[Federal Register Volume 83, Number 132 (Tuesday, July 10, 2018)]
[Notices]
[Pages 31987-31990]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-14689]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2018-0030]
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-
[[Page 31988]]
966-2830, Email address: [email protected].
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2018-0030].
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
September 10, 2018. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Medical Source Opinion of Patient's Capability to Manage
Benefits--20 CFR 404.2015 and 416.615--0960-0024. SSA appoints a
representative payee in cases where we determine beneficiaries are not
capable of managing their own benefits. In these instances, we require
medical evidence to determine the beneficiaries' capability of managing
or directing their benefit payments. SSA collects medical evidence on
Form SSA-787 to: (1) Determine beneficiaries' capability or inability
to handle their own benefits; and (2) assist in determining the
beneficiaries' need for a representative payee. The respondents are the
beneficiary's physicians, or medical officers of the institution in
which the beneficiary resides.
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-787..................................... 131,556 1 20 43,852
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2. Work Activity Report--Employee--20 CFR 404.1520(b), 404.1571-
404.1576, 404.1584-404.1593, and 416.971-404.976--0960-0059. SSA uses
Form SA-821-BK to collect recipient employment information to determine
whether recipients worked after becoming disabled and, if so, whether
the work is substantial gainful activity. SSA uses Form SSA-821-BK to
obtain work information during the initial claims process, the
continuing disability review process, post-adjudicative work issue
actions, and for Supplemental Security Income (SSI) claims involving
work issues. SSA reviews and evaluates the data to determine if the
applicant or recipient meets the disability requirements of the law.
The respondents are applicants and recipients of Title II Social
Security and Title XVI SSI disability payments.
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-821-BK.................................. 300,000 1 30 150,000
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3. Appointment of Representative--20 CFR 404.1707, 404.1720,
408.1101, 416.1507, and 416.1520--0960-0527. Individuals claiming
rights or benefits under the Social Security Act (Act) must notify SSA
in writing when they appoint an individual to represent them in dealing
with SSA. In addition, SSA requires representatives to sign the notice
of appointment, or submit the equivalent in writing, if the
representative is not an attorney. Recipients use Form SSA-1696-U4 to
appoint a representative to handle their claim before SSA, and their
appointed representative uses the SSA-1696-U4 to indicate whether they
will charge a fee, and to show their eligibility for direct fee
payment. In addition, representatives also use the SSA-1696-U4 to
inform SSA of their disbarment; suspension from a court or bar in which
they previously admitted to practice; or their disqualification from
participating in or appearing before a Federal program or agency.
Finally, SSA requires non-attorney appointed representatives to sign
the SSA-1696-U4, or an equivalent written statement. SSA uses the
information on the SSA-1696-U4 to document the appointment of the
representative. Respondents are applicants for, or recipients of,
Social Security disability benefits (SSDI) or SSI payments who are
notifying SSA they have appointed a person to represent them in their
dealings with SSA, and their non-attorney representatives who need to
sign the form.
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-1696-U4................................. 800,000 1 13 173,333
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4. Representative Payee Report of Benefits and Dedicated Account--
20 CFR 416.546, 416.635, 416.640, and 416.665--0960-0576. SSA requires
representative payees (RPs) to submit a written report accounting for
the use of money paid to Social Security or SSI recipients, and to
establish and maintain a dedicated account for these payments. SSA uses
Form SSA-6233 to: (1) Ensure the RPs use the payments for the
recipient's current maintenance and personal needs; and (2) confirm the
expenditures of funds from the dedicated account remain in compliance
with the law. Respondents are RPs for SSI and Social Security
recipients.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 31989]]
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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-6233.................................... 36,228 1 20 12,076
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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 August 9, 2018. Individuals can obtain copies of the
OMB clearance packages by writing to [email protected].
1. Claimant's Medication--20 CFR 404.1512, 416.912--0960-0289. In
cases where claimants request a hearing after denial of their
disability claim for Social Security, SSA uses Form HA-4632 to request
information from the claimant regarding the medications they use. This
information helps the administrative law judge overseeing the case to
fully investigate: (1) The claimant's medical treatment and (2) the
effects of the medications on the claimant's medical impairments and
functional capacity. The respondents are applicants (or their
representatives) for Old Age, Survivors, and Disability Insurance
(OASDI) benefits or SSI payments who request a hearing to contest an
agency denial of their claim.
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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HA-4632 (paper)................................. 20,000 1 15 5,000
Electronic Records Express...................... 180,000 1 15 45,000
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Total....................................... 200,000 .............. .............. 50,000
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2. Representative Payee Report--Special Veterans Benefits--20 CFR
408.665--0960-0621. Title VIII of the Act allows for payment of monthly
Social Security benefits to qualified World War II veterans residing
outside the United States. An SSA-appointed representative payee may
receive and manage the monthly payment for the beneficiary's use and
benefit. SSA uses the information on Form SSA-2001-F6 to determine
whether the representative payee used the certified payments properly,
and continues to demonstrate strong concern for the beneficiary's best
interests.
Representative payees who receive Special Veterans Benefits (SVB)
on behalf of beneficiaries residing outside the United States must
complete the SSA-2001-F6 annually. We also require these representative
payees to complete the form any time we have reason to believe they
could be misusing the benefit payments. The respondents are individuals
or organizations serving as representative payees who receive SVB on
behalf of beneficiaries living outside the United States.
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-2001-F6................................. 16 1 20 5
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3. Data Exchange Request Form--20 CFR 401.100--0960-0802. SSA
maintains approximately 3,000 data exchange agreements and regularly
receives new requests from Federal, State, local, and foreign
governments, as well as private organizations, to share data
electronically. SSA engages in various forms of data exchanges from
Social Security number verifications to computer matches for benefit
eligibility, depending on the requestor's business needs. Section 1106
of the Act requires we consider the requestor's legal authority to
receive the data, our disclosure policies, systems' feasibility,
systems' security, and costs before entering into a data exchange
agreement. We use Form SSA-157, Data Exchange Request Form, for this
purpose. Requesting agencies, governments, or private organizations use
the SSA-157 when voluntarily initiating a request for data exchange
from SSA. Respondents are Federal, State, local, and foreign
governments, as well as private organizations seeking to share data
electronically with SSA.
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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State, local, and tribal governments............ 114 1 30 57
Private sector organizations.................... 32 1 30 16
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[[Page 31990]]
Totals...................................... 146 .............. .............. 73
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Dated: July 3, 2018.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2018-14689 Filed 7-9-18; 8:45 am]
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