[Federal Register Volume 79, Number 100 (Friday, May 23, 2014)]
[Notices]
[Pages 29834-29835]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-11928]
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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 one extension 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 collection below is pending at SSA. SSA will
submit it 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 July
22, 2014. Individuals can obtain copies of the collection instruments
by writing to the above email address.
Medical Permit Parking Application--41 CFR 101-20--104.2--0960-
0624. SSA employees and contractors with a qualifying medical condition
who park at SSA-owned and leased facilities may apply to receive a
medical parking permit. SSA uses three forms for this program: (1) SSA-
3192, the Application and Statement, which an individual completes when
first applying for the medical parking space; (2) SSA-3193, the
Physician's Report, which the applicant's physician completes to verify
the medical condition; and (3) SSA-3194, Renewal Certification, which
medical parking permit holders complete to verify their continued need
for the permit. The respondents are SSA employees and contractors
seeking medical parking permits and their physicians.
Note: Because SSA employees are Federal workers exempt from the
requirements of the Paperwork Reduction Act, the burden below is
only for SSA contractors and physicians (of both SSA employees and
contractors).
Type of Request: Revision of an OMB-approved information
collection.
[[Page 29835]]
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Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
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SSA-3192........................................ 290 1 30 145
SSA-3193........................................ 580 1 90 870
SSA-3194........................................ 93 1 5 8
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Totals...................................... 963 .............. .............. 1,023
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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 June 23, 2014. Individuals can obtain copies of the OMB
clearance packages by writing to [email protected].
1. Disability Update Report--20 CFR 404.1589-404.1595 and 416.988-
416.996--0960-0511. As part of our statutory requirements, SSA
periodically uses Form SSA-455, the Disability Update Report, to
evaluate current Title II disability beneficiaries' and Title XVI
disability payment recipients' continued eligibility for Social
Security disability payments. Specifically, SSA uses the form to
determine if: (1) There is enough evidence to warrant referring the
respondent for a full medical Continuing Disability Review (CDR); (2)
the respondent's impairment(s) is still present and is indicative of no
medical improvement, precluding the need for a CDR; or (3) there are
unresolved work-related issues for the respondent. SSA mails Form SSA-
455 to specific disability recipients, whom we select as possibly
qualifying for the continuing disability review process. SSA pre-fills
the form with data specific to the disability recipient, except for the
sections we ask the beneficiary to complete. When SSA receives the
completed form, we scan it into SSA's system. This allows us to gather
the information electronically to enable SSA to process the returned
forms through automated decision logic to decide the proper course of
action to take. The respondents are recipients of Title II and Title
XVI Social Security disability payments.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
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SSA-455..................................... 1,500,000 1 15 375,000
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2. Request for Evidence from Doctor and Request for Evidence from
Hospital--20 CFR 404 Subpart P and 20 CFR 416 Subpart I--0960-0722.
Sections 223(d)(5) and 1614(a)(3)(H)(i) of the Social Security Act
require claimants to furnish medical evidence of their disability when
filing a disability claim. SSA uses Forms HA-66 and HA-67 to obtain
evidence from medical sources identified by the claimants as having
information relative to their impairments or ability to do work-related
activities. In addition to accepting manual paper responses, SSA sends
a barcode with the HA-66 and HA-67, allowing respondents to fax the
information directly into the electronic claims folder rather than
submitting it manually. SSA uses the information to determine
eligibility for benefits. The respondents are medical sources, doctors,
and hospitals that evaluate the claimants. Type of Request: Extension
of an OMB-approved information collection.
Note: This is a correction notice. When we published the 60-day
Notice for this collection on 3/3/14 at 79 FR 11852 we listed it as
a revision; however, this is an extension of a currently approved
information collection.
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Average
Number of Frequency of Number of burden per Estimated
Modality of completion respondents response responses response total annual
(minutes) burden (hours)
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HA-66--Paper.................... 3,060 22 67,320 15 16,830
HA-66--Electronic............... 8,940 22 196,680 15 49,170
HA-67--Paper.................... 3,060 22 67,320 15 16,830
HA-67--Electronic............... 8,940 22 196,680 15 49,170
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Totals...................... 24,000 .............. 528,000 .............. 132,000
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Dated: May 20, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-11928 Filed 5-22-14; 8:45 am]
BILLING CODE 4191-02-P