[Federal Register Volume 79, Number 211 (Friday, October 31, 2014)]
[Notices]
[Pages 64872-64874]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-25860]
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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 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: [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
December 30, 2014. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Modified Benefit Formula Questionnaire-Foreign Pension--0960-
0561. SSA uses Form SSA-308 to determine exactly how much (if any) of a
foreign pension may be used to reduce the amount of Title II Social
Security retirement or disability benefits under the modified benefit
formula. The respondents are applicants for Title II Social Security
retirement or disability benefits who have foreign pensions.
Type of Request: Extension of an OMB-approved information
collection.
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Average
Number of Frequency of burden per Estimated
Modality of completion responses response response total annual
(minutes) burden (hours)
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SSA-308......................................... 13,452 1 10 2,242
Greenberg cases................................. 1,666 1 60 1,666
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Totals...................................... 15,118 .............. .............. 3,908
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2. Filing Claims Under the Federal Tort Claims Act--20 CFR 429.101-
429.110--0960-0667. The Federal Tort Claims Act is the legal mechanism
for compensating persons injured by negligent or wrongful acts that
occur during the performance of official duties by Federal employees.
In accordance with the law, SSA accepts monetary claims filed under the
Federal Tort Claims Act for damages against the United States, loss of
property, personal injury, or death resulting from an SSA employee's
wrongful act or omission. The regulation sections cleared under this
information collection request require claimants to provide information
SSA can use to investigate and determine whether to make an award,
compromise, or settlement under the Federal Tort Claims Act. The
respondents are individuals or entities making a claim under the
Federal Tort Claims Act.
Type of Request: Extension of an OMB-approved information
collection.
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Average
Number of Frequency of burden per Estimated
Modality of completion responses response response total annual
(minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
429.102; 429.103 \1\............................ 1 .............. .............. 1
429.104(a)...................................... 11 1 5 1
429.104(b)...................................... 43 1 5 4
429.104(c)...................................... 1 1 5 0
429.106(b)...................................... 6 1 10 1
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Totals...................................... 62 .............. .............. 7
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\1\ The 1 hour represents a placeholder burden. We are not reporting a burden for this collection because
respondents complete OMB-approved Form SF-95.
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 December 1, 2014. Individuals can obtain copies of the
OMB clearance package by writing to [email protected].
1. Partnership Questionnaire--20 CFR 404.1080-1082--0960-0025. SSA
considers partnership income in determining entitlement to Social
Security benefits. SSA uses information from Form SSA-7104 to determine
[[Page 64873]]
several aspects of eligibility for benefits, including the accuracy of
reported partnership earnings, the veracity of a retirement, and lag
earnings. The respondents are applicants for, and recipients of, Title
II Social Security Old Age, Survivors, and Disability Insurance
benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Total
Number of Frequency of Average burden estimated
Modality of completion responses response per response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-7104.................................... 12,350 1 30 6,175
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2. 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.
Note: This is a correction notice. SSA published this
information collection as a revision on August 28, 2014, at 79 FR
51387. Since we are no longer revising this information collection,
it is now an extension of an OMB-approved information collection.
Type of Request: Extension 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
responses response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-754-F4.................................. 30,000 1 30 15,000
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3. 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
conducts face-to-face interviews with applicants using the electronic
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. The respondents are applicants for the Title II DIB.
Type of Request: Extension of an OMB-approved information
collection.
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Total
Number of Frequency of Average burden estimated
Modality of completion responses response per response annual burden
(minutes) (hours)
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MCS......................................... 248,000 1 15 62,000
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4. 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 for (2) special SSI
eligibility status for a person who works despite a disabling
condition. It also explains how, in order 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 uses the information
required by this regulation 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.
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Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
responses response (minutes) (hours)
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20 CFR 416.268.............................. 60,000 1 3 3,000
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5. Medical Report on Adult with Allegation of Human
Immunodeficiency Virus Infection; Medical Report on Child with
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.933-20
CFR 416.934--0960-0500. Section 1631(e)(i) of the Act authorizes the
Commissioner of SSA to gather information to make a determination about
an applicant's claim for SSI payments; this procedure is the
presumptive disability (PD). SSA uses Forms SSA-4814-F5 and SSA-4815-F6
to collect information necessary to determine if an individual with
human immunodeficiency virus infection, who is applying for SSI
disability benefits, meets the requirements for PD. The respondents are
the medical sources of the applicants for SSI disability payments.
[[Page 64874]]
Type of Request: Revision of an OMB-approved information
collection.
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Average Total
Number of Frequency of burden per estimated
Modality of completion responses response response total annual
(minutes) burden (hours)
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SSA-4814-F5..................................... 46,200 1 10 7,700
SSA-4815-F6..................................... 12,900 1 10 2,150
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Totals...................................... 59,100 9,850
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Dated: October 27, 2014.
Faye Lipsky,
Reports Clearance Director, Social Security Administration.
[FR Doc. 2014-25860 Filed 10-30-14; 8:45 am]
BILLING CODE 4191-02-P