Agency Information Collection Activities: Proposed Request and Comment Request, 43270-43274 [E6-12255]
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Federal Register / Vol. 71, No. 146 / Monday, July 31, 2006 / Notices
U.S. Small Business Administration,
Office of Small Business Development
Centers, 409 3rd Street, SW.,
Washington, DC 20416, telephone (202)
205–7045 or fax (202) 481–0681.
Thomas Dwyer,
Committee Management Officer.
[FR Doc. E6–12146 Filed 7–28–06; 8:45 am]
BILLING CODE 8025–01–P
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages that will require
clearance by the Office of Management
and Budget (OMB) in compliance with
Pub. L. 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. The information collection
packages that may be included in this
notice are for new information
collections, approval of existing
information collections, revisions to
OMB-approved information collections,
and extensions (no change) of OMBapproved 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 on ways
to minimize burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Written
comments and recommendations
regarding the information collection(s)
should be submitted to the OMB Desk
Officer and the SSA Reports Clearance
Officer. The information can be mailed
and/or faxed to the individuals at the
addresses and fax numbers listed below:
(OMB), Office of Management and
Budget, Attn: Desk Officer for SSA,
Fax: 202–395–6974.
(SSA), Social Security Administration,
DCFAM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–965–6400.
I. The information collections listed
below are pending at SSA and will be
submitted to OMB within 60 days from
the date of this notice. Therefore, your
comments should be submitted to SSA
within 60 days from the date of this
publication. You can obtain copies of
the collection instruments by calling the
SSA Reports Clearance Officer at 410–
965–0454 or by writing to the address
listed above.
1. Employment Relationship
Questionnaire—20 CFR 404.1007—
0960–0040. Form SSA–7160–F4 is used
in developing the question of employeremployee relationships, except where
the worker is an officer of a corporation.
This form gathers the information
needed for developing the employment
relationship, and determining whether a
beneficiary is self-employed or an
employee. Respondents are beneficiaries
questioning their status as employees
and employers.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 16,000.
Frequency of Response: 1.
Average Burden Per Response: 25
minutes.
Estimated Annual Burden: 6,667
hours.
2. State Supplementation Provisions:
Agreement; Payments—20 CFR
416.2095–416.2098, 416.2099—0960–
0240. Section 1618 of the Social
Security Act contains pass-along
provisions of the Social Security
amendments. These provisions require
that States which supplement the
Federal Supplemental Security Income
(SSI) payments also pass along Federal
cost-of-living increases to individuals
who are eligible for State supplemental
payments. If a State fails to keep
payments at the required level, it
becomes ineligible for Medicaid
reimbursement under Title XIX of the
Social Security Act. In order to make
sure the States are keeping the
payments, they submit their payment
amounts to SSA. Seven of the
participating States may use a totalexpenditures method, in which they
send their total expenditures to SSA
four times per year to prove that they
are maintaining the regulated cost-ofliving increase. The remaining twenty
three States send SSA one annual report
which shows that they have maintained
the cost-of-living increase as per the
regulations. Respondents are State
agencies administering supplemental
programs.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 30.
Number of
respondents
Frequency
of response
Average
burden per
response
Estimated
annual burden hours
Total Expenditures ...........................................................................................................
Maintenance of Payment Levels .....................................................................................
7
23
4
1
60
60
28
23
Total ..........................................................................................................................
30
....................
....................
51
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Reporting method
Estimated Annual Burden: 51 hours.
3. Vocational Rehabilitation Provider
Claim—20 CFR 404.2108(b),
404.2117(c)(1) and (2), 404.2101(b) and
(c), 404.2121(a), 416.2208(b),
416.2217(c)(1) and (2), 416.2201(b) and
(c), 416.2221(a)—0960–0310. SSA refers
certain disability beneficiaries to State
Vocational Rehabilitation (VR) agencies
for vocational rehabilitation services.
Under Social Security regulations, the
State VR agencies must report certain
information to SSA as follows:
(a) The State VR agencies use the
SSA–199 to make claims for
reimbursement of the costs incurred
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from providing VR services for the
beneficiaries. The information collected
on the SSA–199 is used by SSA to
determine whether or not, and how
much, to pay the VR agencies under
SSA’s VR program (20 CFR 404.2108(b)
and 416.2208(b).
(b) SSA requires the VR agencies to
certify their adherence to cost
containment policies and procedures to
ensure that the costs we reimburse are
in accordance with these cost
containment policies (20 CFR
404.2117(c) and 416.2217(c).
(c) SSA requires the VR agencies to
prepare causality statements for
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validation review. This enables SSA to
assess the appropriateness of its
reimbursement policies, and when/
where changes should be considered to
ensure that maximum benefits from VR
services are secured at the appropriate
level of cost to the trust/general funds.
Respondents are State VR agencies
who offer Vocational and Employment
services for SSA beneficiaries.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 80.
Estimated Annual Burden: 5,320
hours.
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Number of
respondents
Frequency
of response
(a) SSA–199, 404.2108(b) & 416.2208(b) ...............................................
(b) 404.2117(c) & 416.2217(c) ................................................................
(c) 404.2121(a) & 416.2221(a) ................................................................
80
80
80
* 160
** 1
** 3
Total ..................................................................................................
80
....................
CFR sections
Average
burden per
response
Estimated
annual burden hours
12,800
80
240
23
60
100
4,907
80
400
13,120
....................
5,387
Total
responses
* Each year.
** Per year.
4. Medicare Part B Income-Related
Premium—Life-Changing Event Form—
0960–NEW. As per the Medicare
Modernization Act of 2003, beginning in
January 2007 selected beneficiaries of
Medicare Part B insurance will have to
pay a new income-related monthly
adjustment amount (IRMAA). The
amount of the IRMAA is based on
income tax return data obtained from
the Internal Revenue Service. If affected
Medicare Part B beneficiaries believe
that more recent tax data should be used
because a life-changing event has
occurred that significantly reduces their
income, they can report these changes to
SSA and ask for a new initial
determination of their IRMAA. SSA
believes that most respondents will go
to a field office and do this in person;
however some respondents may choose
to contact SSA by mail and they can use
form SSA–44, the Medicare Part B
Income-Related Premium—LifeChanging Event form. The respondents
are Medicare Part B beneficiaries who
want SSA to use more recent income
data in determining the amount of their
IRMAA.
Type of Request: New information
collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
annual burden hours
Personal Interview ...........................................................................................................
Form .................................................................................................................................
68,490
7,610
1
1
60
90
68,490
11,415
Total ..........................................................................................................................
76,100
....................
....................
79,905
Method of information collection
Total Burden Hours: 79,905 hours.
4. Protection and Advocacy for
Beneficiaries of Social Security
(PABSS)—Program Performance
Report—0960–NEW.
Background
In August of 2004, SSA announced its
intention to award grants to establish
community-based protection and
advocacy projects in every State and
U.S. Territory, as authorized under
section 1150 of the Social Security Act.
Potential awardees were protection and
advocacy organizations established
under Title I of the Developmental
Disabilities Assistance and Bill of Rights
Act which submitted a timely
application conforming to the
requirements in the notice. The projects
funded under this grant are part of
SSA’s strategy to increase the number of
beneficiaries who return to work and
achieve self-sufficiency as the result of
receiving advocacy or other services.
The overall goal of the program is to
provide information and advice about
obtaining vocational rehabilitation and
employment services and to provide
advocacy or other services that a
beneficiary with a disability may need
to secure, maintain, or regain gainful
employment.
Collection Activity
The PABSS Program Performance
Report collects statistical information
from the various Protection and
Advocacy (P&A) projects to manage
program performance. SSA uses the
information to evaluate the efficacy of
the program and to ensure that those
dollars appropriated for PABSS services
are being spent on SSA beneficiaries.
The project data will be valuable to SSA
in its analysis of and future planning for
the Social Security Disability Insurance
(SSDI) and SSI programs. The
respondents to this collection are the 57
designated P&A project system sites in
each of the fifty States, the District of
Columbia, and the U.S. Territories.
Type of Request: New information
collection.
Number of
annual
Respondents
Frequency
of response
Average
burden per
response
(hours)
PABSS Program Performance Report ............................................................................
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Title of collection
57
2
1
114
5. Pilot Program for Participating in
Administrative Law Judge Hearings by
Using Privately Owned Video
Teleconferencing (VTC) Equipment.
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Background
On February 3, 2003, the
Commissioner of Social Security
published a final rule allowing SSA to
conduct hearings before administrative
law judges (ALJs) at which a party or
parties to the hearing and/or a witness
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or witnesses may appear before the ALJ
by video teleconferencing (68 FR No. 22,
5210). In that final rule we noted that
dialing into SSA’s VTC network from
private facilities, such as facilities
owned by a law firm, could be possible
at a future date. Appearances by video
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teleconference are also central to the
rules for the new disability
determination process (final rule
published March 31, 2006 71 FR No. 62,
16423). Pursuant to these rules, SSA is
now preparing to pilot a program
wherein private representatives and
their clients may appear at ALJ hearings
using privately owned video equipment.
The VTC Activity
SSA plans to expand its Video
Teleconferencing program of
Administrative Law Judge hearings by
allowing these hearings to be conducted
from private representative sites that
have been certified by the agency.
Representatives who are interested in
participating in the pilot program or the
permanent program will need to provide
some basic information about their
location, the area they serve and their
expected workload. Because private
video sites are being used, the pilot
guidelines provide for site inspections,
certain on-the-record certifications and
other claimant safeguards to help ensure
that no claimants are disadvantaged by
participating in their hearing from a
private site. Respondents to this
collection will be the claimant’s
representatives who elect to participate
in the pilot.
The pilot is structured to begin with
10 private video sites expanding to 30
private sites after a six month evaluation
period. There will be a second
evaluation period after the 30 sites have
operated for a six month period. SSA
will then make final decisions regarding
operating procedures for a permanent
program.
Type of Request: New Information
Collection.
Total Burden Hours for all
Collections: 717 burden hours (shown
below).
PHASE-I
[10 sites for 6 months]
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
annual burden hours
Expression of Interest/Initial Contact ...............................................................................
Certifications Made in the Opening Statement of the Hearing .......................................
100
10
1
100
15
10
25
167
Totals ........................................................................................................................
110
....................
....................
192
Number of
respondents
Frequency
of response
Average
burden per
response
Estimated
annual burden hours
Expression of Interest/Initial Contact ...............................................................................
Certifications Made in the Opening Statement of the Hearing .......................................
100
30
1
100
15
10
25
500
Totals ........................................................................................................................
130
....................
....................
525
Collection activity
PHASE-II
[30 sites for 6 months]
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Collection activity
II. The information collections listed
below have been submitted to OMB for
clearance. Your comments on the
information collections would be most
useful if received by OMB and SSA
within 30 days from the date of this
publication. You can obtain a copy of
the OMB clearance packages by calling
the SSA Reports Clearance Officer at
410–965–0454, or by writing to the
address listed above.
1. Request for Reconsideration—
Disability Cessation—20 CFR 404.909,
416.1409—0960–0349. Form SSA–789–
U4 is used by claimants to request
reconsideration of a determination and
to indicate whether or not they wish to
appear at a disability hearing. This form
can also be used to submit any
additional information/evidence for use
in the reconsidered determination and
to indicate if an interpreter is needed for
the hearing. SSA will use this
information to either arrange for a
hearing or to prepare a decision based
on the evidence of record. The
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respondents are applicants or claimants
for Social Security benefits or
Supplemental Security Income (SSI)
payments.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 49,000.
Frequency of Response: 1.
Average Burden Per Response: 13
minutes.
Estimated Annual Burden: 10,617
hours.
2. Psychiatric Review Technique—20
CFR 404.1520a, 416.920a—0960–0413.
Form SSA–2506–BK assists the State
Disability Determination Services
(DDSs) in evaluating mental
impairments by helping to: organize and
present the mental findings in a clear,
concise and consistent manner; consider
and evaluate all aspects of the mental
impairment relevant to the individual’s
ability to perform work-related mental
functions; and identify additional
evidence needed to determine
impairment severity. The respondents
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are the 52 State DDSs administering the
Title II and Title XVI programs.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 52.
Frequency of Response: 20,595.
Total Annual Responses: 1,070,940.
Average Burden Per Response: 15
minutes.
Estimated Annual Burden: 267,735
hours.
3. Request for Internet ServicesPassword Authentication—20 CFR
401.45—0960–0632. Password
Authentication is used to establish a
password process for verifying the
identity of individuals who choose to
use the Internet and Automated
Telephone Response for conducting
business with SSA. Services are
password protected when it is necessary
due to the nature of the information
being transmitted or because the
requestor requires a higher level of
protection. The password process
allows requestors to establish their
identities with SSA and create a
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password which they can then use to
access their own personal information.
The respondents are individuals
electing to do business with SSA
through an electronic medium.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 1,630,771.
Frequency of Response: 1.
Average Burden Per Response: 10
minutes.
Estimated Annual Burden: 271,795
hours.
4. Function Report—Adult—Third
Party—20 CFR 404.1512, 416.912—
0960–0635. The information collected
on the SSA–3380–BK is needed to make
determinations on SSI and Social
Security Disability (SSDI) claims. This
information is necessary for case
development and adjudication, and is
used by State DDS evaluators as an
evidentiary source used in the disability
evaluation process. The respondents are
third parties familiar with the functional
limitations (or lack thereof) of claimants
who apply for SSDI benefits and SSI
payments.
Type of Request: Revision of an OMBapproved information collection.
Number of Respondents: 1,000,000.
Frequency of Response: 1.
Average Burden Per Response: 60
minutes.
Estimated Annual Burden: 1,000,000
hours.
5. Disability Hearing Officer’s
Decision—Title XVI Disabled Child (DC)
Continuing Disability Review—20 CFR
404.913–.914, 404.917, 416.994a,
416.1413–.1414, 416.1417—0960–0657.
Form SSA–1209–BK is used by the
disability hearing officer conducting the
disability hearing to prepare and issue
a written reconsidered determination—
specifically for evaluating Title XVI
childhood disability cases. The form
provides the framework for addressing
the crucial elements of the case in a
sequential and logical fashion, and the
completed form is the official document
of the decision. Respondents are
disability hearing officers in State DDSs.
Type of Request: Extension of an
OMB-approved information collection.
Number of Respondents: 35,000.
Frequency of Response: 1.
Average Burden Per Response: 75
minutes.
Estimated Annual Burden: 43,750
hours.
6. Representative Payment Policies
Regulation—20 CFR 404.2011,
404.2025, 416.611, 416.625—0960–
0679. In cases where SSA determines
that it is not in a beneficiary’s best
interest to receive payments directly as
it may cause substantial harm, the
beneficiaries may dispute this decision.
If they do, they provide SSA with
information which SSA will take into
consideration when reevaluating the
decision. Representative payees must
also provide SSA with information
regarding their relationship,
responsibility, and how payments were
used for the beneficiary. Respondents
are beneficiaries and representative
payees.
Type of Request: Revision of an OMBapproved information collection.
Estimated Annual Burden: 363 hours.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
annual burden hours
404.2011(a) (1), 416.611(a) (1) .......................................................................................
404.2025, 416.625 ...........................................................................................................
250
3,000
1
1
15
6
63
300
Totals ........................................................................................................................
3,250
....................
....................
363
CFR section
7. Statement of Reclamation Action—
31 CFR 210—0960–NEW. Form SSA–
1713 collects information regarding
whether, how and when a Canadian
bank was able to return erroneous
payments made after the death of a
beneficiary who elected to have
payments sent to Canada. The SSA–
1713 is sent with the SSA–1712, an
SSA-generated cover sheet which
provides the Canadian bank with
information regarding the deceased
beneficiary. In this way, SSA can
reclaim funds which were erroneously
paid. The respondents are Canadian
financial institutions to which Social
Security payments have been made.
Type of Request: Existing Information
Collection in Use Without an OMB
Number.
Number of Respondents: 15.
Frequency of Response: 1.
Average Burden Per Response: 5
minutes.
Estimated Annual Burden: 1 hour.
8. Statement for Determining
Continuing Eligibility, Supplemental
Security Income Payment—20 CFR,
Subpart D, 416.204—0960–0145. SSA
uses form SSA–8202–BK to conduct
low- and middle-error-profile (LEPMEP) telephone or face-to-face
redetermination (RZ) interviews with
SSI recipients and representative
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
annual burden hours
SSA–8202–F6 ..................................................................................................................
SSA–8202–OCR–SM ......................................................................................................
1,000,000
700,000
1
1
21
11
350,000
128,333
Totals ........................................................................................................................
1,700,000
....................
....................
478,333
Forms
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payees. The information collected
during the interview is used to
determine whether SSI recipients have
met and continue to meet all statutory
and regulatory requirements for SSI
eligibility and whether they have been,
and are still receiving, the correct
payment amount. Form SSA–8202–
OCR–SM (Optical Character Recognition
Self-Mailer) collects information similar
to that collected on Form SSA–8202–
BK. However, it is used exclusively in
LEP RZ cases on a 6-year cycle.
Type of Request: Revision of an OMBapproved collection.
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9. Statement for Determining
Continuing Eligibility, Supplemental
Security Income Payment(s)—20 CFR
Subpart B, 416.204—0960–0416. SSA
uses the information collected on form
SSA–8203–BK for high-error-profile
(HEP) redeterminations of disability to
determine whether SSI recipients have
met and continue to meet all statutory
and regulatory requirements for SSI
eligibility and whether they have been,
and are still receiving, the correct
payment amount. The information is
normally completed in field offices by
personal contact (face-to-face or
telephone interview) using the
automated Modernized SSI Claim
System (MSSICS). The respondents are
recipients of Title XVI benefits.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
annual burden hours
MISSICS ..........................................................................................................................
MISSICS/Signature Proxy ...............................................................................................
Paper ...............................................................................................................................
109,012
36,338
25,650
1
1
1
20
19
20
36,337
11,507
8,550
Totals ........................................................................................................................
171,000
....................
....................
56,394
Collection method
Dated: July 26, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. E6–12255 Filed 7–28–06; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION
ADMINISTRATION
Notice of Availability of Draft Advisory
Circulars, Other Policy Documents and
Proposed Technical Standard Orders
Federal Aviation
Administration (FAA), DOT.
ACTION: This is a recurring Notice of
Availability, and request for comments,
on the draft advisory circulars (ACs),
other policy documents, and proposed
technical standard orders (TSOs)
currently offered by the Aircraft
Certification Service.
AGENCY:
The FAA’s Aircraft
Certification Service publishes proposed
non-regulatory documents that are
available for public comment on the
Internet at https://www.faa.gov/aircraft/
draftldocs/.
DATES: We must receive comments on or
before the due date for each document
as specified on the Web site.
ADDRESSES: Send comments on
proposed documents to the Federal
Aviation Administration at the address
specified on the Web site for the
document being commented on, to the
attention of the individual and office
identified as point of contact for the
document.
FOR FURTHER INFORMATION CONTACT: See
the individual or FAA office identified
on the Web site for the specified
document.
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SUMMARY:
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SUPPLEMENTARY INFORMATION:
DEPARTMENT OF TRANSPORTATION
Comments Invited
Federal Highway Administration
When commenting on draft ACs,
other policy documents or proposed
TSOs, you should identify the
document by its number. The Director,
Aircraft Certification Service, will
consider all comments received on or
before the closing date before issuing a
final document. You can obtain a paper
copy of the draft document or Proposed
TSO by contacting the individual or
FAA office responsible for the
document as identified on the Web site.
You will find the draft ACs, other policy
documents and proposed TSOs on the
‘‘Aircraft Certification Draft Documents
Open for Comment’’ Web site at https://
www.faa.gov/aircraft/draft_docs/. For
Internet retrieval assistance, contact the
AIR Internet Content Program Manager
at 202–267–8361.
Notice of Final Federal Agency Actions
on Proposed Highways in Texas
Background
We do not publish an individual
Federal Register Notice for each
document we make available for public
comment. Persons wishing to comment
on our draft ACs, other policy
documents and proposed TSOs can find
them by using the FAA’s Internet
address listed above. This notice of
availability and request for comments
on documents produced by the Aircraft
Certification Service will appear again
in 30 days.
Issued in Washington, DC on July 25, 2006.
Terry Allen,
Acting Manager, Production and
Airworthiness Division Aircraft Certification
Service.
[FR Doc. 06–6566 Filed 7–28–06; 8:45 am]
BILLING CODE 4910–13–M
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Federal Highway
Administration (FHWA), DOT.
ACTION: Notice of Limitation on claims
for judicial review of actions by FHWA
and other Federal agencies.
AGENCY:
SUMMARY: This notice announces actions
taken by the FHWA and other Federal
agencies that are final within the
meaning of 23 U.S.C. 139(1)(1). The
actions relate to various proposed
highway projects in the State of Texas.
Those actions grant licenses, permits,
and approvals for the projects.
DATES: By this notice, the FHWA is
advising the public of final agency
actions subject to 23 U.S.C. 139(1)(1). A
claim seeking judicial review of the
Federal agency actions on any of the
listed highway projects will be barred
unless the claim is filed on or before
January 29, 2007. If the Federal law that
authorizes judicial review of a claim
provides a time period of less than 180
days for filing such claim, then that
shorter time period still applies.
FOR FURTHER INFORMATION CONTACT:
Salvador Deocampo, District Engineer,
Texas Division, Federal Highway
Administration, 826 Federal Building
Room 826 300 E. 8th Street Austin,
Texas 78701, 8 a.m. to 5 p.m. Monday
through Friday, 512–536–5950,
salvador.deocampo@fhwa.dot.gov. Ms.
Dianna Noble, P.E., Director
Environmental Affairs Division, Texas
Department of Transportation, 118 E.
Riverside, Austin, Texas, 78704; 512–
416–2734; e-mail:
dnoble@dot.state.tx.us. Texas
Department of Transportation normal
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]]>Agencies
[Federal Register Volume 71, Number 146 (Monday, July 31, 2006)]
[Notices]
[Pages 43270-43274]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-12255]
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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 that will require clearance by the
Office of Management and Budget (OMB) in compliance with Pub. L. 104-
13, the Paperwork Reduction Act of 1995, effective October 1, 1995. The
information collection packages that may be included in this notice are
for new information collections, approval of existing information
collections, revisions to OMB-approved information collections, and
extensions (no change) 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 on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed and/or faxed to the individuals
at the addresses and fax numbers listed below:
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974.
(SSA), Social Security Administration, DCFAM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
Fax: 410-965-6400.
I. The information collections listed below are pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
1. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. Form SSA-7160-F4 is used in developing the question of employer-
employee relationships, except where the worker is an officer of a
corporation. This form gathers the information needed for developing
the employment relationship, and determining whether a beneficiary is
self-employed or an employee. Respondents are beneficiaries questioning
their status as employees and employers.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 16,000.
Frequency of Response: 1.
Average Burden Per Response: 25 minutes.
Estimated Annual Burden: 6,667 hours.
2. State Supplementation Provisions: Agreement; Payments--20 CFR
416.2095-416.2098, 416.2099--0960-0240. Section 1618 of the Social
Security Act contains pass-along provisions of the Social Security
amendments. These provisions require that States which supplement the
Federal Supplemental Security Income (SSI) payments also pass along
Federal cost-of-living increases to individuals who are eligible for
State supplemental payments. If a State fails to keep payments at the
required level, it becomes ineligible for Medicaid reimbursement under
Title XIX of the Social Security Act. In order to make sure the States
are keeping the payments, they submit their payment amounts to SSA.
Seven of the participating States may use a total-expenditures method,
in which they send their total expenditures to SSA four times per year
to prove that they are maintaining the regulated cost-of-living
increase. The remaining twenty three States send SSA one annual report
which shows that they have maintained the cost-of-living increase as
per the regulations. Respondents are State agencies administering
supplemental programs.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 30.
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Estimated
Number of Frequency Average annual
Reporting method respondents of response burden per burden
response hours
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Total Expenditures.......................................... 7 4 60 28
Maintenance of Payment Levels............................... 23 1 60 23
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Total................................................... 30 ........... ........... 51
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Estimated Annual Burden: 51 hours.
3. Vocational Rehabilitation Provider Claim--20 CFR 404.2108(b),
404.2117(c)(1) and (2), 404.2101(b) and (c), 404.2121(a), 416.2208(b),
416.2217(c)(1) and (2), 416.2201(b) and (c), 416.2221(a)--0960-0310.
SSA refers certain disability beneficiaries to State Vocational
Rehabilitation (VR) agencies for vocational rehabilitation services.
Under Social Security regulations, the State VR agencies must report
certain information to SSA as follows:
(a) The State VR agencies use the SSA-199 to make claims for
reimbursement of the costs incurred from providing VR services for the
beneficiaries. The information collected on the SSA-199 is used by SSA
to determine whether or not, and how much, to pay the VR agencies under
SSA's VR program (20 CFR 404.2108(b) and 416.2208(b).
(b) SSA requires the VR agencies to certify their adherence to cost
containment policies and procedures to ensure that the costs we
reimburse are in accordance with these cost containment policies (20
CFR 404.2117(c) and 416.2217(c).
(c) SSA requires the VR agencies to prepare causality statements
for validation review. This enables SSA to assess the appropriateness
of its reimbursement policies, and when/where changes should be
considered to ensure that maximum benefits from VR services are secured
at the appropriate level of cost to the trust/general funds.
Respondents are State VR agencies who offer Vocational and
Employment services for SSA beneficiaries.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 80.
Estimated Annual Burden: 5,320 hours.
[[Page 43271]]
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Estimated
Number of Frequency Total Average annual
CFR sections respondents of response responses burden per burden
response hours
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(a) SSA-199, 404.2108(b) & 416.2208(b)......... 80 * 160 12,800 23 4,907
(b) 404.2117(c) & 416.2217(c).................. 80 ** 1 80 60 80
(c) 404.2121(a) & 416.2221(a).................. 80 ** 3 240 100 400
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Total...................................... 80 ........... 13,120 ........... 5,387
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* Each year.
** Per year.
4. Medicare Part B Income-Related Premium--Life-Changing Event
Form--0960-NEW. As per the Medicare Modernization Act of 2003,
beginning in January 2007 selected beneficiaries of Medicare Part B
insurance will have to pay a new income-related monthly adjustment
amount (IRMAA). The amount of the IRMAA is based on income tax return
data obtained from the Internal Revenue Service. If affected Medicare
Part B beneficiaries believe that more recent tax data should be used
because a life-changing event has occurred that significantly reduces
their income, they can report these changes to SSA and ask for a new
initial determination of their IRMAA. SSA believes that most
respondents will go to a field office and do this in person; however
some respondents may choose to contact SSA by mail and they can use
form SSA-44, the Medicare Part B Income-Related Premium--Life-Changing
Event form. The respondents are Medicare Part B beneficiaries who want
SSA to use more recent income data in determining the amount of their
IRMAA.
Type of Request: New information collection.
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Average Estimated
Number of Frequency burden per annual
Method of information collection respondents of response response burden
(minutes) hours
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Personal Interview.......................................... 68,490 1 60 68,490
Form........................................................ 7,610 1 90 11,415
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Total................................................... 76,100 ........... ........... 79,905
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Total Burden Hours: 79,905 hours.
4. Protection and Advocacy for Beneficiaries of Social Security
(PABSS)--Program Performance Report--0960-NEW.
Background
In August of 2004, SSA announced its intention to award grants to
establish community-based protection and advocacy projects in every
State and U.S. Territory, as authorized under section 1150 of the
Social Security Act. Potential awardees were protection and advocacy
organizations established under Title I of the Developmental
Disabilities Assistance and Bill of Rights Act which submitted a timely
application conforming to the requirements in the notice. The projects
funded under this grant are part of SSA's strategy to increase the
number of beneficiaries who return to work and achieve self-sufficiency
as the result of receiving advocacy or other services. The overall goal
of the program is to provide information and advice about obtaining
vocational rehabilitation and employment services and to provide
advocacy or other services that a beneficiary with a disability may
need to secure, maintain, or regain gainful employment.
Collection Activity
The PABSS Program Performance Report collects statistical
information from the various Protection and Advocacy (P&A) projects to
manage program performance. SSA uses the information to evaluate the
efficacy of the program and to ensure that those dollars appropriated
for PABSS services are being spent on SSA beneficiaries. The project
data will be valuable to SSA in its analysis of and future planning for
the Social Security Disability Insurance (SSDI) and SSI programs. The
respondents to this collection are the 57 designated P&A project system
sites in each of the fifty States, the District of Columbia, and the
U.S. Territories.
Type of Request: New information collection.
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Average Estimated
Number of Frequency of burden per annual
Title of collection annual Respondents response response burden
(hours) hours
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PABSS Program Performance Report............... 57 2 1 114
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5. Pilot Program for Participating in Administrative Law Judge
Hearings by Using Privately Owned Video Teleconferencing (VTC)
Equipment.
Background
On February 3, 2003, the Commissioner of Social Security published
a final rule allowing SSA to conduct hearings before administrative law
judges (ALJs) at which a party or parties to the hearing and/or a
witness or witnesses may appear before the ALJ by video
teleconferencing (68 FR No. 22, 5210). In that final rule we noted that
dialing into SSA's VTC network from private facilities, such as
facilities owned by a law firm, could be possible at a future date.
Appearances by video
[[Page 43272]]
teleconference are also central to the rules for the new disability
determination process (final rule published March 31, 2006 71 FR No.
62, 16423). Pursuant to these rules, SSA is now preparing to pilot a
program wherein private representatives and their clients may appear at
ALJ hearings using privately owned video equipment.
The VTC Activity
SSA plans to expand its Video Teleconferencing program of
Administrative Law Judge hearings by allowing these hearings to be
conducted from private representative sites that have been certified by
the agency. Representatives who are interested in participating in the
pilot program or the permanent program will need to provide some basic
information about their location, the area they serve and their
expected workload. Because private video sites are being used, the
pilot guidelines provide for site inspections, certain on-the-record
certifications and other claimant safeguards to help ensure that no
claimants are disadvantaged by participating in their hearing from a
private site. Respondents to this collection will be the claimant's
representatives who elect to participate in the pilot.
The pilot is structured to begin with 10 private video sites
expanding to 30 private sites after a six month evaluation period.
There will be a second evaluation period after the 30 sites have
operated for a six month period. SSA will then make final decisions
regarding operating procedures for a permanent program.
Type of Request: New Information Collection.
Total Burden Hours for all Collections: 717 burden hours (shown
below).
Phase-I
[10 sites for 6 months]
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Average Estimated
Number of Frequency burden per annual
Collection activity respondents of response response burden
(minutes) hours
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Expression of Interest/Initial Contact...................... 100 1 15 25
Certifications Made in the Opening Statement of the Hearing. 10 100 10 167
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Totals.................................................. 110 ........... ........... 192
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Phase-II
[30 sites for 6 months]
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Estimated
Number of Frequency Average annual
Collection activity respondents of response burden per burden
response hours
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Expression of Interest/Initial Contact...................... 100 1 15 25
Certifications Made in the Opening Statement of the Hearing. 30 100 10 500
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Totals.................................................. 130 ........... ........... 525
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II. The information collections listed below have been submitted to
OMB for clearance. Your comments on the information collections would
be most useful if received by OMB and SSA within 30 days from the date
of this publication. You can obtain a copy of the OMB clearance
packages by calling the SSA Reports Clearance Officer at 410-965-0454,
or by writing to the address listed above.
1. Request for Reconsideration--Disability Cessation--20 CFR
404.909, 416.1409--0960-0349. Form SSA-789-U4 is used by claimants to
request reconsideration of a determination and to indicate whether or
not they wish to appear at a disability hearing. This form can also be
used to submit any additional information/evidence for use in the
reconsidered determination and to indicate if an interpreter is needed
for the hearing. SSA will use this information to either arrange for a
hearing or to prepare a decision based on the evidence of record. The
respondents are applicants or claimants for Social Security benefits or
Supplemental Security Income (SSI) payments.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 49,000.
Frequency of Response: 1.
Average Burden Per Response: 13 minutes.
Estimated Annual Burden: 10,617 hours.
2. Psychiatric Review Technique--20 CFR 404.1520a, 416.920a--0960-
0413. Form SSA-2506-BK assists the State Disability Determination
Services (DDSs) in evaluating mental impairments by helping to:
organize and present the mental findings in a clear, concise and
consistent manner; consider and evaluate all aspects of the mental
impairment relevant to the individual's ability to perform work-related
mental functions; and identify additional evidence needed to determine
impairment severity. The respondents are the 52 State DDSs
administering the Title II and Title XVI programs.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 52.
Frequency of Response: 20,595.
Total Annual Responses: 1,070,940.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 267,735 hours.
3. Request for Internet Services-Password Authentication--20 CFR
401.45--0960-0632. Password Authentication is used to establish a
password process for verifying the identity of individuals who choose
to use the Internet and Automated Telephone Response for conducting
business with SSA. Services are password protected when it is necessary
due to the nature of the information being transmitted or because the
requestor requires a higher level of protection. The password process
allows requestors to establish their identities with SSA and create a
[[Page 43273]]
password which they can then use to access their own personal
information. The respondents are individuals electing to do business
with SSA through an electronic medium.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,630,771.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 271,795 hours.
4. Function Report--Adult--Third Party--20 CFR 404.1512, 416.912--
0960-0635. The information collected on the SSA-3380-BK is needed to
make determinations on SSI and Social Security Disability (SSDI)
claims. This information is necessary for case development and
adjudication, and is used by State DDS evaluators as an evidentiary
source used in the disability evaluation process. The respondents are
third parties familiar with the functional limitations (or lack
thereof) of claimants who apply for SSDI benefits and SSI payments.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 1,000,000.
Frequency of Response: 1.
Average Burden Per Response: 60 minutes.
Estimated Annual Burden: 1,000,000 hours.
5. Disability Hearing Officer's Decision--Title XVI Disabled Child
(DC) Continuing Disability Review--20 CFR 404.913-.914, 404.917,
416.994a, 416.1413-.1414, 416.1417--0960-0657. Form SSA-1209-BK is used
by the disability hearing officer conducting the disability hearing to
prepare and issue a written reconsidered determination--specifically
for evaluating Title XVI childhood disability cases. The form provides
the framework for addressing the crucial elements of the case in a
sequential and logical fashion, and the completed form is the official
document of the decision. Respondents are disability hearing officers
in State DDSs.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 35,000.
Frequency of Response: 1.
Average Burden Per Response: 75 minutes.
Estimated Annual Burden: 43,750 hours.
6. Representative Payment Policies Regulation--20 CFR 404.2011,
404.2025, 416.611, 416.625--0960-0679. In cases where SSA determines
that it is not in a beneficiary's best interest to receive payments
directly as it may cause substantial harm, the beneficiaries may
dispute this decision. If they do, they provide SSA with information
which SSA will take into consideration when reevaluating the decision.
Representative payees must also provide SSA with information regarding
their relationship, responsibility, and how payments were used for the
beneficiary. Respondents are beneficiaries and representative payees.
Type of Request: Revision of an OMB-approved information
collection.
Estimated Annual Burden: 363 hours.
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Average Estimated
Number of Frequency burden per annual
CFR section respondents of response response burden
(minutes) hours
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404.2011(a) (1), 416.611(a) (1)............................. 250 1 15 63
404.2025, 416.625........................................... 3,000 1 6 300
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Totals.................................................. 3,250 ........... ........... 363
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7. Statement of Reclamation Action--31 CFR 210--0960-NEW. Form SSA-
1713 collects information regarding whether, how and when a Canadian
bank was able to return erroneous payments made after the death of a
beneficiary who elected to have payments sent to Canada. The SSA-1713
is sent with the SSA-1712, an SSA-generated cover sheet which provides
the Canadian bank with information regarding the deceased beneficiary.
In this way, SSA can reclaim funds which were erroneously paid. The
respondents are Canadian financial institutions to which Social
Security payments have been made.
Type of Request: Existing Information Collection in Use Without an
OMB Number.
Number of Respondents: 15.
Frequency of Response: 1.
Average Burden Per Response: 5 minutes.
Estimated Annual Burden: 1 hour.
8. Statement for Determining Continuing Eligibility, Supplemental
Security Income Payment--20 CFR, Subpart D, 416.204--0960-0145. SSA
uses form SSA-8202-BK to conduct low- and middle-error-profile (LEP-
MEP) telephone or face-to-face redetermination (RZ) interviews with SSI
recipients and representative payees. The information collected during
the interview is used to determine whether SSI recipients have met and
continue to meet all statutory and regulatory requirements for SSI
eligibility and whether they have been, and are still receiving, the
correct payment amount. Form SSA-8202-OCR-SM (Optical Character
Recognition Self-Mailer) collects information similar to that collected
on Form SSA-8202-BK. However, it is used exclusively in LEP RZ cases on
a 6-year cycle.
Type of Request: Revision of an OMB-approved collection.
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Average Estimated
Number of Frequency burden per annual
Forms respondents of response response burden
(minutes) hours
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SSA-8202-F6................................................. 1,000,000 1 21 350,000
SSA-8202-OCR-SM............................................. 700,000 1 11 128,333
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Totals.................................................. 1,700,000 ........... ........... 478,333
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[[Page 43274]]
9. Statement for Determining Continuing Eligibility, Supplemental
Security Income Payment(s)--20 CFR Subpart B, 416.204--0960-0416. SSA
uses the information collected on form SSA-8203-BK for high-error-
profile (HEP) redeterminations of disability to determine whether SSI
recipients have met and continue to meet all statutory and regulatory
requirements for SSI eligibility and whether they have been, and are
still receiving, the correct payment amount. The information is
normally completed in field offices by personal contact (face-to-face
or telephone interview) using the automated Modernized SSI Claim System
(MSSICS). The respondents are recipients of Title XVI benefits.
Type of Request: Revision of an OMB-approved information
collection.
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Average Estimated
Number of Frequency burden per annual
Collection method respondents of response response burden
(minutes) hours
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MISSICS..................................................... 109,012 1 20 36,337
MISSICS/Signature Proxy..................................... 36,338 1 19 11,507
Paper....................................................... 25,650 1 20 8,550
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Totals.................................................. 171,000 ........... ........... 56,394
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Dated: July 26, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-12255 Filed 7-28-06; 8:45 am]
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