Agency Information Collection Activities: Proposed Request, 31972-31976 [2019-14173]
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Federal Register / Vol. 84, No. 128 / Wednesday, July 3, 2019 / Notices
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW, Suite 6050,
Washington, DC 20416, (202) 205–6734.
SUPPLEMENTARY INFORMATION: The notice
of the President’s major disaster
declaration for the State of South
Dakota, dated 06/07/2019, is hereby
amended to include the following areas
as adversely affected by the disaster:
Primary Counties (Physical Damage and
Economic Injury Loans): Turner
Contiguous Counties (Economic Injury
Loans Only): None
All other information in the original
declaration remains unchanged.
(Catalog of Federal Domestic Assistance
Number 59008)
James Rivera,
Associate Administrator for Disaster
Assistance.
[FR Doc. 2019–14145 Filed 7–2–19; 8:45 am]
BILLING CODE 8026–03–P
SMALL BUSINESS ADMINISTRATION
[Disaster Declaration #16016 and #16017;
North Carolina Disaster Number NC–00110]
Administrative Declaration of a
Disaster for the State of North Carolina
U.S. Small Business
Administration.
ACTION: Notice.
AGENCY:
This is a notice of an
Administrative declaration of a disaster
for the State of North Carolina dated 06/
27/2019.
Incident: Flooding and Heavy Winds.
Incident Period: 06/06/2019.
DATES: Issued on 06/27/2019.
Physical Loan Application Deadline
Date: 08/26/2019.
Economic Injury (EIDL) Loan
Application Deadline Date: 03/27/2020.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW, Suite 6050,
Washington, DC 20416, (202) 205–6734.
SUPPLEMENTARY INFORMATION: Notice is
hereby given that as a result of the
jspears on DSK30JT082PROD with NOTICES
SUMMARY:
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Administrator’s disaster declaration,
applications for disaster loans may be
filed at the address listed above or other
locally announced locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties: Catawba,
Mecklenburg.
Contiguous Counties:
North Carolina: Alexander, Burke,
Cabarrus, Caldwell, Gaston, Iredell,
Lincoln, Union.
South Carolina: Lancaster, York.
The Interest Rates are:
Percent
For Physical Damage:
Homeowners with Credit Available Elsewhere ......................
Homeowners without Credit
Available Elsewhere ..............
Businesses with Credit Available Elsewhere ......................
Businesses
without
Credit
Available Elsewhere ..............
Non-Profit Organizations with
Credit Available Elsewhere ...
Non-Profit Organizations without Credit Available Elsewhere .....................................
For Economic Injury:
Businesses & Small Agricultural
Cooperatives without Credit
Available Elsewhere ..............
Non-Profit Organizations without Credit Available Elsewhere .....................................
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes extensions
and revisions of OMB-approved
information collections.
SSA is soliciting comments on the
accuracy of the agency’s burden
estimate; the need for the information;
its practical utility; ways to enhance its
quality, utility, and clarity; and ways to
minimize burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Mail, email, or
fax your comments and
recommendations on the information
collection(s) to the OMB Desk Officer
and SSA Reports Clearance Officer at
the following addresses or fax numbers.
(OMB), Office of Management and
Budget, Attn: Desk Officer for SSA,
1.938
Fax: 202–395–6974, Email address:
OIRA_Submission@omb.eop.gov
8.000
(SSA), Social Security Administration,
OLCA, Attn: Reports Clearance
4.000
Director, 3100 West High Rise, 6401
2.750
Security Blvd., Baltimore, MD 21235,
Fax: 410–966–2830, Email address:
OR.Reports.Clearance@ssa.gov
3.875
2.750
Or you may submit your comments
online through www.regulations.gov,
referencing Docket ID Number [SSA–
4.000 2019–0026].
The information collections below are
pending at SSA. SSA will submit them
2.750
to OMB within 60 days from the date of
this notice. To be sure we consider your
The number assigned to this disaster
comments, we must receive them no
for physical damage is 16016 6 and for
later than September 3, 2019.
economic injury is 16017 0.
Individuals can obtain copies of the
The States which received an EIDL
collection instruments by writing to the
Declaration # are North Carolina, South
above email address.
Carolina.
1. Application for Child’s Insurance
(Catalog of Federal Domestic Assistance
Benefits—20 CFR 404.350–404.368,
Number 59008)
404.603, & 416.350—0960–0010. Title II
Christopher Pilkerton,
of the Social Security Act (Act) provides
for the payment of monthly benefits to
Acting Administrator.
children of an insured retired, disabled,
[FR Doc. 2019–14151 Filed 7–2–19; 8:45 am]
or deceased worker. Section 202(d) of
BILLING CODE 8026–03–P
the Act discloses the conditions and
requirements the applicant must meet
when filing an application. SSA uses
SOCIAL SECURITY ADMINISTRATION
the information on Form SSA–4–BK to
[Docket No: SSA–2019–0026]
determine entitlement for children of
living and deceased workers to monthly
Agency Information Collection
Social Security payments. Respondents
Activities: Proposed Request
are guardians completing the form on
behalf of the children of living or
The Social Security Administration
deceased workers, or the children of
(SSA) publishes a list of information
living or deceased workers.
collection packages requiring clearance
by the Office of Management and
Type of Request: Revision of an OMBBudget (OMB) in compliance with
approved information collection.
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Federal Register / Vol. 84, No. 128 / Wednesday, July 3, 2019 / Notices
Number of
respondents
Modality of completion
Estimated
total annual
burden
(hours)
Application for Child’s Insurance Benefits/Death Claim/Paper SSA–4–BK ....
Application for Child’s Insurance Benefits/Death Claim/Modernized Claims
System (MCS) and Preliminary Claims System (PCS) ...............................
Application for Child’s Insurance Benefits/Life Claim/Paper SSA–4–BK ........
Application for Child’s Insurance Benefits/Life Claim/MCS and PCS .............
1,204
1
12
241
204,777
3,484
422,267
1
1
1
11
12
11
37,542
697
77,416
Totals ........................................................................................................
631,732
........................
........................
115,896
2. Request for Hearing by
Administrative Law Judge—20 CFR
404.929, 404.933, 416.1429, 404.1433,
418.1350, and 42 CFR 405.722—0960–
0269. When SSA denies applicants’,
claimants’, or beneficiaries’ requests for
new or continuing disability benefits or
payments, the Act entitles those
applicants, claimants, or beneficiaries to
request a hearing to appeal the decision.
To request a hearing, individuals
complete Form HA–501; the associated
Modernized Claims System (MCS) or
Supplemental Security Income (SSI)
Claims System interview; or the internet
application (i501). SSA uses the
information to determine if the
individual: (1) Filed the request within
the prescribed time; (2) is the proper
party; and (3) took the steps necessary
to obtain the right to a hearing. SSA also
uses the information to determine: (1)
The individual’s reason(s) for
disagreeing with SSA’s prior
determinations in the case; (2) if the
individual has additional evidence to
submit; (3) if the individual wants an
oral hearing or a decision on the record;
Number of
respondents
Modality of completion
and (4) whether the individual has (or
wants to appoint) a representative. The
respondents are Social Security
disability applicants and recipients who
want to appeal SSA’s denial of their
request for new or continued benefits
for disability and non-medical hearing
requests; and Medicare Part B recipients
who must pay the Medicare Part B
Income-Related Monthly Adjustment
Amount.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
HA–501; MCS; SSI Claims System .................................................................
i501 (Internet iAppeals) ...................................................................................
10,325
653,318
1
1
10
5
1,721
54,443
Totals ........................................................................................................
663,643
........................
........................
56,164
3. Travel Expense Reimbursement—
20 CFR 404.999(d) and 416.1499—
0960–0434. The Act provides for travel
expense reimbursement from Federal
and State agencies for claimant travel
incidental to medical examinations, and
to parties, their representatives, and all
reasonably necessary witnesses for
jspears on DSK30JT082PROD with NOTICES
Average
burden per
response
(minutes)
Frequency
of response
travel exceeding 75 miles to attend
medical examinations; reconsideration
interviews; and proceedings before an
administrative law judge.
Reimbursement procedures require the
claimant to provide: (1) A list of
expenses incurred, and (2) receipts of
such expenses. Federal and state
personnel review the listings and
receipts to verify the reimbursable
amount to the requestor. The
respondents are claimants for Title II
benefits and Title XVI payments, their
representatives, and witnesses.
Type of Request: Extension of an
OMB-approved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
404.99(d) & 416.1499 ......................................................................................
60,000
1
10
10,000
4. Certificate of Coverage Request—20
CFR 404.1913—0960–0554. The United
States (U.S.) has agreements with 30
foreign countries to eliminate double
Social Security coverage and taxation
where, except for the provisions of the
agreement, a worker would be subject to
coverage and taxes in both countries.
These agreements contain rules for
determining the country under whose
laws the worker’s period of employment
is covered, and to which country the
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worker will pay taxes. The agreements
further dictate that, upon the request of
the worker or employer, the country
under whose system the period of work
is covered will issue a certificate of
coverage. The certificate serves as proof
of exemption from coverage and
taxation under the system of the other
country. The information we collect
assists us in determining a worker’s
coverage and in issuing a U.S. certificate
of coverage as appropriate. Per our
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agreements, we ask a set number of
questions to the workers and employers
prior to issuing a certificate of coverage;
however, our agreements with Denmark,
Netherlands, Norway, and Sweden
require us to ask more questions in
those countries. Respondents are
workers and employers wishing to
establish exemption from foreign Social
Security taxes.
Type of Request: Revision of an OMBapproved information collection.
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Number of
respondents
Modality of completion
Requests via Letter—Individuals (minus Denmark, Netherlands, Norway,
Poland & Sweden) .......................................................................................
Requests via Internet—Individuals (minus Denmark, Netherlands, Norway,
Poland & Sweden) .......................................................................................
Requests via Letter—Individuals in Denmark, Netherlands, Norway, & Sweden ...............................................................................................................
Requests via Letter—Individuals in Poland .....................................................
Requests via Internet—Individuals in Denmark, Netherlands, Norway, &
Sweden ........................................................................................................
Requests via Internet—Individuals in Poland ..................................................
Requests via Letter—Employers (minus Denmark, Netherlands, Norway,
Poland & Sweden) .......................................................................................
Requests via Internet—Employers (minus Denmark, Netherlands, Norway,
Poland, & Sweden) ......................................................................................
Requests via Letter—Employers in Denmark, Netherlands, Norway, & Sweden ...............................................................................................................
Requests via Letter—Employers in Poland .....................................................
Requests via Internet—Employers in Denmark, Netherlands, Norway, &
Sweden ........................................................................................................
Requests via Internet—Employers in Poland ..................................................
Totals ........................................................................................................
5. Privacy and Disclosure of Official
Records and Information; Availability of
Information and Records to the Public—
20 CFR 401.40(b)&(c), 401.55(b),
401.100(a), 402.130, 402.185—0960–
0566. SSA established methods for the
public to: (1) Access their SSA records;
(2) allow SSA to disclose records; (3)
1
40
3,889
9,761
1
40
6,507
284
16
1
1
44
41
208
11
427
25
1
1
44
41
313
17
26,047
1
40
17,365
39,096
1
40
26,064
1,137
57
1
1
44
41
834
39
1,704
86
1
1
44
41
1,250
59
84,473
........................
........................
56,556
Number of
respondents
consent for release of records, for which
we use Form SSA–3288. The
respondents are individuals requesting
access to, correction of, or disclosure of
SSA records.
Type of Request: Extension of an
OMB-approved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
Access to Records ...........................................................................................
Designating a Representative for Disclosure of Records ...............................
Amendment of Records ...................................................................................
Consent of Release of Records ......................................................................
FOIA Requests for Records ............................................................................
Respondents who request access to an extract of their SSN record .............
10,000
3,000
100
3,000,760
15,000
10
1
1
1
1
1
1
11
120
10
3
5
8.5
1,833
6,000
17
150,038
1,250
1
Totals ........................................................................................................
3,028,870
........................
........................
159,139
6. Disability Report—Child—20 CFR
416.912—0960–0577—Sections
223(d)(5)(A) and 1631(e)(1) of the Act
require SSI claimants to furnish medical
and other evidence to prove they are
disabled. SSA uses Form SSA–3820 to
collect various types of information
about a child’s condition from treating
sources or other medical sources of
evidence. The State Disability
Determination Services evaluators use
the information from Form SSA–3820 to
develop medical and school evidence,
and to assess the alleged disability. The
information, together with medical
evidence, forms the evidentiary basis
Number of
respondents
Modality of completion
jspears on DSK30JT082PROD with NOTICES
Estimated
total annual
burden
(hours)
5,833
correct or amend their SSA records; (4)
consent for release of their records; (5)
request records under the Freedom of
Information Act (FOIA); and (6) request
access to an extract of their SSN record.
SSA often collects the necessary
information for these requests through a
written letter, with the exception of the
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
upon which SSA makes its initial
disability evaluation. The respondents
are claimants seeking SSI childhood
disability payments.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
SSA–3820 ........................................................................................................
EDCS ...............................................................................................................
i3820 ................................................................................................................
177,572
1,000
176,572
1
1
1
90
120
120
266,358
2,000
353,144
Totals ........................................................................................................
355,144
........................
........................
621,502
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7. Request for Reconsideration—20
CFR 404.907–404.921, 416.1407–
416.1421, 408.1009, and 418.1325—
0960–0622. The Act states those
individuals who are dissatisfied with
the results of an initial determination
regarding their Title II disability; Tile
XVI disability (SSI); Title VIII (Special
Veterans benefits); or Title XVIII
(Medicare benefits), can request a
reconsideration hearing. Individuals use
Form SSA–561–U2; the associated MCS
or SSI Claims System interview; or the
internet application (i561) to initiate a
request for reconsideration of a denied
claim. SSA uses the information to
document the request and to determine
an individual’s eligibility or entitlement
to Social Security benefits (Title II); SSI
payments (Title XVI); Special Veterans
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
SSA–561 and Modernized Claims System (MCS) ..........................................
I561 (Internet iAppeals) ...................................................................................
330,370
1,161,300
1
1
8
5
40,049
96,775
Totals ........................................................................................................
1,491,670
........................
........................
136,824
8. Request to Withdraw a Hearing
Request; Request to Withdraw an
Appeals Council Request for Review;
and Administrative Review Process for
Adjudicating Initial Disability Claims—
20 CFR parts 404, 405, and 416—0960–
0710. Claimants have a statutory right
under the Act and current regulations to
apply for Social Security Disability
Insurance (SSDI) benefits or SSI
payments. SSA collects information at
each step of the administrative process
to adjudicate claims fairly and
efficiently. SSA collects this
information to establish a claimant’s
right to administrative review, and
determine the severity of the claimant’s
alleged impairments. SSA uses the
information we collect to determine
entitlement or continuing eligibility to
SSDI benefits or SSI payments, and to
enable appeals of these determinations.
Number of
respondents
20 CFR section No.
jspears on DSK30JT082PROD with NOTICES
Benefits (Title VIII); Medicare (Title
XVIII); and for initial determinations
regarding Medicare Part B incomerelated premium subsidy reductions.
The respondents are applicants,
claimants, beneficiaries, or recipients
filing for reconsideration of an initial
determination.
Type of Request: Revision of an OMBapproved information collection.
In addition, SSA collects information on
Forms HA–85 and HA–86 to allow
claimants to withdraw a hearing request
or an Appeals Council review request.
The respondents are applicants for Title
II SSDI or Title XVI SSI benefits; their
appointed representatives; legal
advocates; medical sources; and
schools.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
annual
burden
(hours)
404.961, 416.1461, 405.330, and 405.366 .....................................................
404.950, 416.1450, and 405.332 ....................................................................
404.949 and 416.1449 .....................................................................................
405.334 ............................................................................................................
404.957, 416.1457, and 405.380 ....................................................................
405.381 ............................................................................................................
405.401 ............................................................................................................
404.971 and 416.1471 .....................................................................................
(HA–85; HA–86) ..............................................................................................
404.982 and 416.1482 .....................................................................................
404.987 & 404.988 and 416.1487 & 416.1488 and 405.601 ..........................
404.1740(b)(1) .................................................................................................
416.1540(b)(1) .................................................................................................
404.1512, 404.1740(c)(4), 416.912, and 416.1540(c)(4) ................................
405.372(c) ........................................................................................................
405.1(b)(5) .......................................................................................................
405.372(b) ........................................................................................................
405.505 ............................................................................................................
405.1(c)(2) .......................................................................................................
405.20 ..............................................................................................................
12,220
1,040
2,868
20
21,041
37
5,310
1
1
1
1
1
1
1
20
20
60
60
10
30
10
4,073
347
2,868
20
3,507
19
885
1,606
1,687
12,425
150
150
150
5,310
833
1
1
1
1
1
1
1
1
10
30
30
2
2
2
10
30
268
844
6,213
5
5
5
885
417
833
5,310
5,310
1
1
1
30
10
10
417
885
885
Totals ........................................................................................................
76,300
........................
........................
22,548
9. Request for Accommodation in
Communication Method—0960–0777.
SSA allows disabled or impaired Social
Security applicants, beneficiaries,
recipients, and representative payees to
choose one of seven alternative methods
of communication they want SSA to use
when we send them benefit notices and
other related communications. The
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seven alternative methods we offer are:
(1) Standard print notice by first-class
mail; (2) standard print mail with a
follow-up telephone call; (3) certified
mail; (4) Braille; (5) Microsoft Word file
on data CD; (6) large print (18-point
font); or (7) audio CD. However,
respondents who want to receive
notices from SSA through a
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communication method other than the
seven methods listed above must
explain their request to us. Those
respondents use Form SSA–9000 to: (1)
Describe the type of accommodation
they want; (2) disclose their condition
necessitating the need for a different
type of accommodation; and (3) explain
why none of the seven methods
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described above are sufficient for their
needs. SSA uses Form SSA–9000 to
determine, based on applicable law and
regulation, whether to grant the
respondents’ requests for an
accommodation based on their
impairment or disability. SSA collects
beneficiaries, recipients, and
representative payees who ask SSA to
send notices and other communications
in an alternative method besides the
seven modalities we currently offer.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–9000/iAccommodate ...............................................................................
5,000
1
20
1,667
10. Report of Adult FunctioningEmployer—20 CFR 404.1512 and
416.912—0960–0805. Section 205(a),
223(d)(5)(A), 1631(d)(1), and 1631(e)(1)
of the Act require claimants’ applying
for SSDI benefits or SSI payments to
provide SSA with medical and other
evidence of their disability. 20 CFR
404.1512 and 20 CFR 416.912 of the
Code of Federal Regulations provides
detailed requirements of the types of
evidence SSDI beneficiaries and SSI
claimants must provide showing how
their impairment(s) affect their ability to
work (e.g., evidence of age; education
and training, work experience; daily
activities; efforts to work; and any other
evidence). Past employers familiar with
the claimant’s ability to perform work
activities complete Form SSA–385–BK,
Report of Adult Functioning-Employer
to provide SSA with information about
the employees day-to-day functioning in
the work setting. SSA and Disability
Determination Services use the
information Form SSA–3385–BK
collects as the basis to determine
eligibility or continued eligibility for
disability benefits. The respondents are
claimants’ past employers.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
responses
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–3385–BK .................................................................................................
3,601
1
20
1,200
Dated: June 27, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2019–14173 Filed 7–2–19; 8:45 am]
BILLING CODE 4191–02–P
SURFACE TRANSPORTATION BOARD
[Docket No. FD 36322]
Athens Transportation Partners, LLC—
Acquisition Exemption—The Athens
Line, LLC
jspears on DSK30JT082PROD with NOTICES
this information electronically through
either an in-person interview or a
telephone interview during which the
SSA employee keys in the information
on our iAccommodate Intranet screens.
The respondents are disabled or
impaired Social Security applicants,
Athens Transportation Partners, LLC
(ATP) has filed a verified notice of
exemption under 49 CFR 1150.31 to
acquire from The Athens Line, LLC
(Athens Line) approximately 6.5 miles
of rail line in Athens, Ga., extending
between milepost F–98.8 and milepost
F–105.3. (the Line).
ATP states that Athens Line recently
discontinued service over the Line 1 and
has agreed, subject to closing, to convey
the Line and the appurtenant rights
thereof to ATP pursuant to a Purchase
and Sale Agreement. ATP states that it
will assume the common carrier
1 See Athens Line—Discontinuance of Serv.
Exemption—in Oconee & Clarke Ctys., Ga., AB
1274X (STB served Apr. 25, 2019).
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Jkt 247001
obligation for the Line and arrange for
any common carrier service that may be
required.
ATP certifies that its projected annual
revenues as a result of this transaction
will not exceed those that would qualify
it as a Class III rail carrier. ATP further
certifies that its acquisition of the Line
does not involve any provision or
agreement that would limit future
interchange with a third-party
connecting carrier.
The transaction may be consummated
on or after July 20, 2019, the effective
date of the exemption (30 days after the
verified notice was filed).
If the verified notice contains false or
misleading information, the exemption
is void ab initio. Petitions to revoke the
exemption under 49 U.S.C. 10502(d)
may be filed at any time. The filing of
a petition to revoke will not
automatically stay the effectiveness of
the exemption. Petitions to stay must be
filed no later than July 12, 2019 (at least
seven days before the exemption
becomes effective).
All pleadings, referring to Docket No.
FD 36322, must be filed with the
Surface Transportation Board either via
e-filing or in writing addressed to 395 E
Street SW, Washington, DC 20423–0001.
In addition, a copy of each pleading
must be served on ATP’s representative,
PO 00000
Frm 00145
Fmt 4703
Sfmt 4703
Paul A. Cunningham, Harkins
Cunningham, LLP, 1700 K Street NW,
Suite 400, Washington, DC 20006.
Board decisions and notices are
available at www.stb.gov.
Decided: June 28, 2019.
By the Board, Allison C. Davis, Director,
Office of Proceedings.
Jeffrey Herzig,
Clearance Clerk.
[FR Doc. 2019–14260 Filed 7–2–19; 8:45 am]
BILLING CODE 4915–01–P
SUSQUEHANNA RIVER BASIN
COMMISSION
Public Hearing
Susquehanna River Basin
Commission.
ACTION: Notice.
AGENCY:
The Susquehanna River Basin
Commission will hold a public hearing
on August 1, 2019, in Harrisburg,
Pennsylvania. At this public hearing,
the Commission will hear testimony on
the projects listed in the SUPPLEMENTARY
INFORMATION section of this notice. Such
projects are intended to be scheduled
for Commission action at its next
business meeting, tentatively scheduled
for September 6, 2019, which will be
SUMMARY:
E:\FR\FM\03JYN1.SGM
03JYN1
]]>Agencies
[Federal Register Volume 84, Number 128 (Wednesday, July 3, 2019)]
[Notices]
[Pages 31972-31976]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-14173]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2019-0026]
Agency Information Collection Activities: Proposed Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes extensions and revisions of OMB-approved information
collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974, Email address: [email protected]
(SSA), Social Security Administration, OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-966-2830, Email address: [email protected]
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2019-0026].
The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than
September 3, 2019. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Application for Child's Insurance Benefits--20 CFR 404.350-
404.368, 404.603, & 416.350--0960-0010. Title II of the Social Security
Act (Act) provides for the payment of monthly benefits to children of
an insured retired, disabled, or deceased worker. Section 202(d) of the
Act discloses the conditions and requirements the applicant must meet
when filing an application. SSA uses the information on Form SSA-4-BK
to determine entitlement for children of living and deceased workers to
monthly Social Security payments. Respondents are guardians completing
the form on behalf of the children of living or deceased workers, or
the children of living or deceased workers.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 31973]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Application for Child's Insurance Benefits/Death 1,204 1 12 241
Claim/Paper SSA-4-BK...........................
Application for Child's Insurance Benefits/Death 204,777 1 11 37,542
Claim/Modernized Claims System (MCS) and
Preliminary Claims System (PCS)................
Application for Child's Insurance Benefits/Life 3,484 1 12 697
Claim/Paper SSA-4-BK...........................
Application for Child's Insurance Benefits/Life 422,267 1 11 77,416
Claim/MCS and PCS..............................
---------------------------------------------------------------
Totals...................................... 631,732 .............. .............. 115,896
----------------------------------------------------------------------------------------------------------------
2. Request for Hearing by Administrative Law Judge--20 CFR 404.929,
404.933, 416.1429, 404.1433, 418.1350, and 42 CFR 405.722--0960-0269.
When SSA denies applicants', claimants', or beneficiaries' requests for
new or continuing disability benefits or payments, the Act entitles
those applicants, claimants, or beneficiaries to request a hearing to
appeal the decision. To request a hearing, individuals complete Form
HA-501; the associated Modernized Claims System (MCS) or Supplemental
Security Income (SSI) Claims System interview; or the internet
application (i501). SSA uses the information to determine if the
individual: (1) Filed the request within the prescribed time; (2) is
the proper party; and (3) took the steps necessary to obtain the right
to a hearing. SSA also uses the information to determine: (1) The
individual's reason(s) for disagreeing with SSA's prior determinations
in the case; (2) if the individual has additional evidence to submit;
(3) if the individual wants an oral hearing or a decision on the
record; and (4) whether the individual has (or wants to appoint) a
representative. The respondents are Social Security disability
applicants and recipients who want to appeal SSA's denial of their
request for new or continued benefits for disability and non-medical
hearing requests; and Medicare Part B recipients who must pay the
Medicare Part B Income-Related Monthly Adjustment Amount.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
HA-501; MCS; SSI Claims System.................. 10,325 1 10 1,721
i501 (Internet iAppeals)........................ 653,318 1 5 54,443
---------------------------------------------------------------
Totals...................................... 663,643 .............. .............. 56,164
----------------------------------------------------------------------------------------------------------------
3. Travel Expense Reimbursement--20 CFR 404.999(d) and 416.1499--
0960-0434. The Act provides for travel expense reimbursement from
Federal and State agencies for claimant travel incidental to medical
examinations, and to parties, their representatives, and all reasonably
necessary witnesses for travel exceeding 75 miles to attend medical
examinations; reconsideration interviews; and proceedings before an
administrative law judge. Reimbursement procedures require the claimant
to provide: (1) A list of expenses incurred, and (2) receipts of such
expenses. Federal and state personnel review the listings and receipts
to verify the reimbursable amount to the requestor. The respondents are
claimants for Title II benefits and Title XVI payments, their
representatives, and witnesses.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
404.99(d) & 416.1499........................ 60,000 1 10 10,000
----------------------------------------------------------------------------------------------------------------
4. Certificate of Coverage Request--20 CFR 404.1913--0960-0554. The
United States (U.S.) has agreements with 30 foreign countries to
eliminate double Social Security coverage and taxation where, except
for the provisions of the agreement, a worker would be subject to
coverage and taxes in both countries. These agreements contain rules
for determining the country under whose laws the worker's period of
employment is covered, and to which country the worker will pay taxes.
The agreements further dictate that, upon the request of the worker or
employer, the country under whose system the period of work is covered
will issue a certificate of coverage. The certificate serves as proof
of exemption from coverage and taxation under the system of the other
country. The information we collect assists us in determining a
worker's coverage and in issuing a U.S. certificate of coverage as
appropriate. Per our agreements, we ask a set number of questions to
the workers and employers prior to issuing a certificate of coverage;
however, our agreements with Denmark, Netherlands, Norway, and Sweden
require us to ask more questions in those countries. Respondents are
workers and employers wishing to establish exemption from foreign
Social Security taxes.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 31974]]
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Requests via Letter--Individuals (minus Denmark, 5,833 1 40 3,889
Netherlands, Norway, Poland & Sweden)..........
Requests via Internet--Individuals (minus 9,761 1 40 6,507
Denmark, Netherlands, Norway, Poland & Sweden).
Requests via Letter--Individuals in Denmark, 284 1 44 208
Netherlands, Norway, & Sweden..................
Requests via Letter--Individuals in Poland...... 16 1 41 11
Requests via Internet--Individuals in Denmark, 427 1 44 313
Netherlands, Norway, & Sweden..................
Requests via Internet--Individuals in Poland.... 25 1 41 17
Requests via Letter--Employers (minus Denmark, 26,047 1 40 17,365
Netherlands, Norway, Poland & Sweden)..........
Requests via Internet--Employers (minus Denmark, 39,096 1 40 26,064
Netherlands, Norway, Poland, & Sweden).........
Requests via Letter--Employers in Denmark, 1,137 1 44 834
Netherlands, Norway, & Sweden..................
Requests via Letter--Employers in Poland........ 57 1 41 39
Requests via Internet--Employers in Denmark, 1,704 1 44 1,250
Netherlands, Norway, & Sweden..................
Requests via Internet--Employers in Poland...... 86 1 41 59
---------------------------------------------------------------
Totals...................................... 84,473 .............. .............. 56,556
----------------------------------------------------------------------------------------------------------------
5. Privacy and Disclosure of Official Records and Information;
Availability of Information and Records to the Public--20 CFR
401.40(b)&(c), 401.55(b), 401.100(a), 402.130, 402.185--0960-0566. SSA
established methods for the public to: (1) Access their SSA records;
(2) allow SSA to disclose records; (3) correct or amend their SSA
records; (4) consent for release of their records; (5) request records
under the Freedom of Information Act (FOIA); and (6) request access to
an extract of their SSN record. SSA often collects the necessary
information for these requests through a written letter, with the
exception of the consent for release of records, for which we use Form
SSA-3288. The respondents are individuals requesting access to,
correction of, or disclosure of SSA records.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Access to Records............................... 10,000 1 11 1,833
Designating a Representative for Disclosure of 3,000 1 120 6,000
Records........................................
Amendment of Records............................ 100 1 10 17
Consent of Release of Records................... 3,000,760 1 3 150,038
FOIA Requests for Records....................... 15,000 1 5 1,250
Respondents who request access to an extract of 10 1 8.5 1
their SSN record...............................
---------------------------------------------------------------
Totals...................................... 3,028,870 .............. .............. 159,139
----------------------------------------------------------------------------------------------------------------
6. Disability Report--Child--20 CFR 416.912--0960-0577--Sections
223(d)(5)(A) and 1631(e)(1) of the Act require SSI claimants to furnish
medical and other evidence to prove they are disabled. SSA uses Form
SSA-3820 to collect various types of information about a child's
condition from treating sources or other medical sources of evidence.
The State Disability Determination Services evaluators use the
information from Form SSA-3820 to develop medical and school evidence,
and to assess the alleged disability. The information, together with
medical evidence, forms the evidentiary basis upon which SSA makes its
initial disability evaluation. The respondents are claimants seeking
SSI childhood disability payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3820........................................ 177,572 1 90 266,358
EDCS............................................ 1,000 1 120 2,000
i3820........................................... 176,572 1 120 353,144
---------------------------------------------------------------
Totals...................................... 355,144 .............. .............. 621,502
----------------------------------------------------------------------------------------------------------------
[[Page 31975]]
7. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009, and 418.1325--0960-0622. The Act states those
individuals who are dissatisfied with the results of an initial
determination regarding their Title II disability; Tile XVI disability
(SSI); Title VIII (Special Veterans benefits); or Title XVIII (Medicare
benefits), can request a reconsideration hearing. Individuals use Form
SSA-561-U2; the associated MCS or SSI Claims System interview; or the
internet application (i561) to initiate a request for reconsideration
of a denied claim. SSA uses the information to document the request and
to determine an individual's eligibility or entitlement to Social
Security benefits (Title II); SSI payments (Title XVI); Special
Veterans Benefits (Title VIII); Medicare (Title XVIII); and for initial
determinations regarding Medicare Part B income-related premium subsidy
reductions. The respondents are applicants, claimants, beneficiaries,
or recipients filing for reconsideration of an initial determination.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-561 and Modernized Claims System (MCS)...... 330,370 1 8 40,049
I561 (Internet iAppeals)........................ 1,161,300 1 5 96,775
---------------------------------------------------------------
Totals...................................... 1,491,670 .............. .............. 136,824
----------------------------------------------------------------------------------------------------------------
8. Request to Withdraw a Hearing Request; Request to Withdraw an
Appeals Council Request for Review; and Administrative Review Process
for Adjudicating Initial Disability Claims--20 CFR parts 404, 405, and
416--0960-0710. Claimants have a statutory right under the Act and
current regulations to apply for Social Security Disability Insurance
(SSDI) benefits or SSI payments. SSA collects information at each step
of the administrative process to adjudicate claims fairly and
efficiently. SSA collects this information to establish a claimant's
right to administrative review, and determine the severity of the
claimant's alleged impairments. SSA uses the information we collect to
determine entitlement or continuing eligibility to SSDI benefits or SSI
payments, and to enable appeals of these determinations. In addition,
SSA collects information on Forms HA-85 and HA-86 to allow claimants to
withdraw a hearing request or an Appeals Council review request. The
respondents are applicants for Title II SSDI or Title XVI SSI benefits;
their appointed representatives; legal advocates; medical sources; and
schools.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
20 CFR section No. respondents response response annual burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
404.961, 416.1461, 405.330, and 405.366......... 12,220 1 20 4,073
404.950, 416.1450, and 405.332.................. 1,040 1 20 347
404.949 and 416.1449............................ 2,868 1 60 2,868
405.334......................................... 20 1 60 20
404.957, 416.1457, and 405.380.................. 21,041 1 10 3,507
405.381......................................... 37 1 30 19
405.401......................................... 5,310 1 10 885
404.971 and 416.1471............................ 1,606 1 10 268
(HA-85; HA-86)..................................
404.982 and 416.1482............................ 1,687 1 30 844
404.987 & 404.988 and 416.1487 & 416.1488 and 12,425 1 30 6,213
405.601........................................
404.1740(b)(1).................................. 150 1 2 5
416.1540(b)(1).................................. 150 1 2 5
404.1512, 404.1740(c)(4), 416.912, and 150 1 2 5
416.1540(c)(4).................................
405.372(c)...................................... 5,310 1 10 885
405.1(b)(5)..................................... 833 1 30 417
405.372(b)......................................
405.505......................................... 833 1 30 417
405.1(c)(2)..................................... 5,310 1 10 885
405.20.......................................... 5,310 1 10 885
---------------------------------------------------------------
Totals...................................... 76,300 .............. .............. 22,548
----------------------------------------------------------------------------------------------------------------
9. Request for Accommodation in Communication Method--0960-0777.
SSA allows disabled or impaired Social Security applicants,
beneficiaries, recipients, and representative payees to choose one of
seven alternative methods of communication they want SSA to use when we
send them benefit notices and other related communications. The seven
alternative methods we offer are: (1) Standard print notice by first-
class mail; (2) standard print mail with a follow-up telephone call;
(3) certified mail; (4) Braille; (5) Microsoft Word file on data CD;
(6) large print (18-point font); or (7) audio CD. However, respondents
who want to receive notices from SSA through a communication method
other than the seven methods listed above must explain their request to
us. Those respondents use Form SSA-9000 to: (1) Describe the type of
accommodation they want; (2) disclose their condition necessitating the
need for a different type of accommodation; and (3) explain why none of
the seven methods
[[Page 31976]]
described above are sufficient for their needs. SSA uses Form SSA-9000
to determine, based on applicable law and regulation, whether to grant
the respondents' requests for an accommodation based on their
impairment or disability. SSA collects this information electronically
through either an in-person interview or a telephone interview during
which the SSA employee keys in the information on our iAccommodate
Intranet screens. The respondents are disabled or impaired Social
Security applicants, beneficiaries, recipients, and representative
payees who ask SSA to send notices and other communications in an
alternative method besides the seven modalities we currently offer.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-9000/iAccommodate....................... 5,000 1 20 1,667
----------------------------------------------------------------------------------------------------------------
10. Report of Adult Functioning-Employer--20 CFR 404.1512 and
416.912--0960-0805. Section 205(a), 223(d)(5)(A), 1631(d)(1), and
1631(e)(1) of the Act require claimants' applying for SSDI benefits or
SSI payments to provide SSA with medical and other evidence of their
disability. 20 CFR 404.1512 and 20 CFR 416.912 of the Code of Federal
Regulations provides detailed requirements of the types of evidence
SSDI beneficiaries and SSI claimants must provide showing how their
impairment(s) affect their ability to work (e.g., evidence of age;
education and training, work experience; daily activities; efforts to
work; and any other evidence). Past employers familiar with the
claimant's ability to perform work activities complete Form SSA-385-BK,
Report of Adult Functioning-Employer to provide SSA with information
about the employees day-to-day functioning in the work setting. SSA and
Disability Determination Services use the information Form SSA-3385-BK
collects as the basis to determine eligibility or continued eligibility
for disability benefits. The respondents are claimants' past employers.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
responses response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3385-BK................................. 3,601 1 20 1,200
----------------------------------------------------------------------------------------------------------------
Dated: June 27, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-14173 Filed 7-2-19; 8:45 am]
BILLING CODE 4191-02-P
