[Federal Register Volume 82, Number 157 (Wednesday, August 16, 2017)]
[Notices]
[Pages 38982-38984]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-17269]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2017-0041]
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
[[Page 38983]]
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].
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2017-0041].
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
October 16, 2017. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application to Collect a Fee for Payee Service--20 CFR 404.2040a
& 20 CFR 416.640a--0960-0719. Sections 205(j)(4)(A)&(B), and 1631(a)(2)
of the Social Security Act (Act) allow SSA to authorize certain
organizational representative payees to collect a fee for providing
payee services. Before an organization may collect this fee, they
complete and submit Form SSA-445. SSA uses the information to determine
whether to authorize or deny permission to collect fees for payee
services. The respondents are private sector businesses or State and
local government offices applying to become fee-for-service
organizational representative payees.
Type of Request: Revision of an OMB-approved information
collection.
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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-445--Private sector business................ 90 1 10 15
SSA-445--State/local government offices......... 10 1 10 2
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Totals...................................... 100 .............. .............. 17
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2. Redetermination of Eligibility for Help with Medicare
Prescription Drug Plan Costs--20 CFR 418.3125--0960-0723. As per the
requirements of the Medicare Modernization Act of 2003, SSA conducts
low-income subsidy eligibility redeterminations for Medicare
beneficiaries who currently receive the Medicare Part D subsidy and who
meet certain criteria. Respondents complete Form SSA-1026-REDE under
the following circumstances: (1) When individuals became entitled to
the Medicare Part D subsidy during the past 12 months; (2) if they were
eligible for the Part D subsidy for more than 12 months; or (3) if they
reported a change in income, resources, or household size. Part D
beneficiaries complete the SSA-1026-SCE when they need to report a
potentially subsidy-changing event, including the following: (1)
Marriage; (2) spousal separation; (3) divorce; (4) annulment of a
marriage; (5) spousal death; or (6) moving back in with one's spouse
following a separation. The respondents are current recipients of the
Medicare Part D low-income subsidy who will undergo an eligibility
redetermination for one of the reasons mentioned above.
Type of Request: Revision of an OMB-approved information
collection.
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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-1026-REDE................................... 98,990 1 18 29,697
SSA-1026-SCE.................................... 4,267 1 18 1,280
SSA-1026-REDE--Field Office Interview........... 50,529 1 18 15,159
SSA-1026-SCE--Field Office Interview............ 3,468 1 18 1,040
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Total....................................... 157,254 .............. .............. 47,176
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II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding these 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 September 15, 2017. Individuals can obtain copies of
the OMB clearance packages by writing to [email protected].
1. Statement Regarding Date of Birth and Citizenship--20CFR
404.716--0960-0016. Section 205(a) of the Act gives the Commissioner of
SSA the authority to make rules and regulations and to establish
procedures for collecting evidence from individuals applying for Social
Security benefits. When individuals apply for Social Security benefits
and cannot provide preferred methods of proving age or citizenship, SSA
uses Form SSA-702 to establish these facts. Specifically, SSA uses the
SSA-702 to establish age as a factor of entitlement to Social Security
benefits, or U.S. citizenship as a payment factor. Respondents are
individuals with knowledge about the date of birth or citizenship of
applicants filing for one or more Social Security benefits who need to
establish age or citizenship.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 38984]]
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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-702..................................... 1,200 1 10 200
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2. Marital Relationship Questionnaire--20 CFR 416.1826--0960-0460.
SSA uses Form SSA-4178, Marital Relationship Questionnaire, to
determine if unrelated individuals of the opposite sex who live
together are misrepresenting themselves as husband and wife. SSA needs
this information to determine whether we are making correct payments to
couples and individuals applying for or currently receiving
Supplemental Security Income (SSI) payments. The respondents are
applicants for and recipients of SSI 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-4178--Modernized SSI Claims System.......... 1,200 1 10 200
SSA-4178........................................ 3,825 1 5 319
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Totals...................................... 5,100 .............. .............. 425
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3. Medical Source Statement of Ability To Do Work Related
Activities (Physical and Mental)--20 CFR 404.1512-404.1513, 416.912-
416.913, 404.1517, and 416.917--0960-0662. In some instances when a
claimant appeals a denied disability claim, SSA may ask the claimant to
have a consultative examination at the agency's expense, if the
claimant's medical sources cannot or will not give the agency
sufficient evidence to determine whether the claimant is disabled. The
medical providers who perform these consultative examinations provide a
statement about the claimant's state of disability. Specifically, these
medical source statements determine the work-related capabilities of
these claimants. SSA collects the medical data on the HA-1151 and HA-
1152 to assess the work-related physical and mental capabilities of
claimants who appeal SSA's previous determination on their issue of
disability. The respondents are medical sources who provide reports
based either on existing medical evidence or on consultative
examinations.
Type of Request: Revision of an OMB-approved information
collection.
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Estimated
Number of Frequency of Number of Average burden total annual
Modality of completion respondents response responses per response burden
(minutes) (hours)
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HA-1151......................... 5,000 30 150,000 15 37,500
HA-1152......................... 5,000 30 150,000 15 37,500
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Totals...................... 10,000 .............. 300,000 .............. 75,000
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Dated: August 10, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-17269 Filed 8-15-17; 8:45 am]
BILLING CODE 4191-02-P