Agency Information Collection Activities: Proposed Request and Comment Request, 1253-1257 [E8-10]

Download as PDF Federal Register / Vol. 73, No. 4 / Monday, January 7, 2008 / Notices 19(b)(3)(A) of the Act 9 and Rule 19b– 4(f)(6) thereunder.10 A proposed rule change filed pursuant to Rule 19b–4(f)(6) under the Act 11 normally does not become operative for 30 days after the date of its filing. However, Rule 19b–4(f)(6)(iii) 12 permits the Commission to designate a shorter time if such action is consistent with the protection of investors and the public interest. The NYSE has requested that the Commission waive the 30-day operative delay. The Commission believes that waiving the 30-day operative delay is consistent with the protection of investors and the public interest because it would allow the Moratorium to continue without interruption so that the Exchange may have additional time to make a final determination as to the future roles of RCMMs and CTs in the Hybrid Market, if any, and to file with the Commission a proposed rule change outlining such roles. For these reasons, the Commission designates that the proposed rule change become operative immediately.13 At any time within 60 days of the filing of the proposed rule change, the Commission may summarily abrogate the rule change if it appears to the Commission that such action is necessary or appropriate in the public interest, for the protection of investors, or otherwise in furtherance of the purposes of the Act. IV. Solicitation of Comments Interested persons are invited to submit written data, views and arguments concerning the foregoing, including whether the proposed rule change is consistent with the Act. Comments may be submitted by any of the following methods: Electronic Comments • Use the Commission’s Internet comment form (https://www.sec.gov/ rules/sro.shtml); or 9 15 U.S.C. 78s(b)(3)(A). CFR 240.19b–4(f)(6). Pursuant to Rule 19b– 4(f)(6)(iii) under the Act, the Exchange is required to give the Commission written notice of its intent to file the proposed rule change, along with a brief description and text of the proposed rule change, at least five business days prior to the date of filing of the proposed rule change, or such shorter time as designated by the Commission. The Exchange has requested that the Commission waive the 5-day pre-filing notice requirement. The Commission has determined to waive this requirement to allow the Exchange to file its proposal to extend the Moratorium, which expires on December 31, 2007, without delay. 11 17 CFR 240.19b–4(f)(6). 12 17 CFR 240.19b–4(f)(6)(iii). 13 For purposes only of waiving the 30-day operative delay, the Commission has considered the proposed rule’s impact on efficiency, competition, and capital formation. 15 U.S.C. 78c(f). pwalker on PROD1PC71 with NOTICES 10 17 VerDate Aug<31>2005 19:05 Jan 04, 2008 Jkt 214001 • Send an e-mail to rulecomments@sec.gov. Please include File Number SR–NYSE–2007–125 on the subject line. 1253 and Budget (OMB) in compliance with Public Law 104–13, the Paperwork Reduction Act of 1995, effective October 1, 1995. The information collection packages that may be included in this Paper Comments notice are for new information • Send paper comments in triplicate collections, approval of existing to Nancy M. Morris, Secretary, information collections, revisions to Securities and Exchange Commission, OMB-approved information collections 100 F Street, NE., Washington, DC and extensions (no change) of OMB20549–1090. approved information collections. All submissions should refer to File SSA is soliciting comments on the Number SR–NYSE–2007–125. This file accuracy of the Agency’s burden number should be included on the estimate; the need for the information; subject line if e-mail is used. To help the its practical utility; ways to enhance its Commission process and review your quality, utility and clarity; and on ways comments more efficiently, please use to minimize the burden on respondents, only one method. The Commission will including the use of automated post all comments on the Commission’s collection techniques or other forms of Internet Web site (https://www.sec.gov/ information technology. Written rules/sro.shtml). Copies of the comments and recommendations submission, all subsequent regarding the information collection(s) amendments, all written statements should be submitted to the OMB Desk with respect to the proposed rule Officer and the SSA Reports Clearance change that are filed with the Officer. The information can be mailed, Commission, and all written faxed or emailed to the individuals at communications relating to the the addresses and fax numbers listed proposed rule change between the below: Commission and any person, other than (OMB), Office of Management and those that may be withheld from the Budget, Attn: Desk Officer for SSA, public in accordance with the Fax: 202–395–6974, E-mail address: provisions of 5 U.S.C. 552, will be OIRA_Submission@omb.eop.gov. available for inspection and copying in (SSA), Social Security Administration, the Commission’s Public Reference DCBFM, Attn: Reports Clearance Room, on official business days between Officer, 1333 Annex Building, 6401 the hours of 10 a.m. and 3 p.m. Copies Security Blvd., Baltimore, MD 21235, of the filing also will be available for Fax: 410–965–6400, E-mail address: inspection and copying at the principal OPLM.RCO@ssa.gov. office of the Exchange. All comments I. The information collections listed received will be posted without change; below are pending at SSA and will be the Commission does not edit personal submitted to OMB within 60 days from identifying information from the date of this notice. Therefore, your submissions. You should submit only comments should be submitted to SSA information that you wish to make within 60 days from the date of this available publicly. All submissions publication. You can obtain copies of should refer to File Number SR–NYSE– the collection instruments by calling the 2007–125 and should be submitted on SSA Reports Clearance Officer at 410– or before January 28, 2008. 965–0454 or by writing to the address For the Commission, by the Division of listed above. Trading and Markets, pursuant to delegated 1. Function Report—Adult—Third authority.14 Party—20 CFR 404.1512, 416.912— Nancy M. Morris, 0960–0635. The information collected Secretary. on the SSA–3380–BK is needed to make [FR Doc. E7–25654 Filed 1–4–08; 8:45 am] determinations on Supplemental BILLING CODE 8011–01–P Security Income (SSI) and Social Security disability (SSDI) claims. This information is necessary for case SOCIAL SECURITY ADMINISTRATION development and adjudication, and is used by State Disability Determination Agency Information Collection Services (DDS) evaluators as an Activities: Proposed Request and evidentiary source used in the disability Comment Request evaluation process. The respondents are third parties familiar with the functional The Social Security Administration limitations (or lack thereof) of claimants (SSA) publishes a list of information who apply for SSDI benefits and SSI collection packages that will require payments. clearance by the Office of Management Type of Request: Revision of an OMB14 17 CFR 200.30–3(a)(12). approved information collection. PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 E:\FR\FM\07JAN1.SGM 07JAN1 1254 Federal Register / Vol. 73, No. 4 / Monday, January 7, 2008 / Notices Number of Respondents: 1,000,000. Frequency of Response: 1. Average Burden per Response: 60 minutes. Estimated Annual Burden: 1,000,000 hours. 2. Function Report—Adult—20 CFR 404.1512 and 419.912—0960–0681. Form SSA–3373 is used to collect information about a disability applicant’s impairment-related limitations and ability to function. It documents the types of information specified in SSA regulations and provides disability interviewers with a convenient means to record information about how the claimant’s condition affects his or her ability to function. This information, together with medical evidence, forms the evidentiary basis upon which the initial disability process is founded. The respondents are SSDI and SSI applicants. Type of Request: Revision to an OMBapproved information collection. Number of Respondents: 4,005,367. Frequency of Response: 1. Average Burden per Response: 60 minutes. Estimated Annual Burden: 4,005,367 hours. 3. Information Collections conducted by State DDS’s on Behalf of SSA—20 CFR, subpart P, 404.1503a, 404.1512, 404.1513, 404.1514 404.1517, 404.1519; 20 CFR subpart Q, 404.1613, 404.1614, 404.1624; 20 CFR subpart I, 416.903a, 416.912, 416.913, 416.914, 416.917, 416.919 and 20 CFR subpart J, 416.1013, 416.1024, 416.1014—0960–0555. The State DDS’s collect certain information to administer the SSDI and SSI programs. They collect information from medical sources on consultative examination (CE) medical evidence, CE credentials and Medical Evidence of Number of respondents Record (MER). The DDS’s collect information from claimants regarding medical appointments and pain/ symptoms. The respondents are medical providers, other sources of MER and disability claimants. Type of Request: Revision of an OMBapproved information collection. The total combined burden is 1,803,810 hours. CE Collections There are two collections from CE providers: (a) Medical evidence about claimants, which DDS’s use to make disability determinations when the claimant’s own medical sources cannot or will not provide the required information; and (b) when CE providers offer proof of their credentials. (a) Medical Evidence from CE Providers Frequency of response Average burden per response (minutes) Estimated annual burden (hours) Paper Submissions .............................................................................. Electronic Records Express (ERE) Submissions ................................ 1,215,000 285,000 1 1 30 15 607,500 71,250 Totals ............................................................................................ 1,500,000 — — 678,750 CE Credentials Number of respondents Paper Submission ................................................................................ There are two CE claimant collections: (a) CE claimant completion of a response form in which claimants 3,000 1 indicate if they intend to keep their CE appointment; and (b) CE claimant completion of a form indicating whether Number of respondents Paper Submission ................................................................................ Average burden per response (minutes) Frequency of response 20 1,000 they want a copy of the CE report to be sent to their doctor. (a) Claimants re Appointment Letter Average burden per response (minutes) Frequency of response 750,000 Estimated annual burden (hours) 1 Estimated annual burden (hours) 5 62,500 (b) Claimants re Report to Medical Provider Number of respondents Paper Submission ................................................................................ pwalker on PROD1PC71 with NOTICES MER Collections The DDS’s collect MER information from the claimant’s own medical VerDate Aug<31>2005 19:05 Jan 04, 2008 Jkt 214001 Frequency of response 1,500,000 Average burden per response (minutes) 1 5 sources to determine a claimant’s physical and/or mental status, prior to making a disability determination. PO 00000 Frm 00057 Fmt 4703 Sfmt 4703 E:\FR\FM\07JAN1.SGM Estimated annual burden (hours) 07JAN1 125,000 1255 Federal Register / Vol. 73, No. 4 / Monday, January 7, 2008 / Notices Number of respondents Average burden per response (minutes) Frequency of response Estimated annual burden (hours) Paper Submissions .............................................................................. Connect Direct (CD), (electronic transfer) ........................................... ERE Submission .................................................................................. 2,480,800 218,400 100,800 1 1 1 15 15 7 620,200 54,600 11,760 Total .............................................................................................. 2,800,000 ........................ .............................. 686,560 Pain/Other Symptoms Information From Claimants The DDSs use information about pain/ symptoms to determine how pain/ symptoms affect the claimant’s ability to do work-related activities, prior to making a disability determination. Number of respondents Paper Submission ................................................................................ 4. Social Security Number (SSN) Verification Services—20 CFR 401.45— 0960–0660. Under Internal Revenue Service regulations employers are obligated to provide wage and tax data to the SSA using Form W–2 or its electronic equivalent. As part of this process the employer must furnish the employee’s name and their SSN. The employee’s name and SSN must match SSA’s records in order for the employee’s earnings to be properly posted to their Earnings Record, which is maintained by SSA. 1,000,000 1 In order to better assure that employers provide accurate employee name and SSN data that match SSA’s records, SSA offers serveral cost-free methods for employers to verify the information, as follows: (1) Internetbased service, known as the Social Secuirty Number Verification Service (SSNVS), where the employer can verify if the reported names and SSNs of their employees matches SSA’s records; (2) the Employee Verification Service (EVS), where employers can verify, via cartridge, diskette, paper and telephone Number of respondents Verification system Frequency of response Average burden per response (minutes) Frequency of response Estimated annual burden (hours) 15 250,000 if the reported name and SSN of their employees matches SSA’s records; (3) through our National 800 Number SSA, which is introducing an automated telephone employee verification service (TNEV) that will allow callers, who have been authenicated and have a pin and password to use for this process, to verify employee’s names and SSNs through the telephone system. Type of Request: Revision of an OMBapproved information collection. Number of responses Average burden per response (minutes) Total annual burden (hours) 50,000 200,000 5,798 16 60 60 800,000 12,000,000 347,880 10 5 9 133,333 1,000,000 52,182 Total .................................................................. pwalker on PROD1PC71 with NOTICES EVS .......................................................................... SSNVS ..................................................................... TNEV ........................................................................ 255,798 ........................ 2,347,880 .............................. 1,185,515 5. Agreement to Sell Property—20 CFR 416.1240–1245—0960–0127. Individuals or couples who are otherwise eligible for SSI benefits but whose resources exceed the allowable limit may receive conditional payments if they agree to dispose of the excess non-liquid resources and make repayment. Form SSA–8060 is used to document this agreement and to ensure that the individuals understand their obligations. Respondents are applicants and recipients of SSI benefits who will be disposing of excess non-liquid resources. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 20,000. Frequency of Response: 1. Average Burden per Response: 10 minutes. VerDate Aug<31>2005 19:05 Jan 04, 2008 Jkt 214001 Estimated Annual Burden: 3,333 hours. 6. Listing of Impairments—Part 404, Subpart P, Appendix I and II—0960– 0642. and other evidence. This clearance request covers sections in parts A and B. Background The medical evidence documentation described in the listings is used by State DDS’s to assess the alleged disability. The information, together with other evidence, is used to determine if an individual claiming disability benefits has an impairment that meets severity and duration requirements. The respondents are disability applicants and other sources of evidence. The public reporting burden is accounted for in the Information Collection Requests (ICR) for the various forms that the public uses to submit the information to SSA. Consequently, we are reporting no The Listing of Impairments (the listings), part 404, subpart P, appendix I and II, describes for each of the major body systems, impairments which are severe enough to prevent a person from doing any gainful activity. As part of the listings, we provide a preface which identifies specific requirements that affect the body system, such as documentation requirements and other factors which must be considered when evaluating impairments within that body system. These can include requirements which include medical PO 00000 Frm 00058 Fmt 4703 Sfmt 4703 The Information Collection E:\FR\FM\07JAN1.SGM 07JAN1 1256 Federal Register / Vol. 73, No. 4 / Monday, January 7, 2008 / Notices burden for this regulation aside from a 1-hour placeholder burden. Type of Request: Extension of an OMB-approved information collection. 7. Reporting Events—SSI—20 CFR 416.701–.732—0960–0128. The Social Security Act and regulations requires SSA to collection information to determine eligibility for SSI payments and to determine the correct payment amount. SSA periodically requests information from recipients to reevaluate their continuing SSI eligibility and payment amount using form SSA–8150–EV. Form SSA–8150– EV informs recipients of the information that needs to be reported to SSA in order to retain their benefits. Form SSA–8150–EV provides recipients with a means of reporting changes in their circumstances in writing. SSA uses the reported changes to determine SSI eligibility and correct payment amounts. Type of Request: Extension of an approved OMB information collection. Number of Respondents: 27,320. Frequency of Response: 1. Average Burden per Response: 5 minutes. Estimated Annual Burden: 2,277 hours. 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 Number of respondents Type of respondent the SSA Reports Clearance Officer at 410–965–0454, or by writing to the address listed above. 1. Advanced Notice of Termination of Child’s Benefits & Student’s Statement Regarding School Attendance—20 CFR 404.350–404.352, 404.367–404.368— 0960–0105. The information collected on Forms SSA–1372–BK and SSA– 1372–BK–FC is needed to determine whether children of an insured worker are eligible for student benefits. The respondents are student claimants for Social Security benefits, their respective schools and, in some cases, their representative payees. Type of Request: Revision of an OMBapproved information collection. SSA–1372–BK: Frequency of response Average burden per response (minutes) Total annual burden (hours) Individuals/Households ........................................................................ State/Local/Tribal Government ............................................................ 99,850 99,850 1 1 11 11 18,306 18,306 Totals ............................................................................................ 199,700 ........................ .............................. 36,612 Frequency of response Average burden per response (minutes) SSA–1372–BK–FC: Number of respondents Type of respondent Total annual burden (hours) Individuals/Households ........................................................................ State/Local/Tribal Government ............................................................ 150 150 1 1 11 11 27 27 Totals ............................................................................................ 300 ........................ .............................. 54 Correction Notice: In the First Federal Register Notice, we inadvertently labeled this ICR as an extension instead of a revision. 2. Authorization to Disclose Information to SSA—20 CFR 404.1512 & 20 CFR 416.912—0960–0623. SSA must obtain sufficient medical evidence to make eligibility determinations for SSDI benefits and SSI payments. For SSA to obtain medical evidence, an applicant must authorize his or her medical source(s) to release the information to SSA. The applicant may use one of the forms SSA–827, SSA–827–OP1 or SSA– 827–OP2 to provide consent for the release of information. Generally, the State DDS completes the form(s) based on information provided by the applicant, and sends the form(s) to the designated medical source(s). Type of Request: Revision of a currently approved information collection. Number of Respondents: 3,853,928. Frequency of Response (Average per case): 4. Total Annual Responses: 15,415,712. Average Burden per Response: 13 minutes to complete all 4 forms. Estimated Annual Burden: 835,018 hours. 3. Acknowledgement of Receipt (Notice of Hearing)—20 CFR 404.938 & Number of respondents pwalker on PROD1PC71 with NOTICES Form 416.1438—0960–0671. The HA–504 and HA–504–OP1 are used to acknowledge receipt of the notice of hearing issued by an Administrative Law Judge (ALJ). The ALJ uses the information collected on the HA–504 and HA–504–OP1 to: (1) Prepare for the hearing as scheduled; or (2) reschedule the hearing to a different date and/or location. The respondents are applicants for Social Security benefits or SSI payments who request a hearing to appeal an unfavorable entitlement or eligibility determination. Type of Request: Revision of an OMBapproved information collection. Frequency of response (per year) Average burden per response (minutes) Total annual burden (hours) HA–504 ................................................................................................ HA–504–OP1 ....................................................................................... 60,000 540,000 1 1 1 1 1000 9000 Totals ............................................................................................ 600,000 ........................ .............................. 10,000 VerDate Aug<31>2005 19:05 Jan 04, 2008 Jkt 214001 PO 00000 Frm 00059 Fmt 4703 Sfmt 4703 E:\FR\FM\07JAN1.SGM 07JAN1 1257 Federal Register / Vol. 73, No. 4 / Monday, January 7, 2008 / Notices Correction Notice: In the notice published on October 18, 2007 at 75 FR 59132 we inadvertently labeled this ICR as an extension. It is, in fact, a revision in order to reflect both versions of the form HA–504. Also, we are correcting the burden data from 660,000 respondents and 11,000 burden hours to 600,000 respondents and 10,000 burden hours. 4. Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate—20 CFR 408.900–408.950, 408.923(b), 408.931(b), 408.932(c), (d) and (e), 408.941(b) and 408.942—0960– 0698. Title VIII allows the payment of a monthly benefit by the Commissioner of Social Security to a qualified World War II veteran who resides outside the United States. When an overpayment in SVB occurs, the beneficiary can use this form to request waiver of recovery of the overpayment or a change in the repayment rate. The SSA–2032–BK will be used to obtain the information necessary to determine whether the provisions of the Act regarding waiver of recovery of the overpayment are met. The information on the form is needed to determine a repayment rate if repayment cannot be waived. Respondents are beneficiaries who have overpayments on their Title VIII record and wish to file a claim for waiver of recovery or change in repayment rate. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 450. Frequency of Response: 1. Average Burden per Response: 120 minutes. Total Annual Burden: 900 hours. Correction Notice: We are correcting information published on September 20, 2007 at 72 FR 53803 and on November 5, 2007 at 72 FR 62510 to show updated burden information. We changed the number of respondents from 39 to 450 and the burden hours from 78 to 900 hours. 5. Request for Medical Treatment in an SSA Employee Health Facility: Patient Self-Administered or Staff Administered Care—0960–NEW. SSA operates Employee Health Clinics onsite in eight different states. These clinics provide health care for all SSA employees including treatment of personal medical conditions when Number of respondents Reporting method Frequency of response authorized by a physician. The SSA– 5072 is the employee’s personal physician’s order form. The information collected on the SSA–5072 gives the nurses the guidance they need by law to perform certain medical procedures and to administer prescription medications such as allergy immunotherapy. Also, the information collected by the SSA– 5072 allows the SSA Medical Officer to determine whether the treatment can be administered safely and appropriately in the SSA Employee Health Units. Each State has a Nurse Practice Act governing the practice of registered nurses in the State. All Nurse Practice Acts require that registered nurses administer prescription medications and certain medical treatments by following a licensed physician’s orders. Form SSA– 5072 provides the vehicle for the physician to provide these orders to the SSA nursing staff. Respondents are physicians of SSA employees who need to have medical treatment in the SSA Employee Health Unit. Type of Request: Information Collection in Use without an OMB Number. Number of responses Average burden per response (minutes) Estimated annual burden (hours) Annual ...................................................................... Bi-Annual .................................................................. 25 75 1 2 25 150 5 5 2 13 Totals ................................................................ 100 ........................ 175 .............................. 15 6. Sheltered Workshop Wage Reporting—0960–NEW. Collection Background Section 1612(1)(C) of the Social Security Act (the Act) and 42 U.S.C. 1382a define remuneration received for services performed in a sheltered workshop as earned income for the SSI program. The amount of monthly wages determines an individual’s SSI benefit amount. pwalker on PROD1PC71 with NOTICES Collection Description SSA has maintained a working relationship with sheltered workshops since the inception of the SSI program. Most workshops report monthly wage totals to the local SSA office so that the client’s SSI check is adjusted timely and overpayments are prevented. While participation of the workshop is strictly voluntary, they are highly motivated to report the wages because it provides a service to their clients. Sheltered Workshop reporting reduces the number of overpayments to SSI recipients. Processing these wage reports VerDate Aug<31>2005 19:05 Jan 04, 2008 Jkt 214001 electronically reduces the cost of administering the program. SSA uses the information collected to verify and post monthly wages to the SSI recipient’s record. Respondents are sheltered workshops that report monthly wages for services performed in the workshop. Type of Request: New information collection. Number of Respondents: 1,000. Frequency of Response: 12. Average Burden per Response: 15 minutes. Estimated Annual Burden: 3,000 hours. Correction Notice: We are updating information that was contained in the notices that were published at 72 FR 46529 on August 20, 2007 and 725 FR 62510 on November 5, 2007. We are changing the burden estimate from 5 to 15 minutes. 7. Request for Social Security Earnings Information—20 CFR 404.810 & 401.100—0960–0525. The Social Security Act provides that a wage earner, or someone authorized by a wage earner, may request Social PO 00000 Frm 00060 Fmt 4703 Sfmt 4703 Security earnings information from SSA using form SSA–7050. SSA uses the information collected on the form to verify that the requestor is authorized to access the earnings record and to produce the earnings statement. The respondents are wage earners and organizations and legal representatives authorized by the wage earner. Type of Request: Extension of an OMB-approved information collection. Number of Respondents: 60,000. Frequency of Response: 1. Average Burden per Response: 11 minutes. Estimated Annual Burden: 11,000 hours. Dated: December 31, 2007. Elizabeth A. Davidson, Reports Clearance Officer, Social Security Administration. [FR Doc. E8–10 Filed 1–4–08; 8:45 am] BILLING CODE 4191–02–P E:\FR\FM\07JAN1.SGM 07JAN1

Agencies

Social Security Administration

[Federal Register Volume 73, Number 4 (Monday, January 7, 2008)]
[Notices]
[Pages 1253-1257]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-10]

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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 Public Law
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 the
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, faxed or emailed 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, E-mail address: OIRA--Submission@omb.eop.gov.
(SSA), Social Security Administration, DCBFM, Attn: Reports Clearance
Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, MD 21235,
Fax: 410-965-6400, E-mail address: OPLM.RCO@ssa.gov.

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. 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 Supplemental Security Income (SSI) and Social
Security disability (SSDI) claims. This information is necessary for
case development and adjudication, and is used by State Disability
Determination Services (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.

[[Page 1254]]

Number of Respondents: 1,000,000.
Frequency of Response: 1.
Average Burden per Response: 60 minutes.
Estimated Annual Burden: 1,000,000 hours.
2. Function Report--Adult--20 CFR 404.1512 and 419.912--0960-0681.
Form SSA-3373 is used to collect information about a disability
applicant's impairment-related limitations and ability to function. It
documents the types of information specified in SSA regulations and
provides disability interviewers with a convenient means to record
information about how the claimant's condition affects his or her
ability to function. This information, together with medical evidence,
forms the evidentiary basis upon which the initial disability process
is founded. The respondents are SSDI and SSI applicants.
Type of Request: Revision to an OMB-approved information
collection.
Number of Respondents: 4,005,367.
Frequency of Response: 1.
Average Burden per Response: 60 minutes.
Estimated Annual Burden: 4,005,367 hours.
3. Information Collections conducted by State DDS's on Behalf of
SSA--20 CFR, subpart P, 404.1503a, 404.1512, 404.1513, 404.1514
404.1517, 404.1519; 20 CFR subpart Q, 404.1613, 404.1614, 404.1624; 20
CFR subpart I, 416.903a, 416.912, 416.913, 416.914, 416.917, 416.919
and 20 CFR subpart J, 416.1013, 416.1024, 416.1014--0960-0555. The
State DDS's collect certain information to administer the SSDI and SSI
programs. They collect information from medical sources on consultative
examination (CE) medical evidence, CE credentials and Medical Evidence
of Record (MER). The DDS's collect information from claimants regarding
medical appointments and pain/symptoms. The respondents are medical
providers, other sources of MER and disability claimants.
Type of Request: Revision of an OMB-approved information
collection.
The total combined burden is 1,803,810 hours.

CE Collections

There are two collections from CE providers: (a) Medical evidence
about claimants, which DDS's use to make disability determinations when
the claimant's own medical sources cannot or will not provide the
required information; and (b) when CE providers offer proof of their
credentials.
(a) Medical Evidence from CE Providers

----------------------------------------------------------------------------------------------------------------
Average burden
Number of Frequency of per response Estimated annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Paper Submissions......................... 1,215,000 1 30 607,500
Electronic Records Express (ERE) 285,000 1 15 71,250
Submissions..............................
---------------------------------------------------------------------
Totals................................ 1,500,000 -- -- 678,750
----------------------------------------------------------------------------------------------------------------

CE Credentials

There are two CE claimant collections: (a) CE claimant completion
of a response form in which claimants indicate if they intend to keep
their CE appointment; and (b) CE claimant completion of a form
indicating whether they want a copy of the CE report to be sent to
their doctor.
(a) Claimants re Appointment Letter

(b) Claimants re Report to Medical Provider

MER Collections

The DDS's collect MER information from the claimant's own medical
sources to determine a claimant's physical and/or mental status, prior
to making a disability determination.

[[Page 1255]]

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Average burden
Number of Frequency of per response Estimated annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Paper Submissions......................... 2,480,800 1 15 620,200
Connect Direct (CD), (electronic transfer) 218,400 1 15 54,600
ERE Submission............................ 100,800 1 7 11,760
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Total................................. 2,800,000 .............. ................. 686,560
----------------------------------------------------------------------------------------------------------------

Pain/Other Symptoms Information From Claimants

The DDSs use information about pain/symptoms to determine how pain/
symptoms affect the claimant's ability to do work-related activities,
prior to making a disability determination.

4. Social Security Number (SSN) Verification Services--20 CFR
401.45--0960-0660. Under Internal Revenue Service regulations employers
are obligated to provide wage and tax data to the SSA using Form W-2 or
its electronic equivalent. As part of this process the employer must
furnish the employee's name and their SSN. The employee's name and SSN
must match SSA's records in order for the employee's earnings to be
properly posted to their Earnings Record, which is maintained by SSA.
In order to better assure that employers provide accurate employee
name and SSN data that match SSA's records, SSA offers serveral cost-
free methods for employers to verify the information, as follows: (1)
Internet-based service, known as the Social Secuirty Number
Verification Service (SSNVS), where the employer can verify if the
reported names and SSNs of their employees matches SSA's records; (2)
the Employee Verification Service (EVS), where employers can verify,
via cartridge, diskette, paper and telephone if the reported name and
SSN of their employees matches SSA's records; (3) through our National
800 Number SSA, which is introducing an automated telephone employee
verification service (TNEV) that will allow callers, who have been
authenicated and have a pin and password to use for this process, to
verify employee's names and SSNs through the telephone system.
Type of Request: Revision of an OMB-approved information
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
Average burden
Verification system Number of Frequency of Number of per response Total annual
respondents response responses (minutes) burden (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
EVS............................................................... 50,000 16 800,000 10 133,333
SSNVS............................................................. 200,000 60 12,000,000 5 1,000,000
TNEV.............................................................. 5,798 60 347,880 9 52,182
-------------------------------------------------------------------------------------
Total......................................................... 255,798 .............. 2,347,880 ................. 1,185,515
--------------------------------------------------------------------------------------------------------------------------------------------------------

5. Agreement to Sell Property--20 CFR 416.1240-1245--0960-0127.
Individuals or couples who are otherwise eligible for SSI benefits but
whose resources exceed the allowable limit may receive conditional
payments if they agree to dispose of the excess non-liquid resources
and make repayment. Form SSA-8060 is used to document this agreement
and to ensure that the individuals understand their obligations.
Respondents are applicants and recipients of SSI benefits who will be
disposing of excess non-liquid resources.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 20,000.
Frequency of Response: 1.
Average Burden per Response: 10 minutes.
Estimated Annual Burden: 3,333 hours.
6. Listing of Impairments--Part 404, Subpart P, Appendix I and II--
0960-0642.

Background

The Listing of Impairments (the listings), part 404, subpart P,
appendix I and II, describes for each of the major body systems,
impairments which are severe enough to prevent a person from doing any
gainful activity. As part of the listings, we provide a preface which
identifies specific requirements that affect the body system, such as
documentation requirements and other factors which must be considered
when evaluating impairments within that body system. These can include
requirements which include medical and other evidence. This clearance
request covers sections in parts A and B.

The Information Collection

The medical evidence documentation described in the listings is
used by State DDS's to assess the alleged disability. The information,
together with other evidence, is used to determine if an individual
claiming disability benefits has an impairment that meets severity and
duration requirements. The respondents are disability applicants and
other sources of evidence. The public reporting burden is accounted for
in the Information Collection Requests (ICR) for the various forms that
the public uses to submit the information to SSA. Consequently, we are
reporting no

[[Page 1256]]

burden for this regulation aside from a 1-hour placeholder burden.
Type of Request: Extension of an OMB-approved information
collection.
7. Reporting Events--SSI--20 CFR 416.701-.732--0960-0128. The
Social Security Act and regulations requires SSA to collection
information to determine eligibility for SSI payments and to determine
the correct payment amount. SSA periodically requests information from
recipients to reevaluate their continuing SSI eligibility and payment
amount using form SSA-8150-EV. Form SSA-8150-EV informs recipients of
the information that needs to be reported to SSA in order to retain
their benefits. Form SSA-8150-EV provides recipients with a means of
reporting changes in their circumstances in writing. SSA uses the
reported changes to determine SSI eligibility and correct payment
amounts.
Type of Request: Extension of an approved OMB information
collection.
Number of Respondents: 27,320.
Frequency of Response: 1.
Average Burden per Response: 5 minutes.
Estimated Annual Burden: 2,277 hours.
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. Advanced Notice of Termination of Child's Benefits & Student's
Statement Regarding School Attendance--20 CFR 404.350-404.352, 404.367-
404.368--0960-0105. The information collected on Forms SSA-1372-BK and
SSA-1372-BK-FC is needed to determine whether children of an insured
worker are eligible for student benefits. The respondents are student
claimants for Social Security benefits, their respective schools and,
in some cases, their representative payees.
Type of Request: Revision of an OMB-approved information
collection.
SSA-1372-BK:

----------------------------------------------------------------------------------------------------------------
Average burden
Type of respondent Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Individuals/Households.................... 99,850 1 11 18,306
State/Local/Tribal Government............. 99,850 1 11 18,306
---------------------------------------------------------------------
Totals................................ 199,700 .............. ................. 36,612
----------------------------------------------------------------------------------------------------------------

SSA-1372-BK-FC:

----------------------------------------------------------------------------------------------------------------
Average burden
Type of respondent Number of Frequency of per response Total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
Individuals/Households.................... 150 1 11 27
State/Local/Tribal Government............. 150 1 11 27
---------------------------------------------------------------------
Totals................................ 300 .............. ................. 54
----------------------------------------------------------------------------------------------------------------

Correction Notice: In the First Federal Register Notice, we
inadvertently labeled this ICR as an extension instead of a revision.
2. Authorization to Disclose Information to SSA--20 CFR 404.1512 &
20 CFR 416.912--0960-0623. SSA must obtain sufficient medical evidence
to make eligibility determinations for SSDI benefits and SSI payments.
For SSA to obtain medical evidence, an applicant must authorize his or
her medical source(s) to release the information to SSA. The applicant
may use one of the forms SSA-827, SSA-827-OP1 or SSA-827-OP2 to provide
consent for the release of information. Generally, the State DDS
completes the form(s) based on information provided by the applicant,
and sends the form(s) to the designated medical source(s).
Type of Request: Revision of a currently approved information
collection.
Number of Respondents: 3,853,928.
Frequency of Response (Average per case): 4.
Total Annual Responses: 15,415,712.
Average Burden per Response: 13 minutes to complete all 4 forms.
Estimated Annual Burden: 835,018 hours.
3. Acknowledgement of Receipt (Notice of Hearing)--20 CFR 404.938 &
416.1438--0960-0671. The HA-504 and HA-504-OP1 are used to acknowledge
receipt of the notice of hearing issued by an Administrative Law Judge
(ALJ). The ALJ uses the information collected on the HA-504 and HA-504-
OP1 to: (1) Prepare for the hearing as scheduled; or (2) reschedule the
hearing to a different date and/or location. The respondents are
applicants for Social Security benefits or SSI payments who request a
hearing to appeal an unfavorable entitlement or eligibility
determination.
Type of Request: Revision of an OMB-approved information
collection.

----------------------------------------------------------------------------------------------------------------
Frequency of Average burden
Form Number of response (per per response Total annual
respondents year) (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
HA-504.................................... 60,000 1 1 1000
HA-504-OP1................................ 540,000 1 1 9000
---------------------------------------------------------------------
Totals................................ 600,000 .............. ................. 10,000
----------------------------------------------------------------------------------------------------------------

[[Page 1257]]

Correction Notice: In the notice published on October 18, 2007 at
75 FR 59132 we inadvertently labeled this ICR as an extension. It is,
in fact, a revision in order to reflect both versions of the form HA-
504. Also, we are correcting the burden data from 660,000 respondents
and 11,000 burden hours to 600,000 respondents and 10,000 burden hours.
4. Request for Waiver of Special Veterans Benefits (SVB)
Overpayment Recovery or Change in Repayment Rate--20 CFR 408.900-
408.950, 408.923(b), 408.931(b), 408.932(c), (d) and (e), 408.941(b)
and 408.942--0960-0698. Title VIII allows the payment of a monthly
benefit by the Commissioner of Social Security to a qualified World War
II veteran who resides outside the United States. When an overpayment
in SVB occurs, the beneficiary can use this form to request waiver of
recovery of the overpayment or a change in the repayment rate. The SSA-
2032-BK will be used to obtain the information necessary to determine
whether the provisions of the Act regarding waiver of recovery of the
overpayment are met. The information on the form is needed to determine
a repayment rate if repayment cannot be waived. Respondents are
beneficiaries who have overpayments on their Title VIII record and wish
to file a claim for waiver of recovery or change in repayment rate.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 450.
Frequency of Response: 1.
Average Burden per Response: 120 minutes.
Total Annual Burden: 900 hours.
Correction Notice: We are correcting information published on
September 20, 2007 at 72 FR 53803 and on November 5, 2007 at 72 FR
62510 to show updated burden information. We changed the number of
respondents from 39 to 450 and the burden hours from 78 to 900 hours.
5. Request for Medical Treatment in an SSA Employee Health
Facility: Patient Self-Administered or Staff Administered Care--0960-
NEW. SSA operates Employee Health Clinics onsite in eight different
states. These clinics provide health care for all SSA employees
including treatment of personal medical conditions when authorized by a
physician. The SSA-5072 is the employee's personal physician's order
form. The information collected on the SSA-5072 gives the nurses the
guidance they need by law to perform certain medical procedures and to
administer prescription medications such as allergy immunotherapy.
Also, the information collected by the SSA-5072 allows the SSA Medical
Officer to determine whether the treatment can be administered safely
and appropriately in the SSA Employee Health Units. Each State has a
Nurse Practice Act governing the practice of registered nurses in the
State. All Nurse Practice Acts require that registered nurses
administer prescription medications and certain medical treatments by
following a licensed physician's orders. Form SSA-5072 provides the
vehicle for the physician to provide these orders to the SSA nursing
staff. Respondents are physicians of SSA employees who need to have
medical treatment in the SSA Employee Health Unit.
Type of Request: Information Collection in Use without an OMB
Number.

--------------------------------------------------------------------------------------------------------------------------------------------------------
Average burden
Reporting method Number of Frequency of Number of per response Estimated annual
respondents response responses (minutes) burden (hours)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Annual............................................................ 25 1 25 5 2
Bi-Annual......................................................... 75 2 150 5 13
-------------------------------------------------------------------------------------
Totals........................................................ 100 .............. 175 ................. 15
--------------------------------------------------------------------------------------------------------------------------------------------------------

6. Sheltered Workshop Wage Reporting--0960-NEW.

Collection Background

Section 1612(1)(C) of the Social Security Act (the Act) and 42
U.S.C. 1382a define remuneration received for services performed in a
sheltered workshop as earned income for the SSI program. The amount of
monthly wages determines an individual's SSI benefit amount.

Collection Description

SSA has maintained a working relationship with sheltered workshops
since the inception of the SSI program. Most workshops report monthly
wage totals to the local SSA office so that the client's SSI check is
adjusted timely and overpayments are prevented. While participation of
the workshop is strictly voluntary, they are highly motivated to report
the wages because it provides a service to their clients. Sheltered
Workshop reporting reduces the number of overpayments to SSI
recipients. Processing these wage reports electronically reduces the
cost of administering the program. SSA uses the information collected
to verify and post monthly wages to the SSI recipient's record.
Respondents are sheltered workshops that report monthly wages for
services performed in the workshop.
Type of Request: New information collection.
Number of Respondents: 1,000.
Frequency of Response: 12.
Average Burden per Response: 15 minutes.
Estimated Annual Burden: 3,000 hours.
Correction Notice: We are updating information that was contained
in the notices that were published at 72 FR 46529 on August 20, 2007
and 725 FR 62510 on November 5, 2007. We are changing the burden
estimate from 5 to 15 minutes.
7. Request for Social Security Earnings Information--20 CFR 404.810
& 401.100--0960-0525. The Social Security Act provides that a wage
earner, or someone authorized by a wage earner, may request Social
Security earnings information from SSA using form SSA-7050. SSA uses
the information collected on the form to verify that the requestor is
authorized to access the earnings record and to produce the earnings
statement. The respondents are wage earners and organizations and legal
representatives authorized by the wage earner.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 60,000.
Frequency of Response: 1.
Average Burden per Response: 11 minutes.
Estimated Annual Burden: 11,000 hours.

Dated: December 31, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E8-10 Filed 1-4-08; 8:45 am]
BILLING CODE 4191-02-P

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