[Federal Register Volume 73, Number 181 (Wednesday, September 17, 2008)]
[Notices]
[Pages 53919-53922]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-21591]


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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 requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law (Pub. L.) 
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
This notice includes revisions to OMB-approved information collections 
and extensions (no change) of existing 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 the 
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 the SSA Reports Clearance Officer to the 
addresses or 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#6d22243f2c323e180f00041e1e0402032d02000f4308021d430a021b"><span class="__cf_email__" data-cfemail="622d2b30233d3117000f0b11110b0d0c220d0f004c070d124c050d14">[email protected]</span></a>.
(SSA), Social Security Administration, DCBFM,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#024d524e4f2c50414d427171632c656d74"><span class="__cf_email__" data-cfemail="dc938c9091f28e9f939cafafbdf2bbb3aa">[email protected]</span></a>.
    I. The information collections listed below are pending at SSA. SSA 
will submit them to OMB within 60 days from the date of this notice. 
Therefore, your comments would be most helpful if you submit them to 
SSA within 60 days from the date of this publication. Individuals can 
obtain copies of the collection instruments by calling the SSA Reports 
Clearance Officer at 410-965-0454 or by writing to the e-mail address 
listed above.
    1. Supplement to Claim of Person Outside the United States--20 CFR 
404.460, 404.463, 422.505(b), 42 CFR 407.27(c)--0960-0051. SSA uses the 
information collected from Form SSA-21 to determine continuing 
entitlement to Social Security benefits and the proper benefit amounts 
of alien beneficiaries living outside the United States. SSA also uses 
the information to determine whether benefits are subject to 
withholding tax. The respondents are individuals entitled to Social 
Security benefits who are, will be, or have been residing outside the 
United States.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 35,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 5,833 hours.
    2. Coverage of Employees of State and Local Governments--20 CFR 
404, Subpart M--0960-0425. The Code of Federal Regulations at 20 CFR 
404 prescribe the rules for states submitting reports of deposits and 
related recordkeeping to SSA. States (and interstate instrumentalities) 
are required to provide wage and deposit-related contribution 
information for pre-1987 periods. The respondents are state and local 
governments or interstate instrumentalities.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 52.
    Frequency of Response: 1.
    Average Burden per Response: 1 hour.
    Estimated Annual Burden: 52 hours.
    3. Medical Report on Adult with Allegation of Human 
Immunodeficiency Virus Infection; Medical Report on Child with 
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.993-
416.994--0960-0500. SSA uses Forms SSA-4814-F5 and SSA-4815-F6 to 
collect information necessary to determine if an individual with Human 
Immunodeficiency Virus (HIV) infection, who is applying for 
Supplemental Security Income (SSI) disability benefits, meets the 
requirements for presumptive disability payments. The respondents are 
the medical sources of the applicants for SSI disability payments.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 59,100.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 9,850 hours.
    4. Application To Collect a Fee for Payee Services--20 CFR 
404.2040(a), 416.640(a) 416.1103(f)--0960-0719. SSA uses Form SSA-445 
to collect information to make a determination whether to authorize or 
deny permission to collect fees for payee services. The respondents are 
private sector businesses or state and local government offices 
applying to become a fee-for-service organizational representative 
payee.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 100.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 17 hours.
    5. Request To Be Selected as a Payee--20 CFR 404.2010-404.2055, 
416.601-416.665--0960-0014. An individual applying to be a 
representative payee for a Social Security or SSI recipient completes 
Form SSA-11-BK. SSA designed the form to aid the investigation of a 
payee applicant. SSA uses the information to establish the applicant's 
relationship to the beneficiary, his/her justification and his/her 
concern for the beneficiary, as well as the manner in which the 
applicant will use the benefits. The respondents are representative 
payee applicants for Titles II, VIII, XVI.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 1,500,000.
    Estimated Annual Burden: 248,335 hours.

[[Page 53920]]



----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                Collection method                    Number of     Frequency of     burden per     Total annual
                                                    respondents      response        response         burden
----------------------------------------------------------------------------------------------------------------
Individuals/Households (90%):
    Representative Payee System (RPS)...........         135,000               1            10.5          23,625
    RPS/Signature Proxy.........................         765,000               1             9.5         121,125
      Paper Version.............................         450,000               1            10.5          78,750
                                                 ---------------------------------------------------------------
        Totals..................................       1,350,000  ..............  ..............         223,500
Private Sector (9%):
    RPS.........................................          13,500               1            10.5           2,363
    RPS/Signature Proxy.........................          76.500               1             9.5          12,113
    Paper Version...............................          45,000               1            10.5           7,875
                                                 ---------------------------------------------------------------
        Totals..................................         135,000  ..............  ..............          22,351
State/Local/Tribal Government (1%):
    RPS.........................................           1,500               1            10.5             263
    RPS/Signature Proxy.........................           8,500               1             9.5           1,346
    Paper Version...............................           5,000               1            10.5             875
                                                 ---------------------------------------------------------------
        Totals..................................          15,000  ..............  ..............           2,484
                                                 ---------------------------------------------------------------
            Grand Total:........................       1,500,000  ..............  ..............         248,335
----------------------------------------------------------------------------------------------------------------

    6. Modified Benefit Formula Questionnaire--Foreign Pension--0960-
0561. SSA uses the information collected on Form SSA-308 to determine 
exactly how much (if any) of a foreign pension may be used to reduce 
the amount of Title II Social Security retirement or disability 
benefits under the modified benefit formula. The respondents are 
applicants for Title II Social Security retirement or disability 
benefits who have foreign pensions.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 8,333 hours.
    7. Claimant's Work Background--20 CFR 404.1565(b), 20 CFR 
416.965(b)--0960-0300. SSA uses the information from form HA-4633 when 
an individual has requested a hearing before an administrative law 
judge (ALJ) on the issue of whether or not he or she is disabled. The 
completed HA-4633 provides an updated summary of the individual's 
relevant work history, information the ALJ requires in assessing a 
claimant's disability within the meaning of the Social Security Act. 
The respondents are members of the public who have filed for disability 
benefits under Title II and/or Title XVI and have requested a hearing 
before an ALJ.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 151,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 37,750 hours.
    II. SSA has submitted the information collections listed below. 
Your comments on the information collections will be most useful if OMB 
and SSA receive them within 30 days from the date of this publication. 
You can request a copy of the information collections by e-mail, 
<a href="/cdn-cgi/l/email-protection#3976697574176b7a76794a4a58175e564f"><span class="__cf_email__" data-cfemail="206f706c6d0e72636f605353410e474f56">[email protected]</span></a>, fax 410-965-6400, or by calling the SSA Reports 
Clearance Officer at 410-965-0454.
    1. Statement Regarding Date of Birth and Citizenship--20 CFR 
404.716--0960-0016. Form SSA-702 collects information needed when 
preferred or other evidence is not available to prove age or 
citizenship for an individual applying for Social Security benefits. 
SSA uses the information to establish age as a factor of entitlement to 
Social Security benefits or U.S. citizenship as a payment factor. 
Respondents are individuals with knowledge about the date of birth and/
or citizenship of applicants for one or more Social Security benefits 
who need to establish their dates of birth as a factor of entitlement 
or U.S. citizenship as a factor of payment.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 1,200.
    Frequency of Response: 1.
    Average Burden per Response: 10 minutes.
    Estimated Annual Burden: 200 hours.
    2. Application for Benefits under a U.S. International Social 
Security Agreement--20 CFR 404.1925--0960-0448. SSA uses information 
from Form SSA-2490-BK to determine entitlement to Social Security 
benefits from the United States or from a country that has entered into 
a Social Security agreement with the United States. The respondents are 
individuals who are applying for old age, survivors or disability 
benefits from the United States or from a Totalization agreement 
country.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 26,700.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Average Burden: 13,350 hours.
    3. Plan for Achieving Self-Support--20 CFR 416.110(e), 416.1180-
1182, 416.1225-1227--0960-0559. SSA collects the information on Form 
SSA-545 when an SSI applicant/recipient desires to use available income 
and resources to obtain education and/or training in order to become 
self-supportive. SSA uses the information to evaluate the recipient's 
plan for achieving self-support to determine whether to approve the 
plan under the provisions of the SSI program. The respondents are SSI 
applicants/recipients who are blind or disabled and want to develop a 
plan to go to work.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 7,000.
    Frequency of Response: 1.
    Average Burden per Response: 2 hours.
    Estimated Annual Burden: 14,000 hours.
    4. Authorization to Disclose Information to Social Security 
Administration--20 CFR 404.1512 & 20 CFR 416.912--0960-0623. SSA must 
obtain sufficient medical evidence to make eligibility determinations 
for Social Security disability benefits and

[[Page 53921]]

SSI payments. For SSA to obtain medical evidence, an applicant must 
authorize his or her medical source(s) to release the information to 
SSA. The applicant may use Form SSA-827 to provide consent for the 
release of information. Generally, the State Disability Determination 
Service completes the form(s) based on information provided by the 
applicant, and sends the form(s) to the designated medical source(s). 
The respondents are applicants for Title II benefits and Title XVI 
payments.
    Type of Request: Revision of a currently approved information 
collection.

                            Reading, Signing, and Dating the 1st SSA-827 (10 Minutes)
----------------------------------------------------------------------------------------------------------------
                                                                                   Estimated
                                                 Number of       Total annual      number of       Total burden
              Total respondents               reports by each     responses       minutes per         hours
                                                 respondent                         response
----------------------------------------------------------------------------------------------------------------
3,853,928...................................               1        3,853,928               10          642,321
----------------------------------------------------------------------------------------------------------------


                                  Signing and Dating Three Additional SSA-827s
----------------------------------------------------------------------------------------------------------------
                                                                                   Estimated
                                                 Number of       Total annual      number of       Total burden
              Total respondents               reports by each     responses       minutes per         hours
                                                 respondent                         response
----------------------------------------------------------------------------------------------------------------
3,853,928...................................               3       11,561,784                1          192,696
----------------------------------------------------------------------------------------------------------------


                             Reading the Explanation of the SSA-827 on the Internet
----------------------------------------------------------------------------------------------------------------
                                                                                   Estimated
                                                 Number of       Total annual      number of       Total burden
              Total respondents               reports by each     responses       minutes per         hours
                                                 respondent                         response
----------------------------------------------------------------------------------------------------------------
586,232.....................................               1          586,232                3           29,312
----------------------------------------------------------------------------------------------------------------

    Collectively:
    Number of Respondents: 3,853,928.
    Frequency of Response (Average per case): 4.
    Average Burden per Response: 13 minutes to complete all 4 forms.
    Average Burden to Read Internet Instructions: 3 minutes.
    Estimated Annual Burden for Reading Internet Explanation: 29,312.
    Estimated Annual Burden to read instructions and complete the form: 
864,329 hours.
    5. Review of the Disability Hearing Officer's Reconsidered 
Determinations Before It Is Issued--20 CFR 404.913-404.918, 404.1512-
404.1515, 404.1589, 416.912-416.915, 416.989, 416.1413-416.1418, 
404.918(d) and 416.1418(d)--0960-0709. When SSA approves a claim for 
Social Security disability benefits or SSI payments, it periodically 
conducts a continuing disability review (CDR) during which the agency 
reviews the claimant's status to see if his/her condition has improved 
to the point where the claimant is capable of working. If SSA notifies 
a claimant that the agency will cease paying benefits, the claimant may 
appeal that determination. The first appeal gives the claimant the 
opportunity for a full evidentiary hearing before a disability hearing 
officer (DHO). A federal component reviews a small sample of the DHO's 
determinations. It is rare for the reviewing component to reverse a DHO 
determination favorable to the claimant. Before SSA can produce the 
unfavorable determination, the claimant has 10 days to provide a 
written statement explaining why SSA should not stop payments. That 
written statement is the information collected in this process. 
Respondents are CDR claimants whose benefits are going to cease.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 8.
    Frequency of Response: 1.
    Average Burden per Response: 60 minutes.
    Estimated Annual Burden: 8 hours.
    6. Farm Arrangement Questionnaire--20 CFR 404.1082(c)--0960-0064. 
When self-employed workers submit earnings data to SSA, they cannot 
count rental income from a farm unless they demonstrate ``material 
participation'' in the farm's operation. A material participation 
arrangement means the farm owners who are seeking to have earnings 
counted by SSA must perform a combination of physical duties, 
management decisions, and capital investment in the farm they are 
renting out. In such cases, SSA uses form SSA-7157, the Farm 
Arrangement Questionnaire, to document material participation. The 
respondents are workers who are renting farmland to other people and 
who are involved in the operation of the farm and want to claim 
countable income from their work there.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 38,000.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 19,000 hours.
    7. Disability Update Report--20 CFR 404.1589-.1595, 416.988-.996--
0960-0511. SSA periodically reviews current disability cases to 
determine if the recipients should continue to receive disability 
payments. In cases where these reviews indicate beneficiaries might 
have experienced a medical improvement, SSA must investigate further. 
The agency uses form SSA-455/SSA-455-OCR-SM, the Disability Update 
Report, for this purpose. Specifically, SSA uses the information it 
gathers on this form to determine if (1) there is enough evidence to 
warrant referring the beneficiary for a full medical CDR (2) the 
beneficiary's impairment has not changed enough to warrant a CDR; or 
(3) there are unresolved work-related issues for the beneficiary. The 
respondents are Title II

[[Page 53922]]

and Title XVI disability payment recipients.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 880,000.
    Frequency of Response: 1.
    Average Burden per Response: 15 minutes.
    Estimated Annual Burden: 220,000 hours.

    Dated: September 10, 2008.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E8-21591 Filed 9-16-08; 8:45 am]
BILLING CODE 4191-02-P


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