[Federal Register Volume 75, Number 171 (Friday, September 3, 2010)]
[Notices]
[Pages 54211-54213]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-22068]


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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 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, e-mail, or fax your 
comments and recommendations on the information collection(s) to the 
OMB Desk Officer and SSA Reports Clearance Officer to the following 
addresses or fax numbers.

(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#e7a8aeb5a6b8b492858a8e94948e8889a7888a85c9828897c9808891"><span class="__cf_email__" data-cfemail="f0bfb9a2b1afa385929d998383999f9eb09f9d92de959f80de979f86">[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#c18e918d8cef93828e81b2b2a0efa6aeb7"><span class="__cf_email__" data-cfemail="e9a6b9a5a4c7bbaaa6a99a9a88c78e869f">[email protected]</span></a>.
    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 
November 2, 2010. Individuals can obtain copies of the collection 
instruments by calling the SSA Reports Clearance Officer at 410-965-
8783 or by writing to the above e[dash]mail address.
    1. Modified Benefit Formula Questionnaire-Employer--20 CFR 401 & 
402--0960-0477. SSA collects information on Form SSA-58 to verify the 
claimant's allegations on Form SSA-150 (OMB <greek-i>0960-0395, 
Modified Benefits Formula Questionnaire). SSA uses the SSA-58 to 
determine if the modified benefit formula is applicable and when to 
apply it to a person's benefit. SSA sends Form SSA-58 to an

[[Page 54212]]

employer for pension-related information, if the claimant is unable to 
provide it. The respondents are employers of people who are eligible 
after 1985 for both Social Security benefits and a pension based on 
work not covered by SSA.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden per Response: 20 minutes.
    Estimated Annual Burden: 10,000.
    II. SSA has submitted the information collections listed below to 
OMB for clearance. Your comments on the information collections would 
be most useful if OMB and SSA receive them within 30 days from the date 
of this publication. To be sure we consider your comments, we must 
receive them no later than October 4, 2010. You can obtain a copy of 
the OMB clearance packages by calling the SSA Reports Clearance Officer 
at 410-965-8783 or by writing to the above e-mail address.
    1. Medical Report (General)--20 CFR 404.1512-404.1515, 416.912-
416.915--0960-0052. Through the State Disability Determination Services 
(DDS), SSA uses Form SSA-3826-F4 to make accurate determinations in 
disability claims cases. SSA collects the information to determine the 
claimant's physical and mental status prior to making a disability 
determination, and to document the disability claims folder with the 
medical evidence. The form provides disability adjudicators and 
reviewers with a narrative record and history of the disability and the 
objective medical findings necessary to make a disability 
determination. SSA uses the medical evidence from this form to 
determine if an individual's impairment meets the severity and duration 
requirements for disability benefits. The respondents are members of 
the medical community, including individual physicians, hospital 
doctors, medical records librarians, and other medical sources.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 150,000.
    Frequency of Response: 1.
    Average Burden per Response: 30 minutes.
    Estimated Annual Burden: 75,000 hours.
    2. Disability Report--Child--20 CFR 416.912--0960-0577. When 
claimants file for childhood disability benefits under the Supplemental 
Security Income (SSI) program, they must furnish medical and other 
evidence to prove they are disabled.
    Form SSA-3820 collects various types of information about a child's 
condition from treating sources and other medical sources of evidence. 
The DDS evaluators use the information to develop medical and school 
evidence and assess the alleged disability. The information, together 
with medical evidence, forms the evidentiary basis upon which SSA makes 
its initial disability evaluation. The respondents are claimants 
seeking SSI childhood disability payments.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                               Average burden
            Collection method                 Number of       Frequency of      per responses   Estimated annual
                                             respondents       respondents        (minutes)      burden (hours)
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SSA-3820 (Paper Form)...................               500                 1                60               500
Electronic Disability Collection System            422,000                 1                34           239,133
 EDCS)..................................
I3820 (Internet)........................            93,293                 1               120           186,586
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    Totals..............................           515,793  ................  ................           426,219
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    3. Letter to Custodian of Birth Records/Letter to Custodian of 
School Records--20 CFR 404.704, 404.716, 416.802, and 422.107--0960-
0693. SSA prepares the SSA-L106 and SSA-L706 for individuals who need 
help in obtaining evidence of their age in connection with Social 
Security number (SSN) card applications and claims for benefits. SSA 
also uses the SSA-L706 to determine the existence of primary evidence 
of age for SSN applicants. SSA uses both letters to verify with the 
issuing entity, when necessary, the authenticity of the record 
submitted by the SSN applicant or claimant. The respondents are 
schools, State and local bureaus of vital statistics, and religious 
entities.

    Note: This is a correction notice: SSA published this 
information collection with the correct burden hours at 75 FR 35512 
on June 22, 2010. However, we did not show the breakdown of burden 
hours for the different types of respondents. We are correcting that 
error here.

    Type of Request: Revision of an OMB-approved information 
collection.

                                                    SSA-L106
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                                                                               Average burden
           Type of respondents                Number of       Frequency of      per response      Total annual
                                             respondents        response          (minutes)      burden (hours)
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Private Sector..........................             1,800                 1                10               300
State/Local/Tribal Government...........             1,800                 1                10               300
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    Totals..............................             3,600  ................  ................               600
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                                                    SSA-L706
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                                                                               Average burden
           Type of respondents                Number of       Frequency of      per response      Total annual
                                             respondents        response          (minutes)      burden (hours)
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Private Sector..........................             1,800                 1                10               300
State/Local/Tribal Government...........             1,800                 1                10               300
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[[Page 54213]]

 
    Totals..............................             3,600  ................  ................               600
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    4. Cost Reimbursable Research Request--20 CFR 401.165--0960-0754. 
Qualified researchers need SSA administrative data for a variety of 
projects. To request SSA's program data for research, a researcher must 
submit a completed research application, Form SSA-9901, How to Request 
SSA Program Data for Research, for SSA's evaluation. In the 
application, the requesting researcher must provide 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 Old Age, Survivors, and 
Disability Insurance Programs, and the SSI Program. SSA reviews the 
application and, once we approve it, the researcher signs Form SSA-
9903, SSA Agreement Regarding Conditions for Use of SSA Data, which 
outlines the conditions and safeguards for the research project data 
exchange. The researcher may use the data for research and statistical 
purposes only, and must complete Form SSA-9902, Confidentiality 
Agreement. SSA recovers all expenses incurred in providing this 
information as part of this reimbursable service. The respondents are 
Federal and State government agencies or their contractors, private 
entities, and colleges or universities.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 15.
    Frequency of Response: 1.
    Average Burden per Response: 240 minutes.
    Estimated Annual Burden: 60 hours.
    5. Authorization to Release Medical Report to Physician--20 CFR 
401.55 & 401.100--0960-0761. When evidence provided by a disability 
claimant is inadequate for SSA to determine the disability, SSA 
requests a consultative examination (CE) for additional information or 
clarification. If the claimants, their court appointed representatives, 
or the parents of a minor child want the CE report sent to the 
claimant's treating physician, they complete Form SSA-91 and send it to 
SSA for processing. SSA uses the information on the SSA-91 to release 
the CE report to the authorized physician. Respondents are applicants 
for disability claims.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 7,922.
    Frequency of Response: 1.
    Average Burden per Response: 5 minutes.
    Estimated Annual Burden: 660 hours.
    6. Application Status--20 CFR 401.45--0960-0763. Application Status 
provides users with the capability to check the status of their pending 
Social Security claims either via the Internet or the National 800 
Number Automated Telephone Service. Users need their SSN and a 
confirmation number to access this information. The Application Status 
shows users when SSA received the application, if we requested 
additional documents (e.g., military discharge papers, W-2s, birth 
records, etc.), and provides the address for the office that is 
processing their application. Once SSA makes a decision on a claim, we 
post a copy of the decision notice online for the user to view. There 
are some exceptions to posting a copy online, such as disability denial 
notices (even if filed electronically), or claims that users did not 
file via the Internet, as we may not have those notices available for 
online review. Users access this application either via http://www.ssa.gov/onlineservices/, or through the National 800 Number. 
Respondents are Social Security claimants.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                               Average burden
             Type of request                  Number of       Frequency of      per response      Total annual
                                             respondents        response          (minutes)      burden  (hours)
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Automated Telephone Services............           764,885                 1                 2            25,496
Internet Services.......................         2,881,804                 1                 1            48,030
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    Totals..............................         3,646,689  ................  ................            73,526
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    Dated: August 31, 2010.
Liz Davidson,
Center Director, Center for Reports Clearance, Social Security 
Administration.
[FR Doc. 2010-22068 Filed 9-2-10; 8:45 am]
BILLING CODE 4191-02-P


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