents are the representatives who help 
claimants through the application process.
    Note: SSA originally published this Notice on November 22, 2017, at 
82 FR 55707, and received several public comments. In response to those 
public comments, SSA revised the SSA-1693, and is republishing this 
Notice.
    Type of Request: Request for a new information collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     of  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1693....................................         600,000                1               12          120,000
----------------------------------------------------------------------------------------------------------------

    2. State Supplementation Provisions: Agreement; Payments--20 CFR 
416.2095-416.2098, and 20 CFR 416.2099--0960-0240. Section 1618 of the 
Act requires those states administering their own supplementary income 
payment program(s) to demonstrate compliance with the Act by passing 
Federal cost-of-living increases on to individuals who are eligible for 
state supplementary payments, and informing SSA of their compliance. In 
general, states report their supplementary payment information annually 
by the maintenance-of-payment levels method. However, SSA may ask them 
to report up to four times in a year by the total-expenditures method. 
Regardless of the method, the states confirm their compliance with the 
requirements, and provide any changes to their optional supplementary 
payment rates. SSA uses the information to determine each state's 
compliance or noncompliance with the pass-along requirements of the Act 
to determine eligibility for Medicaid reimbursement. If a state fails 
to keep payments at the required level, it becomes ineligible for 
Medicaid reimbursement under Title XIX of the Act. Respondents are 
state agencies administering supplemental programs.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                                     Number of     Frequency of      Number of      burden per       Estimated
     Modality of completion         respondents      Response        responses       response      total annual
                                                                                     (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
Total Expenditures..............               7               4              28              60              28
Maintenance of Payment Levels...              26               1              26              60              26
                                 -------------------------------------------------------------------------------
    Total.......................              33  ..............  ..............  ..............              54
----------------------------------------------------------------------------------------------------------------

    3. Substitution of Party Upon Death of Claimant--20 CFR 
404.957(c)(4) and 416.1457(c)(4)--0960-0288. An administrative law 
judge (ALJ) may dismiss a request for a hearing on a pending claim of a 
deceased individual for Social Security benefits or Supplemental 
Security Income (SSI) payments. Individuals who believe the dismissal 
may adversely affect them may complete Form HA-539, which allows them 
to request to become a substitute party for the deceased claimant. The 
ALJs and the hearing office support staff use the information from the 
HA-539 to: (1) Maintain a written record of request; (2) establish the 
relationship of the requester to the deceased claimant; (3) determine 
the substituted individual's wishes regarding an oral hearing or 
decision on the record; and (4) admit the data into the claimant's 
official record as an exhibit. The respondents are individuals 
requesting to be substitute parties for a deceased claimant.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     of  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
HA-539......................................           4,000                1                5              333
----------------------------------------------------------------------------------------------------------------

    4. Claimant Statement about Loan of Food or Shelter; Statement 
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA bases an SSI claimant or recipient's eligibility on 
need, as measured by the

[[Page 26734]]

amount of income an individual receives. Per our calculations, income 
includes other people providing in-kind support and maintenance in the 
form of food and shelter to SSI applicants or recipients. SSA uses 
Forms SSA-5062 and SSA-L5063 to obtain statements about food or shelter 
provided to SSI claimants or recipients. SSA uses this information to 
determine whether food or shelters are bona fide loans or income for 
SSI purposes. This determination may affect claimants' or recipients' 
eligibility for SSI as well as the amounts of their SSI payments. The 
respondents are claimants and recipients for SSI payments, and 
individuals who provide loans of food or shelter to them.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of      burden of     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-5062........................................          30,632               1              10           5,105
Paper form......................................
SSA-L5063.......................................          30,632               1              10           5,105
Paper form......................................
SSA-5062........................................          30,632               1              10           5,105
SSI Claim System................................
SSA-L5063.......................................          30,632               1              10           5,105
SSI Claim System................................
                                                 ---------------------------------------------------------------
    Total.......................................         122,528  ..............  ..............          20,420
----------------------------------------------------------------------------------------------------------------

    5. Testimony by Employees and the Production of Records and 
Information in Legal Proceedings--20 CFR 403.100-403.155-0960-0619. 
Regulations at 20 CFR 403.100-403.155 of the Code of Federal 
Regulations establish SSA's policies and procedures for an individual; 
organization; or government entity to request official agency 
information, records, or testimony of an agency employee in a legal 
proceeding when the agency is not a party. The request, which 
respondents submit in writing to SSA, must: (1) Fully set out the 
nature and relevance of the sought testimony; (2) explain why the 
information is not available by other means; (3) explain why it is in 
SSA's interest to provide the testimony; and (4) provide the date, 
time, and place for the testimony. Respondents are individuals or 
entities who request testimony from SSA employees in connection with a 
legal proceeding.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     of  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
20 CFR 403.100-403.155......................             100                1               60              100
----------------------------------------------------------------------------------------------------------------

    6. Function Report Adult-Third Party--20 CFR 404.1512 & 416.912-
0960-0635. Individuals receiving or applying for Social Security 
Disability Insurance (SSDI) or SSI provide SSA with medical evidence 
and other proof SSA requires to prove their disability. SSA, and 
Disability Determination Services (DDS) on our behalf, collect this 
information using Form SSA-3380-BK. We use the information to document 
how claimant's disabilities affect their ability to function, and to 
determine eligibility for SSI and SSDI claims. The respondents are 
third parties familiar with the functional limitations (or lack 
thereof) of claimants who apply for SSI and SSDI benefits.
    Type of Request: Revision of an OMB approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     of  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3380-BK.................................         709,700                1               61          721,528
----------------------------------------------------------------------------------------------------------------

    7. Request for Deceased Individual's Social Security Record--20 CFR 
402.130-0960-0665. When a member of the public requests an individual's 
Social Security record, SSA needs the name and address of the requestor 
as well as a description of the requested record to process the 
request. SSA uses the information the respondent provides on Form SSA-
711, or via an internet request through SSA's electronic Freedom of 
Information Act (eFOIA) website to: (1) Verify the wage earner is 
deceased; and (2) access the correct Social Security record. 
Respondents are members of the public requesting deceased individuals' 
Social Security records.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 26735]]



----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of      burden of     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
Internet Request through eFOIA..................          49,800               1               7           5,810
SSA-711 (paper).................................             200               1               7              23
                                                 ---------------------------------------------------------------
    Total.......................................          50,000  ..............  ..............           5,833
----------------------------------------------------------------------------------------------------------------

    8. Certification of Prisoner Identity Information--20 CFR 422.107-
0960-0688. Inmates of Federal, State, or local prisons may need a 
Social Security card as verification of their Social Security number 
for school or work programs, or as proof of employment eligibility upon 
release from incarceration. Before SSA can issue a replacement Social 
Security card, applicants must show SSA proof of their identity. People 
who are in prison for an extended period typically do not have current 
identity documents. Therefore, under formal written agreement with the 
correctional institution, SSA allows prison officials to verify the 
identity of certain incarcerated U.S. citizens who need replacement 
Social Security cards. Information prison officials provide comes from 
the official prison files, sent on correctional facility letterhead. 
SSA uses this information to establish the applicant's identity in the 
replacement Social Security card process. The respondents are prison 
officials who certify the identity of prisoners applying for 
replacement Social Security cards.
    Type of Request: Extension of an OMB-approved Information 
Collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Average  burden     Estimated
                       Modality of completion                           Number of       Frequency of      Number of       of  response     total annual
                                                                       respondents        response        responses        (minutes)     burden  (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Verification of Prisoner Identity Statements.......................           1,000              200          200,000                3           10,000
--------------------------------------------------------------------------------------------------------------------------------------------------------

    9. Notification of a Social Security Number (SSN) To An Employer 
for Wage Reporting--20 CFR 422.103(a)--0960-0778. Individuals applying 
for employment must provide a Social Security Number, or indicate they 
have applied for one. However, when an individual applies for an 
initial SSN, there is a delay between the assignment of the number and 
the delivery of the SSN card. At an individual's request, SSA uses Form 
SSA-132 to send the individual's SSN to an employer. Mailing this 
information to the employer: (1) Ensures the employer has the correct 
SSN for the individual; (2) allows SSA to receive correct earnings 
information for wage reporting purposes; and (3) reduces the delay in 
the initial SSN assignment and delivery of the SSN information directly 
to the employer. It also enables SSA to verify the employer as a 
safeguard for the applicant's personally identifiable information. The 
majority of individuals who take advantage of this option are in the 
United States with exchange visitor and student visas; however, we 
allow any applicant for an SSN to use the SSA-132. The respondents are 
individuals applying for an initial SSN who ask SSA to mail 
confirmation of their application or the SSN to their employers.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     of  response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-132.....................................         326,000                1                2           10,867
----------------------------------------------------------------------------------------------------------------

    10. Social Security Administration Health IT Partner Program 
Assessment--Participating Facilities and Available Content Form--20 CFR 
404.1614 and 416.1014--0960-0798. The Health Information Technology for 
Economic and Clinical Health (HITECH) Act promotes the adoption and 
meaningful use of health information technology (IT), particularly in 
the context of working with government agencies. Similarly, section 
3004 of the Public Health Service Act requires health care providers or 
health insurance issuers with government contracts to implement, 
acquire, or upgrade their health IT systems and products to meet 
adopted standards and implementation specifications. To support 
expansion of SSA's health IT initiative as defined under HITECH, SSA 
developed Form SSA-680, the Health IT Partner Program Assessment--
participating Facilities and Available Content Form. The SSA-680 allows 
healthcare providers to provide the information SSA needs to determine 
their ability to exchange health information with us electronically. We 
evaluate potential partners (i.e., healthcare providers and 
organizations) on: (1) The accessibility of health information they 
possess; and (2) the content value of their electronic health records' 
systems for our disability adjudication processes. SSA reviews the 
completeness of organizations' SSA-680 responses as one part of our 
careful analysis of their readiness to enter into a health IT 
partnership with us. The respondents are healthcare providers and 
organizations exchanging information with the agency.
    Type of Request: Extension of an OMB-approved information 
collection.

[[Page 26736]]



----------------------------------------------------------------------------------------------------------------
                                                                                Average  burden  Estimated total
           Modality of completion                Number of       Frequency of     of  response    annual burden
                                                respondents        response         (hours)          (hours)
----------------------------------------------------------------------------------------------------------------
SSA-680.....................................              30                1                5              150
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collection below to OMB for 
clearance. Your comments regarding this information collection 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 July 9, 2018. Individuals can obtain copies of the OMB 
clearance packages by writing to <a href="/cdn-cgi/l/email-protection#58170a760a3d28372a2c2b761b343d392a39363b3d182b2b39763f372e"><span class="__cf_email__" data-cfemail="541b067a0631243b2620277a1738313526353a3731142727357a333b22">[email protected]</span></a>.
    Statement of Reclamation Action--31 CFR 210--0960-0734. Regulations 
governing the Federal Government Participation in the Automated 
Clearing House: (1) Allow SSA to send Social Security payments to 
Canada; and (2) mandate the reclamation of funds paid erroneously to a 
Canadian bank, or financial institution, after the death of a Social 
Security beneficiary. SSA uses Form SSA-1713, Notice of Reclamation 
Action, to determine if, how, and when the Canadian bank or financial 
institution is going to return erroneous payments after the death of a 
Social Security beneficiary who elected to have payments sent to 
Canada. Form SSA-1712 (or SSA-1712 CN), Notice of Reclamation-Canada 
Payment Made in the United States, is the cover sheet SSA prepares to 
request return of the payment. The respondents are Canadian banks and 
financial institutions who erroneously received Social Security 
payments.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                      Average        Estimated
                                                     Number of     Frequency of      burden of     total annual
             Modality of completion                 respondents      response        response         burden
                                                                                     (minutes)        (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1712........................................               8               1               5               1
SSA-1713........................................               7               1               5               1
                                                 ---------------------------------------------------------------
    Totals......................................              15  ..............  ..............               2
----------------------------------------------------------------------------------------------------------------


    Dated: June 4, 2018.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2018-12391 Filed 6-7-18; 8:45 am]
BILLING CODE 4191-02-P


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