[Federal Register Volume 79, Number 46 (Monday, March 10, 2014)]
[Notices]
[Pages 13368-13369]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-05054]
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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 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions 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: [email protected].
(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: [email protected].
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 May
9, 2014. Individuals can obtain copies of the collection instruments by
writing to the above email address.
1. Statement Regarding Marriage--20 CFR 404.726--0960-0017.
According to section 216(h)(1)(A) of the Social Security Act (Act), SSA
must apply state law when determining an individual's marital status.
Some state laws recognize marriages without a ceremony (i.e., common-
law marriages). In such cases, SSA provides the same spouse or
widow(er) benefits to common-law spouses as it does to ceremonially
married spouses. To determine if someone is a common-law spouse, SSA
must elicit information from blood relatives or other persons who are
knowledgeable about the alleged common-law relationship. SSA uses Form
SSA-753, Statement Regarding Marriage, to collect information from
third parties to verify the applicant's statements about intent,
cohabitation, and holding out to the public as married, which are the
basic tenets of a common-law marriage. SSA uses the information to
determine if a valid marital relationship exists, and if the common-law
spouse is entitled to Social Security spouse or widow(er) benefits. The
respondents are third parties who can confirm or deny an alleged
common-law marriage.
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)
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SSA-753..................................... 40,000 1 9 6,000
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2. Request for Review of Hearing Decision/Order--20 CFR 404.967--
404.981, 416.1467-416.1481--0960-0277. Claimants have a statutory right
under the Act and current regulations to request review of an
administrative law judge's (ALJ) hearing decision or dismissal of a
hearing request on Title II and Title XVI claims. Claimants may request
Appeals Council review by filing a written request using Form HA-520.
SSA uses the information to establish the claimant filed the request
for review within the prescribed time and to ensure the claimant
completed the requisite steps permitting the Appeals Council review.
The Appeals Council uses the information to: (1) Document the
claimant's reason(s) for disagreeing with the ALJ's decision or
dismissal; (2) determine whether the claimant has additional evidence
to submit; and (3) determine whether the claimant has a representative
or wants to appoint one. The respondents are claimants requesting
review of an ALJ's decision or dismissal of hearing.
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)
----------------------------------------------------------------------------------------------------------------
HA-520...................................... 171,000 1 10 28,500
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[[Page 13369]]
II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding the 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 April 9, 2014. Individuals can obtain copies of the OMB
clearance packages by writing to [email protected].
1. State Mental Institution Policy Review Booklet--20 CFR 404.2035,
404.2065, 416.635, & 416.665--0960-0110. SSA uses Form SSA-9584-BK: (1)
To determine if the policies and practices of a state mental
institution acting as a representative payee for SSA beneficiaries
conform to SSA's regulations in the use of benefits; (2) to confirm
institutions are performing other duties and responsibilities required
of representative payees; and (3) as the basis for conducting onsite
reviews of the institutions and preparing subsequent reports of
findings. The respondents are state mental institutions serving as
representative payees for Social Security beneficiaries and
Supplemental Security Income (SSI) 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-9584-BK................................. 78 1 60 78
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2. Modified Benefit Formula Questionnaire-Employer--20 CFR 401 &
402--0960-0477. Sections 215(a)(7) and 215(d)(3) of the Act require SSA
to use the Windfall Elimination Provision (WEP), a modified benefit
formula, to compute Social Security retirement or disability benefits
for persons first eligible (after 1985) for both a Social Security
benefit and a pension or annuity, based on employment not covered by
Social Security. SSA determines if the WEP is applicable and when to
apply it to a person's benefit. SSA uses Form SSA-58 to verify the
claimant's allegations on Form SSA-150 (OMB No. 0960-0395, Modified
Benefits Formula Questionnaire). SSA sends the SSA-58 to an 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.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-58...................................... 30,000 1 20 10,000
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3. Employee Work Activity Questionnaire--20 CFR 404.1574,
404.1592--0960-0483. Social Security disability beneficiaries and SSI
recipients qualify for payments when a verified physical or mental
impairment prevents them from working. If disability claimants attempt
to return to work after receiving payments, but are unable to continue
working, they submit the SSA-3033, Employee Work Activity
Questionnaire, so SSA can evaluate their work attempt. SSA also uses
this form to evaluate unsuccessful subsidy work and determine
applicants' continuing eligibility for disability payments. The
respondents are employers of Social Security disability beneficiaries
and SSI recipients who unsuccessfully attempted to return to work.
This is a correction notice: SSA published the incorrect burden
information for this collection at 78 FR 76378, on 12/17/13. We are
correcting this error here.
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-3033.................................... 15,000 1 15 3,750
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Date: March 5, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-05054 Filed 3-7-14; 8:45 am]
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