[Federal Register Volume 82, Number 180 (Tuesday, September 19, 2017)]
[Notices]
[Pages 43804-43806]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-19865]



[[Page 43804]]

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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2017-0052]


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#2d62647f6c727e584f40445e5e4442436d42404f0348425d034a425b"><span class="__cf_email__" data-cfemail="4e01071c0f111d3b2c23273d3d2721200e21232c602b213e60292138">[email protected]</span></a>.
(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#5c130e720e392c332e282f721f30393d2e3d323f391c2f2f3d723b332a"><span class="__cf_email__" data-cfemail="48071a661a2d38273a3c3b660b242d293a29262b2d083b3b29662f273e">[email protected]</span></a>. 
Or you may submit your comments online through www.regulations.gov, 
referencing Docket ID Number [SSA-2017-0052].

    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 20, 2017. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Letter to Employer Requesting Information About Wages Earned By 
Beneficiary--20 CFR 404.1520, 20 CFR 404.1571-404.1576, 20 CFR 
404.1584-404.1593, and 20 CFR 416.971-416.976--0960-0034. Social 
Security disability recipients receive payments based on their 
inability to engage in substantial gainful activity (SGA) because of a 
physical or mental condition. If the recipients work, SSA must evaluate 
and determine if they continue to meet the disability requirements of 
the law. Therefore, we use Form SSA-L725 to request monthly earnings 
information from the recipient's employer. We then use the earnings 
data to determine whether the recipient is engaging in SGA, since work 
after a recipient becomes entitled to benefits can cause a cessation of 
disability. The respondents are businesses that employ Social Security 
disability recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-L725....................................         150,000                1               40          100,000
----------------------------------------------------------------------------------------------------------------

    2. Certification of Low Birth Weight for SSI Eligibility of Funds 
You Provided to Another and Statement of Funds You Received--20 CFR 
416.931, 416.926a(m), and 416.924--0960-0720. Hospitals and claimants 
use Form SSA-3380 to provide medical information to local field offices 
(FO) and the Disability Determination Services (DDS) on behalf of 
infants with low birth weight. FOs use the form as a protective filing 
statement, and the medical evidence respondents provide on the form to 
make presumptive disability findings, which allow expedited payment to 
eligible claimants. DDSs use the medical information to determine 
disability and continuing disability. The respondents are hospitals and 
claimants who have information identifying low birth weight babies and 
their medical conditions.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3380....................................          28,125                1               15            7,031
----------------------------------------------------------------------------------------------------------------

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these information collections 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 October 19, 2017. Individuals can obtain copies of 
the OMB clearance packages by writing to <a href="/cdn-cgi/l/email-protection#753a275b2710051a0701065b3619101407141b1610350606145b121a03"><span class="__cf_email__" data-cfemail="7c332e522e190c130e080f523f10191d0e1d121f193c0f0f1d521b130a">[email protected]</span></a>.
    1. Statement of Marital Relationship (By one of the parties)--20 
CFR 404.726--0960-0038. SSA must obtain a signed statement from a 
spousal applicant if the applicant claims a common-law marriage to the 
insured in a state in which such marriages are recognized, and no 
formal marriage documentation exists. SSA uses information we collect 
on Form SSA-754-F4 to determine if an individual applying for spousal 
benefits meets the criteria of common-law marriage under state law. The 
respondents are applicants for spouse's Social Security benefits or 
Supplemental Security Income (SSI) payments.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 43805]]



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                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-754-F4..................................          30,000                1               30           15,000
----------------------------------------------------------------------------------------------------------------

    2. Workers' Compensation/Public Disability Questionnaire--20 CFR 
404.408--0960-0247. Section 224 of the Social Security Act (Act) 
provides for the reduction of disability insurance benefits (DIB) when 
the combination of DIB and any workers' compensation (WC) or certain 
Federal, State, or local public disability benefits (PDB) exceeds 80 
percent of the worker's pre-disability earnings. SSA field office staff 
conduct face-to-face interviews with applicants using the electronic 
SSA-546 WC/PDB screens in the Modernized Claims System (MCS) to 
determine if the worker's receipt of WC or PDB payments will cause a 
reduction of DIB. Respondents are Title Title II disability applicants 
who receive both disability insurance benefits and worker's 
compensation.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
           Modality of completion                Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-546 MCS Screens.........................         248,000                1               15           62,000
----------------------------------------------------------------------------------------------------------------

    3. Medicaid Use Report--20 CFR 416.268--0960-0267. Section 20 CFR 
416.268 of the Code of Federal Regulations requires SSA to determine 
eligibility for: (1) Special SSI cash payments and, (2) special SSI 
eligibility status for a person who works despite a disabling 
condition. Section 20 CFR 416.268 also provides that, to qualify for 
special SSI eligibility status, an individual must establish that 
termination of eligibility for benefits under Title XIX of the Act 
would seriously inhibit the ability to continue employment. SSA 
employees collect the information this regulation requires from 
respondents during a personal interview. We then use this information 
to determine if an individual is entitled to special Title XVI SSI 
payments and, consequently, to Medicaid. The respondents are SSI 
recipients for whom SSA has stopped payments based on earnings.
    Type of Request: Extension of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                 Average burden  Estimated total
             Regulation section                  Number of       Frequency of     per response    annual burden
                                                respondents        response        (minutes)         (hours)
----------------------------------------------------------------------------------------------------------------
20 CFR 416.268..............................          60,000                1                3            3,000
----------------------------------------------------------------------------------------------------------------

    4. Public Information Campaign--0960-0544. Periodically, SSA sends 
various public information materials, including public service 
announcements; news releases; and educational tapes, to public 
broadcasting systems so they can inform the public about various 
programs and activities SSA conducts. SSA frequently sends follow-up 
business reply cards for these public information materials to obtain 
suggestions for improving them. The respondents are broadcast sources.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                         Average burden  Estimated total
                       Modality of completion                           Number of       Frequency of      Number of       per response    annual burden
                                                                       respondents        response       respondents       (minutes)         (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Radio..............................................................           5,000                2           10,000                1              167
--------------------------------------------------------------------------------------------------------------------------------------------------------

    5. Help America Vote Act--0960-0706. House Rule 3295, the Help 
America Vote Act of 2002, mandates that States verify the identities of 
newly registered voters. When newly registered voters do not have 
driver's licenses or State-issued ID cards, they must supply the last 
four digits of their Social Security number to their local State 
election agencies for verification. The election agencies forward this 
information to their State Motor Vehicle Administration (MVA), and the 
State MVA inputs the data into the American Association of MVAs, a 
central consolidation system that routes the voter data to SSA's Help 
America Vote Verification (HAVV) system. Once SSA's HAVV system 
confirms the identity of the voter, the information returns along the 
same route in reverse until it reaches the State election agency. The 
respondents are the State MVAs seeking to confirm voter identities.
    Correction Notice: SSA is updating the burden information for this 
collection, so it differs from the information we published at 82 FR 
31132, on 7/5/17. We are also including the cost burden, which we 
inadvertently did not publish in the previous Notice.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 43806]]



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                                                                                                                         Average burden  Estimated total
                       Modality of completion                           Number of       Frequency of      Number of       per response    annual burden
                                                                       respondents        response        responses        (minutes)         (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
HAVV...............................................................              48          102,877        4,938,096                2          164,603
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Cost Burden: The 48 State MVAs participating in HAVA each pay an 
annual maintenance cost. Additionally, States pay .02 cents per 
verification request. Therefore, the total cost to respondents is 
$291,348.
    6. Medicare Subsidy Quality Review Forms--20 CFR 418(b)(5)--0960-
0707. The Medicare Modernization Act of 2003 mandated the creation of 
the Medicare Part D prescription drug coverage program and provides 
certain subsidies for eligible Medicare beneficiaries to help pay for 
the cost of prescription drugs. As part of its stewardship duties of 
the Medicare Part D subsidy program, SSA must conduct periodic quality 
review checks of the information Medicare beneficiaries report on their 
subsidy applications (SSA-1020, OMB No. 0960-0696). SSA uses the 
Medicare Quality Review program to conduct these checks. The 
respondents are applicants for the Medicare Part D subsidy whom SSA 
chose to undergo a quality review.
    Type of Request: Revision of an OMB-approved information 
collection.

----------------------------------------------------------------------------------------------------------------
                                                                                  Average burden     Estimated
                Form No. and name                    Number of     Frequency of    per response    total annual
                                                    respondents      response        (minutes)    burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9301 (Medicare Subsidy Quality Review Case             3,500               1              30           1,750
 Analysis Questionnaire)........................
SSA-9302 (Notice of Quality Review                         3,500               1              15             875
 Acknowledgement Form for those with Phones)....
SSA-9303 (Notice of Quality Review                           350               1              15              88
 Acknowledgement Form for those without Phones).
SSA-9308 (Request for Information)..............           7,000               1              15           1,750
SSA-9310 (Request for Documents)................           3,500               1               5             292
SSA-9311 (Notice of Appointment--Denial--                    450               1              15             113
 Reviewer Will Call)............................
SSA-9312 (Notice of Appointment--Denial--Please               50               1              15              13
 Call Reviewer).................................
SSA-9313 (Notice of Quality Review                         2,500               1              15             625
 Acknowledgement Form for those with Phones)....
SSA-9314 (Notice of Quality Review                           500               1              15             125
 Acknowledgement Form for those without Phones).
                                                 ---------------------------------------------------------------
    Totals......................................          21,350  ..............  ..............           5,631
----------------------------------------------------------------------------------------------------------------

    7. Electronic Records Express (Third Parties)--20 CFR 404.1700--
404.1715--0960-0767. Electronic Records Express (ERE) is an online 
system which enables medical providers and various third party 
representatives to download and submit disability claimant information 
electronically to SSA as part of the disability application process. To 
ensure only authorized people access ERE, SSA requires third parties to 
complete a unique registration process if they wish to use this system. 
This information collection request (ICR) includes the third-party 
registration process; the burden for submitting evidence to SSA is part 
of other, various ICRs. The respondents are third party representatives 
of disability applicants or recipients who want to use ERE to 
electronically access clients' disability files online and submit 
information to SSA.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                         Average burden  Estimated total
                       Modality of completion                           Number of       Frequency of      Number of       per response    annual burden
                                                                       respondents        response        responses        (minutes)         (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
ERE--Third Parties.................................................          10,413              319        3,321,747                1           55,362
--------------------------------------------------------------------------------------------------------------------------------------------------------


    Dated: September 13, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-19865 Filed 9-18-17; 8:45 am]
 BILLING CODE 4191-02-P


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