[Federal Register Volume 65, Number 1 (Monday, January 3, 2000)]
[Notices]
[Pages 156-157]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-34004]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
In compliance with Public Law 104-13, the Paperwork Reduction Act
of 1995, SSA is providing notice of its information collections that
require submission to the Office of Management and Budget (OMB). 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.
I. The information collections listed below will be submitted to
OMB within 60 days from the date of this notice. Therefore, comments
and recommendations regarding the information collections would be most
useful if received by the Agency within 60 days from the date of this
publication. Comments should be directed to the SSA Reports Clearance
Officer at the address listed at the end of this publication. You can
obtain a copy of the collection instruments by calling the SSA Reports
Clearance Officer on (410) 965-4145, or by writing to him at the
address listed at the end of this publication.
1. Report to United States Social Security Administration by Person
Receiving Benefits for a Child or Adult Unable to Handle Funds--0960-
0049. The information on Forms SSA-7161-OCR-SM and 7162-OCR-SM is used
by the Social Security Administration (SSA) to determine continuing
entitlement and proper benefit amounts for Social Security
beneficiaries who live outside the United States (U.S.). The
respondents are persons living outside the U.S. who are entitled to
benefits or who are representative payees for an entitled beneficiary.
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SSA-7161-OCR-SM SSA-7162-OCR-SM
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Number of Respondents:................................................ 30,000 200,000
Frequency of Response:................................................ 1 1
Average Burden Per Response (minutes):................................ 15 5
Estimated Annual Burden (hours):...................................... 7,500 16,667
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2. State Agency Schedule for Equipment Purchases for SSA Disability
Programs--0960-0406. SSA uses the information collected on Form SSA-871
to budget and account for expenditures of funds for equipment purchases
by the State Disability Determination Services (DDS) that administer
the disability determination program. The respondents are State
governments that make disability determinations.
Number of Respondents: 54.
Frequency of Response: 4.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 216 hours.
3. Physical Residual Functional Capacity Assessment; Mental
Residual Functional Capacity Assessment--0960-0431. The information
collected on forms SSA-4734-BK and SSA-4734-BK-SUP is needed by SSA to
assist in the adjudication of disability claims involving physical and/
or mental impairments. The forms assist the State DDS to evaluate
impairment(s) by providing a standardized data collection format to
present findings in a clear, concise and consistent manner. The
respondents are State DDSs administering title II and title XVI
disability programs.
Number of Responses: 1,130,772.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 376,924 hours.
4. Letter to Employer Requesting Wage Information--0960-0138. The
information collected on form SSA--L4201 is used by SSA to determine
eligibility and proper benefit payments for SSI applicants/recipients.
The respondents are employers of applicants for and recipients of SSI
payments.
Number of Respondents: 133,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 66,500 hours.
5. Privacy and Disclosure of Official Records and Information:
Availability of Information and Records to the Public--20 CFR 401 and
402--0960-0566. The respondents are individuals requesting access to
their SSA records, correction of their SSA records and disclosure of
SSA records. This information is required to:
(a) Identify individuals who request access to their records:
[[Page 157]]
Number of Respondents: 10,000.
Frequency of Response: On Occasion.
Average Burden Per Response: 11 minutes.
Estimated Annual Burden: 1,833.
(b) Designate an individual to receive and review a recordholder's
sensitive medical records in accordance with 20 CFR 401.55 and for
disclosure of such records to the recordholder by his/her designee:
Number of Respondents: 3,000.
Frequency of Response: On Occasion.
Average Burden Per Response: 2 hrs.
Estimated Annual Burden: 6,000 hrs.
(c) Correct or amend records:
Number of Respondents: 100.
Frequency of Response: On Occasion.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 17 hrs.
(d) Obtain consent from an individual to release his/her records to
others. Consents are submitted by letter in writing or by use of an
SSA-3288:
Number of Respondents: 200,000.
Frequency of Response: On Occasion.
Average Burden Per Response: 3 minutes.
Estimated Annual Burden: 10,000 hrs.
(e) Facilitate the release of information under the Freedom of
Information Act (FOIA):
Number of Respondents: 15,000.
Frequency of Response: On Occasion.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 1,250.
(f) Grant Waiver or reduction of fees for records requested under
FOIA:
Number of Respondents: 400.
Frequency of Response: On Occasion.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 33 hrs.
II. The information collections listed below have been submitted to
OMB for clearance. Written comments and recommendations on the
information collections would be most useful if received within 30 days
from the date of this publication. Comments should be directed to the
SSA Reports Clearance Officer and the OMB Desk Officer at the addresses
listed at the end of this publication. You can obtain a copy of the OMB
clearance packages by calling the SSA Reports Clearance Officer on
(410) 965-4145, or by writing to him.
1. Partnership Questionnaire--0960-0025. Form SSA-7104 is used to
establish several aspects of eligibility for benefits, including
accuracy of reported partnership earnings, the veracity of a
retirement, and lag earnings where they are needed for insured status.
The respondents are applicants for OASDI and disability benefits.
Number of Respondents: 12,350.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 6,175 hours.
2. Report of New Information in Disability Cases--0960-0071. The
information collected on Form SSA-612 is used to update the disability
records of respondents, based on changes reported. The respondents are
applicants for and recipients of title II disability benefits.
Number of Respondents: 27,000.
Frequency of Response: 1.
Average Burden Per Response: 6 minutes.
Estimated Annual Burden: 2,700 hours.
3. Claimant's Recent Medical Treatment--0960-0292. The information
collected on Form HA-4631 is used to provide an updated medical history
for a disability claimant who requests a hearing and to afford
claimants their statutory right to a hearing and decision under the
Social Security Act. The respondents are claimants requesting hearings
on entitlement to benefits based on disability under title II (Old-Age,
Survivors and Disability Insurance) and/or title XVI (Supplemental
Security Income) of the Social Security Act.
Number of Respondents: 309,490.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 51,582 hours.
4. Supplemental Security Income (SSI)--Quality Review Case
Analysis--0960-0133. Form SSA-8508-BK is used with a sample of SSI
recipients in a personal interview and covers all elements of SSI
eligibility. The information obtained is used to assess the
effectiveness of SSI policies and procedures and to establish payment
accuracy rates. The respondents are SSI Recipients.
Number of Respondents: 15,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 15,000 hours.
5. Psychiatric Review Technique--0960-0413. The information
collected on Form SSA-2506 is needed by SSA to facilitate the
adjudication of claims involving mental impairments. The information is
used to identify the need for additional evidence for the determination
of impairment severity; to consider aspects of mental impairment
relevant to the individual's ability to work; and to organize and
present the findings in a clear, concise manner. The respondents are
State DDS's administering titles II and XVI disability programs.
Number of Respondents: 1,005,804.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 251,451 hours.
6. Instructions for Completion of Federal Assistance Application
Form SSA-96 for SSA Research and Demonstration Grant Programs--0960-
0184. The information collected on form SSA-96 is needed by SSA to
evaluate and select grant proposals for funding. The respondents are
applicants for Federal assistance, including State and local
governments, educational institutions and other nonprofit and for-
profit organizations.
Number of Respondents: 150.
Frequency of Response: 1.
Average Burden Per Response: 14 hours.
Estimated Annual Burden: 2,100 hours.
7. Work Activity Report--Employee. 0960-0059. The information on
form SSA-821-BK will be used by the Social Security Administration
(SSA) to obtain work issue information from beneficiaries in face-to-
face interviews, telephone interviews, or by mail during the initial
claims process, during the continuing disability review process, and
whenever a work issue arises in SSI claims. The purpose of the SSA-821-
BK is to collect information concerning whether beneficiaries have
worked in employment after becoming disabled and, if so, whether that
work is substantial gainful activity. The information will be used to
determine if the recipient continues to meet the disability
requirements of the law.
Number of Respondents: 300,000.
Frequency of Response: 1.
Average Burden Per Response: 45 minutes.
Estimated Annual Burden: 225,000 hours.
SSA Address: Social Security Administration, DCFAM, Attn: Frederick
W. Brickenkamp, 6401 Security Blvd., 1-A-21 Operations Bldg.,
Baltimore, MD 21235.
OMB Address: Office of Management and Budget, OIRA, Attn: Desk
Officer for SSA, New Executive Office Building, Room 10230, 725 17th
St., NW, Washington, DC 20503.
Dated: December 22, 1999.
Nicholas E. Tagliareni,
Director, Center for Publications Management, Social Security
Administration.
[FR Doc. 99-34004 Filed 12-30-99; 8:45 am]
BILLING CODE 4191-02-U
