[Federal Register Volume 64, Number 150 (Thursday, August 5, 1999)]
[Notices]
[Pages 42747-42748]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-20153]
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SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
In compliance with Pub. L. 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. Workers' Compensation/Public Disability Benefit Questionnaire--
0960-0247. Form SSA-546 is used by the Social Security Administration
(SSA) whenever an applicant for Title II (Disability Insurance Benefits
(DIB)) indicates he or she has filed for, or intends to file for
Workmen's Compensation/Public Disability Benefits (WC/PDB). The form
consolidates all the information necessary to identify the WC/PDB
applied for and/or received, determines whether offset is applicable
under the statute and, when applicable, computes the offset. The
respondents are applicants for Title II benefits (DIB).
Number of Respondents: 100,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 25,000 hours.
2. Statement of Marital Relationship (by One of the Parties)--0960-
0038. SSA uses the information collected on Form SSA-754 to determine
whether the conditions for establishing a common-law marriage under
state law are met. The respondents are applicants for spouse's
benefits.
Number of Respondents: 30,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 15,000 hours.
3. Student Reporting Form--0960-0088. Form SSA-1383 is used by
Social Security student beneficiaries to report events or changes that
may affect continuing entitlement to these benefits. The respondents
are Social Security Student Beneficiaries.
Number of Respondents: 75,000.
Frequency of Response: 1.
Average Burden Per Response: 6 minutes.
Estimated Annual Burden: 7,500 hours.
4. Reporting Changes that Affect Your Social Security Payment-0960-
0073. SSA uses the information collected on form SSA-1425 to determine
continuing entitlement to Social Security Benefits and to determine the
proper benefit amount. The respondents are Social Security
beneficiaries who need to report an event which could affect payments.
Number of Respondents: 70,000.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 5,833 hours.
[[Page 42748]]
5. Black Lung Student's Statement Regarding Resumption of School
Attendance and Report of Black Lung Student Beneficiary at End of
School Year (two forms)--0960-0314. The information collected on forms
SSA-2602 and SSA-2613 is used by SSA to determine whether or not an
entitled student beneficiary will resume (or has resumed) full-time
school attendance at an approved educational institution. If so, the
student will be continuously entitled to benefits. The respondents are
children of disabled or deceased coal miners and officials of schools
they attend.
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SSA-2602 SSA-2613
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Number of Respondents........................... 50 100
Frequency of Response........................... 1 1
Average Burden Per Response (minutes)........... 5 7\1/2\
Estimated Annual Burden (hours) 4 12
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II. The information collection listed below has been submitted to
OMB for clearance. Written comments and recommendations on the
information collection 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 package by calling the SSA Reports Clearance Officer on (410)
965-4145, or by writing to him.
1. Report on Individual with Mental Impairment--0960-0058. Form
SSA-824 is used by the Social Security Administration to determine the
claimant's medical status prior to making a disability determination.
The respondents are physicians, medical directors, medical record
librarians and other health professionals.
Number of Respondents: 50,000.
Frequency of Response: 1.
Average Burden Per Response: 36 minutes.
Estimated Annual Burden: 30,000 hours.
2. Report of Student Beneficiary at End of School Year--0960-0089.
The information collected on Form SSA-1388 is used by SSA to verify a
student's full-time attendance at an approved educational institution.
The respondents are secondary school student beneficiaries or claimants
who are enrolled full time.
Number of Respondents: 200,000.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 33,333 hours.
3. Request for Claimant Conference--0960-NEW. As part of SSA's
disability redesign effort, SSA is testing modifications to the
disability determination procedures. One aspect of the tests includes
notifying claimants when the initial determination of disability by the
State agency will be less than fully favorable. The State agency making
the determination must send a written notice to the claimant offering
him or her the opportunity to have a conference with the Disability
Adjudicator and to provide an opportunity to submit additional
evidence. The claimant can respond by either completing and returning
the form (SSA-378) enclosed with the notice or by telephoning the
Disability Adjudicator. Based on the reply, the Disability Adjudicator
can schedule a conference, request additional medical evidence, and/or
await the receipt of additional evidence or complete the processing of
the claim. The respondents are claimants for title II and title XVI
disability benefits whose claims will receive a less than fully
favorable determination.
Number of Respondents: 163,000.
Frequency of Response: 1.
Average Burden Per Response: 1.5 minutes.
Estimated Annual Burden: 4,075 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: July 30, 1999.
Nicholas E. Tagliareni,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 99-20153 Filed 8-4-99; 8:45 am]
BILLING CODE 4190-29-P
