Agency Information Collection Activities: Proposed Request and Comment Request, 75607-75608 [E6-21364]

Agencies

• Social Security Administration

[Federal Register Volume 71, Number 241 (Friday, December 15, 2006)]
[Notices]
[Pages 75607-75608]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-21364]


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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 are included in this notice are 
for approvals 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. Request for Hearing by Administrative Law Judge--20 CFR 404.929, 
404.933, 416.1429, 404.1433, 405.722, 418.1350--0960-0269. SSA uses 
form HA-501 to document when applicants for Social Security benefits 
have their claims denied and want to request an administrative hearing 
to appeal SSA's decision. The scope of this form is now being expanded 
to include people who wish to appeal the decision that has been made 
regarding their obligation to pay a new Income-Related Monthly 
Adjustment Amount (IRMAA) for Medicare Part B, as per the requirements 
of the Medicare Modernization Act of 2003. Although this information 
will be collected by SSA, the actual hearings will take place before 
administrative law judges (ALJ) who are employed by the Department of 
Health and Human Services (HHS). The current respondents include 
applicants for various Social Security benefits programs who want to 
request a hearing where they can appeal their denial; the new 
additional respondents are Medicare Part B recipients whom SSA has 
determined will have to pay the new Medicare Part B IRMAA and who wish 
to appeal this decision at a hearing before an HHS ALJ.
    Type of Request: Revision to an OMB-approved information 
collection.
    Number of Respondents: 669,469.
    Frequency of Response: 1.
    Average Burden Per Response: 10 minutes.
    Estimated Annual Burden: 111,578 hours.
    2. Pain Report Child--20 CFR 416.912 and 416.1512--0960-0540. The 
information collected by form SSA-3371-BK will be used to obtain the 
types of information specified in SSA's regulations, and to provide 
disability interviewers (and applicants/claimants in self-help 
situations) with a convenient means of recording the information. This 
information is used by the State disability determination services 
(DDS) adjudicators and administrative law judges to assess the effects 
of symptoms on functionality for determining disability under the 
Social Security Act. The respondents are applicants for Supplemental 
Security Income (SSI) benefits.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 250,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 62,500 hours.
    3. Request to Resolve Questionable Quarters of Coverage (QC); 
Request for QC History Based on Relationship--0960-0575. Form SSA-512 
is used by states to request clarification from SSA on questionable QC 
information. The Personal Responsibility and Work Opportunity 
Reconciliation Act states that aliens admitted for lawful residence 
that have worked and earned 40 qualifying QCs for Social Security 
purposes can generally receive state benefits. Form SSA-513 is used by 
states to request QC information for an alien's spouse or child in 
cases where the alien does not sign a consent form giving permission to 
access his/her Social Security records. QCs can also be allocated to a 
spouse and/or to a child under age 18, if needed, to obtain 40 
qualifying QCs for the alien. The respondents are state agencies that 
require QC information in order to determine eligibility for benefits.
    Type of Request: Extension of an OMB-approved information 
collection.

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                                                                                  Average burden     Estimated
                   Collections                       Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minute)         (hours)
----------------------------------------------------------------------------------------------------------------
SSA-512.........................................         200,000               1               2           6,667
SSA-513.........................................         350,000               1               2          11,667
    Totals......................................         550,000  ..............  ..............          18,334
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    4. Application of Circuit Court Law--20 CFR 404.985 & 416.1458--
0960-0581. Under SSA regulations persons may requests re-adjudication 
on the basis that the application of an acquiescence ruling (AR) would 
change a prior determination or decision. We will use the information 
provided to determine whether they are entitled to re-adjudication of 
their claims in accordance with these regulations. We will review the 
available information in the requests to determine whether the issue(s) 
stated in the AR pertains to the claimant's case. If re-adjudication is 
appropriate, we will consider only those issue(s) covered by the AR. 
Any new determination or decision will be

[[Page 75608]]

subject to administrative or judicial review in accordance with our 
regulations. Individuals who request re-adjudication are claimants for 
Social Security benefits and Supplemental Security Income payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 10,000.
    Frequency of Response: 1.
    Average Burden Per Response: 17 minutes.
    Estimated Annual Burden: 2,833 hours.
    5. Certificate of Support--20 CFR 404.370, 404.750, 404.408a--0960-
0001. The information collected on the SSA-760-F4 is used to determine 
whether the parent of a deceased worker or the spouse meets the one-
half support requirement specified in SSA regulations. Respondents are 
parents of deceased workers, or spouses who may qualify for an 
exception to Government Pension Offset.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 18,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 4,500 hours.
    6. Child Relationship Statement--20 CFR 404.355 & 404.731--0960-
0116. The information collected on the SSA-2519 is used to help 
determine the entitlement of children to Social Security benefits under 
section 216(h)(3) of the Social Security Act (deemed child provision). 
Respondents are persons with knowledge of the relationship between the 
number holder and his/her alleged biological child who is filing for 
benefits.
    Type of Request: Revision of an OMB-approved information 
collection.
    Number of Respondents: 50,000.
    Frequency of Response: 1.
    Average Burden Per Response: 15 minutes.
    Estimated Annual Burden: 12,500 hours.
    7. Substitution of Party Upon Death of Claimant--20 CFR 
404.957(c)(4) & 416.1457(c)(4)--0960-0288. The HA-539 is used to 
collect information from any individual who asks to be made a 
substitute party for a claimant for either Social Security benefits or 
Supplemental Security Income payments who dies while his or her request 
for a hearing is pending. This information is needed and used by SSA to 
afford these individuals their statutory right to a hearing and 
decision under the Social Security Act. Respondents are individuals 
requesting to proceed with hearings as substitute parties for deceased 
claimants for Social Security benefits or Supplemental Security Income 
payments.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 4,320.
    Frequency of Response: 1.
    Average Burden Per Response: 5 minutes.
    Estimated Annual Burden: 432 hours.
    8. 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 burden     Estimated
                Collection method                    Number of     Frequency of    per response    annual burden
                                                    respondents      response        (minutes)         hours
----------------------------------------------------------------------------------------------------------------
MISSICS.........................................         109,012               1              20          36,337
MISSICS/Signature Proxy.........................          36,338               1              19          11,507
Paper...........................................          25,650               1              20           8,550
    Totals......................................         171,000  ..............  ..............          56,394
----------------------------------------------------------------------------------------------------------------

    9. Physical Residual Functional Capacity Assessment and Mental 
Residual Functional Capacity Assessment--20 CFR 404.1545-404.1546 & 
416.945-416.946--0960-0431. The information collected on form SSA-4734-
BK and SSA-4734-F4-SUP is needed by SSA to assist in the adjudication 
of disability claims involving physical and/or mental impairments. The 
forms assist the State DDS offices to evaluate the severity of 
impairments by providing standardized data collection forms. The use of 
these forms by the DDSs ensures nationally consistent evaluations 
presented in a concise, clear and readily understandable manner. The 
respondents are primarily doctors in DDSs funded and administered by 
SSA.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 2,397,646.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 799,215 hours.
    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. Representative Payee Report of Benefits and Dedicated Account--
20 CFR 416.546, 416.635, 416.640, 416.665--0960-0576. The Social 
Security Act provides for representative payees (RPs) to submit a 
written report accounting for the use of money paid to SSI recipients, 
and that RPs must establish and maintain a dedicated account for these 
payments. The SSA-6233 is used to ensure that the RP is using the 
benefits received for the beneficiary's current maintenance and 
personal needs, and the expenditures of funds from the dedicated 
account are in compliance with the law. Respondents are representative 
payees for SSI recipients.
    Type of Request: Extension of an OMB-approved information 
collection.
    Number of Respondents: 30,000.
    Frequency of Response: 1.
    Average Burden Per Response: 20 minutes.
    Estimated Annual Burden: 10,000 hours.

    Dated: December 11, 2006.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E6-21364 Filed 12-14-06; 8:45 am]
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