Agency Information Collection Activities: Proposed Request and Comment Request, 48694-48701 [2019-19910]

Download as PDF 48694 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices display a short sale order without regard to whether the short sale order is at a price that is less than or equal to the current national best bid. It is estimated that SRO and non-SRO respondents registered with the Commission and subject to the collection of information requirements of Rule 201 and Rule 200(g) incur an aggregate annual burden of 1,621,571 hours to comply with the Rules and an aggregate annual external cost of $220,000. Written comments are invited on: (a) Whether the proposed collection of information is necessary for the proper performance of the functions of the Commission, including whether the information shall have practical utility; (b) the accuracy of the Commission’s estimates of the burden of the proposed collection of information; (c) ways to enhance the quality, utility, and clarity of the information collected; and (d) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or other forms of information technology. Consideration will be given to comments and suggestions submitted in writing within 60 days of this publication. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information under the PRA unless it displays a currently valid OMB control number. Please direct your written comments to: Charles Riddle, Acting Director/Chief Information Officer, Securities and Exchange Commission, c/o Candace Kenner, 100 F Street NE, Washington, DC 20549, or send an email to: PRA_ Mailbox@sec.gov. Dated: September 11, 2019. Jill M. Peterson, Assistant Secretary. BILLING CODE 8011–01–P Agency Information Collection Activities: Proposed Request and Comment Request SECURITIES AND EXCHANGE COMMISSION Sunshine Act Meetings 10:30 a.m. on Thursday, September 19, 2019. PLACE: The meeting will be held at the Commission’s headquarters, 100 F Street NE, Washington, DC 20549. STATUS: This meeting will be closed to the public. MATTERS TO BE CONSIDERED: Commissioners, Counsel to the Commissioners, the Secretary to the Commission, and recording secretaries TIME AND DATE: jspears on DSK3GMQ082PROD with NOTICES [FR Doc. 2019–20092 Filed 9–12–19; 4:15 pm] [Docket No. SSA–2019–0040] BILLING CODE 8011–01–P 18:14 Sep 13, 2019 Dated: September 12, 2019. Vanessa A. Countryman, Secretary. SOCIAL SECURITY ADMINISTRATION [FR Doc. 2019–19975 Filed 9–13–19; 8:45 am] VerDate Sep<11>2014 will attend the closed meeting. Certain staff members who have an interest in the matters also may be present. In the event that the time, date, or location of this meeting changes, an announcement of the change, along with the new time, date, and/or place of the meeting will be posted on the Commission’s website at https:// www.sec.gov. The General Counsel of the Commission, or his designee, has certified that, in his opinion, one or more of the exemptions set forth in 5 U.S.C. 552b(c)(3), (5), (6), (7), (8), 9(B) and (10) and 17 CFR 200.402(a)(3), (a)(5), (a)(6), (a)(7), (a)(8), (a)(9)(ii) and (a)(10), permit consideration of the scheduled matters at the closed meeting. The subject matters of the closed meeting will consist of the following topics: Institution and settlement of injunctive actions; Institution and settlement of administrative proceedings; Resolution of litigation claims; Post argument discussion; and Other matters relating to enforcement proceedings. At times, changes in Commission priorities require alterations in the scheduling of meeting agenda items that may consist of adjudicatory, examination, litigation, or regulatory matters. CONTACT PERSON FOR MORE INFORMATION: For further information; please contact Vanessa A. Countryman from the Office of the Secretary at (202) 551–5400. Jkt 247001 The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104–13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes revisions, extensions, and corrections of OMBapproved information collections. SSA is soliciting comments on the accuracy of the agency’s burden estimate; the need for the information; its practical utility; ways to enhance its PO 00000 Frm 00116 Fmt 4703 Sfmt 4703 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: OIRA_Submission@omb.eop.gov (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: OR.Reports.Clearance@ssa.gov Or you may submit your comments online through www.regulations.gov, referencing Docket ID Number [SSA– 2019–0040]. I. The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than November 12, 2019. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Incorporation by Reference of Oral Findings of Fact and Rationale in Wholly Favorable Written Decisions (Bench Decision Regulation)—20 CFR 404.953 and 416.1453—0960–0694. If an administrative law judge (ALJ) makes a wholly favorable oral decision, including all the findings and rationale for the decision for a claimant of Title II or Title XVI payments, at an administrative appeals hearing, the ALJ sends a Notice of Decision (Form HA– 82), as the records from the oral hearing preclude the need for a written decision. We call this the incorporation-byreference process. In addition, the regulations for this process state that if the involved parties want a record of the oral decision, they may submit a written request for these records. SSA collects identifying information under the aegis of Sections 20 CFR 404.953 and 416.1453 of the Code of Federal Regulations to determine how to send interested individuals written records of a favorable incorporation-by-reference oral decision made at an administrative review hearing. Since there is no prescribed form to request a written record of the decision, the involved parties send SSA their contact information and reference the hearing for which they would like a record. The respondents are applicants for Disability Insurance Benefits and SSI payments, or E:\FR\FM\16SEN1.SGM 16SEN1 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices their representatives, to whom SSA gave a wholly favorable oral decision under the regulations cited above. 48695 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) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** HA–82 ...................................................... 2,500 1 5 208 * $10.22 ** $2,126 * We based this figure on average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 2. Request for Waiver of Special Veterans Benefits (SVB) Overpayment Recovery or Change in Repayment Rate—20 CFR 408.900–408.950—0960– 0698. Title VIII of the Act requires SSA to pay a monthly benefit to qualified World War II veterans who reside outside the United States. When an overpayment in this SVB occurs, the beneficiary can request a waiver of recovery of the overpayment or a change in the repayment rate. SSA uses the SSA–2032–BK to obtain the information necessary to establish whether the claimant meets the waiver of recovery provisions of the overpayment, and to determine the repayment rate if we do not waive repayment. Respondents are SVB 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: 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) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** SSA–2032–BK ......................................... 134 1 120 268 * $7.67 ** $2,056 * We based this figure on average SVB payments, as per SSA’s data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 3. Protection and Advocacy for Beneficiaries of Social Security (PABSS)—20 CFR 435.51–435.52— 0960–0768. The PABSS projects are part of Social Security’s strategy to increase the number of SSDI or SSI recipients who return to work and achieve financial independence and selfsufficiency as the result of receiving support, representation, advocacy, or other services. PABSS provides: (1) Information and advice about obtaining Number of respondents Modality of completion jspears on DSK3GMQ082PROD with NOTICES vocational rehabilitation and employment services; and (2) advocacy or other services a beneficiary with a disability may need to secure, maintain, or regain gainful employment. The PABSS Annual Program Performance Report collects statistical information from each of the PABSS projects in an effort to manage and capture program performance and quantitative data. Social Security uses the information to evaluate the efficiency of the program, Frequency of response Average burden per response (minutes) and to ensure beneficiaries are receiving quality services. The project data is valuable to Social Security in its analysis of and future planning for the SSDI and SSI programs. The respondents are the 57 PABSS project sites, and recipients of SSDI and SSI programs. Type of Request: Revision of an OMBapproved information collection. Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** PABSS Program Grantees ...................... Beneficiaries ............................................. 57 8,284 1 1 60 30 57 4,142 * 42.66 * $10.22 ** $2,432 ** 42,331 Totals ................................................ 8,341 ........................ ........................ 4,199 ........................ ** 44,763 * We based these figures on average Computer Systems Analyst hourly salary, as reported by Bureau of Labor Statistics data, and average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 4. Methods for Conducting Personal Conferences When Waiver of Recovery of a Title II or Title XVI Overpayment Cannot Be Approved—20 CFR VerDate Sep<11>2014 18:14 Sep 13, 2019 Jkt 247001 404.506(e)(3), 404.506(f)(8), 416.557(c)(3), and 416.557(d)(8)—0960– 0769. SSA conducts personal conferences when we cannot approve a PO 00000 Frm 00117 Fmt 4703 Sfmt 4703 waiver of recovery of a Title II or Title XVI overpayment. The Act and our regulatory citations require SSA to give overpaid Social Security beneficiaries E:\FR\FM\16SEN1.SGM 16SEN1 48696 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices and SSI recipients the right to request a waiver of recovery and automatically schedule a personal conference if we cannot approve their request for waiver of overpayment. We conduct these conferences face-to-face, via telephone, or through video teleconferences. Social Security beneficiaries and SSI recipients, or their representatives, may provide documents to demonstrate they are without fault in causing the overpayment and do not have the ability to repay the debt. They may submit these documents by completing Form SSA–632, Request for Waiver of Overpayment Recovery (OMB No. 0960– 0037); Form SSA–795, Statement of Claimant or Other Person (OMB No. 0960–0045); or through a personal statement submitted by mail, telephone, personal contact, or other suitable method, such as fax or email. This information collection satisfies the requirements for request for waiver of Number of respondents Modality of completion Frequency of response Average burden per response (minutes) recovery of an overpayment, and allows individuals to pursue further levels of administrative appeal via personal conference. Respondents are Social Security beneficiaries and SSI recipients or their representatives seeking reconsideration of an SSA waiver decision. Type of Request: Revision on an OMB-approved information collection. Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** Title II, Personal Conference, 404.506(e)(3) and 404–506(f)(8): Submittal of documents, additional mitigating financial information, and verifications for consideration at personal conferences ................................ 30,271 1 45 22,703 * $22.50 ** $510,818 Title XVI, Personal Conference, 416.557(c)(3) and 416–557(d)(8): Submittal of documents, additional mitigating financial information, and verifications at personal conferences. .. Totals ....................................................... 51,192 81,463 1 ........................ 45 ........................ 38,394 61,097 * $10.22 ........................ ** $392,378 ** 903,205 * We based these figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data; and and average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. II. SSA submitted the information collections below to OMB for clearance. Your comments regarding these information collections would be most useful if OMB and SSA receive them 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than October 15, 2019. Individuals can obtain copies of the OMB clearance packages Number of respondents Modality of completion jspears on DSK3GMQ082PROD with NOTICES by writing to OR.Reports.Clearance@ ssa.gov. 1. Application for Child’s Insurance Benefits—20 CFR 404.350–404.368, 404.603, & 416.350—0960–0010. Title II of the 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 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 ............... Totals ................................................ Frequency of response Average burden per response (minutes) 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 OMBapproved information collection. Estimated total annual burden (hours) 18:14 Sep 13, 2019 Jkt 247001 Total annual opportunity cost (dollars) ** 1,204 1 12 241 * $22.50 ** $27,090 204,777 1 11 37,542 * 22.50 ** 4,607,482 3,484 1 12 697 * 22.50 ** 78,390 422,267 1 11 77,416 * 22.50 ** 9,501,007 631,732 ........................ ........................ 115,896 ........................ ** 14,213,969 * We based this figure on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data. VerDate Sep<11>2014 Average theoretical hourly cost amount (dollars) * PO 00000 Frm 00118 Fmt 4703 Sfmt 4703 E:\FR\FM\16SEN1.SGM 16SEN1 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices 48697 ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 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 Number of respondents Modality of completion Frequency of response Average burden per response (minutes) 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. Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** HA–501; MCS; SSI Claims System ......... i501 (Internet iAppeals) ............................ 10,325 653,318 1 1 10 5 1,721 54,443 * $10.22 * 10.22 ** $17,589 ** 556,407 Totals ................................................ 663,643 ........................ ........................ 56,164 ........................ ** 573,996 * We based this figure on average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 Number of respondents Modality of completion 404.99(d) & 416.1499 .............................. benefits and Title XVI payments, their representatives and witnesses. Correction Notice: SSA published the incorrect burden information for this collection at 84 FR 31972, on 7/3/19. We are correcting this error here. Type of Request: Extension of an OMB-approved information collection. 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 Frequency of response 60,000 Average burden per response (minutes) 1 Estimated total annual burden (hours) 10 10,000 Average theoretical hourly cost amount (dollars) * * $10.22 Total annual opportunity cost (dollars) ** ** $613,200 jspears on DSK3GMQ082PROD with NOTICES * We based this figure on average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 VerDate Sep<11>2014 18:14 Sep 13, 2019 Jkt 247001 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 PO 00000 Frm 00119 Fmt 4703 Sfmt 4703 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. E:\FR\FM\16SEN1.SGM 16SEN1 48698 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices 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 ................................................ Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** 5,833 1 40 3,889 * $22.50 ** $87,503 9,761 1 40 6,507 * 22.50 ** 146,408 284 1 44 208 * 22.50 ** 4,680 16 1 41 11 * 22.50 ** 248 427 1 44 313 * 22.50 ** 7,043 25 1 41 17 * 22.50 ** 383 26,047 1 40 17,365 * 22.50 ** 390,713 39,096 1 40 26,064 * 22.50 ** 586,440 1,137 1 44 834 * 22.50 ** 18,765 57 1 41 39 * 22.50 ** 878 1,704 1 44 1,250 * 22.50 ** 28,125 86 1 41 59 * 22.50 ** 1,328 84,473 ........................ ........................ 56,556 ........................ ** 1,272,514 * We based this figure on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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) Number of respondents Modality of completion jspears on DSK3GMQ082PROD with NOTICES 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 Frequency of response Average burden per response (minutes) access to, correction of, or disclosure of SSA records. Correction Notice: SSA published this information collection as an extension on July 3, 2019 at 84 FR 3197. Since we are revising the Privacy Act Statement, this is now a revision of an OMBapproved information collection. Type of Request: Revision of an OMBapproved information collection. Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** 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 1 11 1,833 * $22.50 ** $41,243 3,000 100 3,000,760 15,000 1 1 1 1 2 10 3 5 6,000 17 150,038 1,250 * 22.50 * 22.50 * 22.50 * 22.50 ** 135,000 ** 383 ** 3,375,855 ** 28,125 10 1 8.5 1 * 22.50 ** 22.50 Totals ................................................ 3,028,870 ........................ ........................ 159,139 ........................ ** 3,580,629 * We based these figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. VerDate Sep<11>2014 18:14 Sep 13, 2019 Jkt 247001 PO 00000 Frm 00120 Fmt 4703 Sfmt 4703 E:\FR\FM\16SEN1.SGM 16SEN1 48699 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices 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 Frequency of response Average burden per response (minutes) 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. Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** SSA–3820 ................................................ EDCS ....................................................... i3820 ........................................................ 177,572 1,000 176,572 1 1 1 90 120 120 266,358 2,000 353,144 10.22 10.22 10.22 ** 1,814,786 ** 10,220 ** 1,804,566 Totals ................................................ 355,144 ........................ ........................ 621,502 ........................ ** 3,629,572 * We based this figure on average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 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 (SVB); or Title XVIII (Medicare benefits), can request a reconsideration hearing. Number of respondents Modality of completion Frequency of response Average burden per response (minutes) (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 OMBapproved information collection. Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** SSA–561 and Modernized Claims System (MCS) ............................................ I561 (Internet iAppeals) ........................... 330,370 1,161,300 1 1 8 5 40,049 96,775 * 10.22 * 10.22 ** 409,301 ** 989,041 Totals ................................................ 1,461,670 ........................ ........................ 136,824 ........................ ** 1,398,342 jspears on DSK3GMQ082PROD with NOTICES * We based this figure on average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 SSDI benefits or SSI payments. SSA collects information at each step of the administrative process to adjudicate VerDate Sep<11>2014 18:14 Sep 13, 2019 Jkt 247001 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 PO 00000 Frm 00121 Fmt 4703 Sfmt 4703 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. E:\FR\FM\16SEN1.SGM 16SEN1 48700 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices Number of respondents 20 CFR section No. 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) and 405.372(b) ...................... 405.505 .................................................... 405.1(c)(2) ................................................ 405.20 ...................................................... Totals ................................................ Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** 12,220 1,040 2,868 20 21,041 37 5,310 1,606 1,687 1 1 1 1 1 1 1 1 1 20 20 60 60 10 30 10 10 30 4,073 347 2,868 20 3,507 19 885 268 844 10.22 10.22 10.22 10.22 10.22 10.22 10.22 10.22 10.22 ** 41,626 ** 3,546 ** 29,311 ** 204 ** 35,842 ** 194 ** 9,045 ** 2,739 ** 8,626 12,425 150 150 1 1 1 30 2 2 6,213 5 5 10.22 22.50 22.50 ** 63,497 ** 113 ** 113 150 5,310 833 833 5,310 5,310 1 1 1 1 1 1 2 10 30 30 10 10 5 885 417 417 885 885 22.50 10.22 10.22 10.22 10.22 10.22 ** 113 ** 9,045 ** 4,262 ** 4,262 ** 9,045 ** 9,045 76,300 ........................ ........................ 22,548 ........................ ** 230,628 * We based these figures on average DI payments, as reported in SSA’s disability insurance payment data, and average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 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 OMBapproved information collection. Modality of completion Number of respondents Frequency of response Average burden per response (minutes) Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** SSA–9000/iAccommodate ....................... 5,000 1 20 1,667 * $10.22 ** $51,100 jspears on DSK3GMQ082PROD with NOTICES * We based this figure on average DI payments, as reported in SSA’s disability insurance payment data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. 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 VerDate Sep<11>2014 18:14 Sep 13, 2019 Jkt 247001 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 PO 00000 Frm 00122 Fmt 4703 Sfmt 4703 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 completes Form SSA–385–BK, Report of Adult Functioning-Employer E:\FR\FM\16SEN1.SGM 16SEN1 48701 Federal Register / Vol. 84, No. 179 / Monday, September 16, 2019 / Notices 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 Modality of completion Number of respondents Frequency of response SSA–3385–BK ......................................... 3,601 1 disability benefits. The respondents are claimants’ past employers. Type of Request: Revision of an OMBapproved information collection. Average burden per response (minutes) Estimated total annual burden (hours) Average theoretical hourly cost amount (dollars) * Total annual opportunity cost (dollars) ** 20 1,200 * $22.50 ** $27,000 * We based these figures on average U.S. citizen’s hourly salary, as reported by Bureau of Labor Statistics data. ** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather, these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to respondents to complete the application. Dated: September 9, 2019. Naomi Sipple, Reports Clearance Officer, Social Security Administration. pursuant to the authority vested in me by the Act of October 19, 1965 (79 Stat. 985; 22 U.S.C. 2459), Executive Order 12047 of March 27, 1978, the Foreign Affairs Reform and Restructuring Act of 1998 (112 Stat. 2681, et seq.; 22 U.S.C. 6501 note, et seq.), Delegation of Authority No. 234 of October 1, 1999, and Delegation of Authority No. 236–3 of August 28, 2000. [FR Doc. 2019–19910 Filed 9–13–19; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice:10875] Notice of Determinations; Culturally Significant Objects Imported for Exhibition—Determinations: ‘‘Flesh and Blood: Italian Masterpieces From the Capodimonte Museum’’ Exhibition Notice is hereby given of the following determinations: I hereby determine that certain objects to be included in the exhibition ‘‘Flesh and Blood: Italian Masterpieces from the Capodimonte Museum,’’ imported from abroad for temporary exhibition within the United States, are of cultural significance. The objects are imported pursuant to agreements with the foreign owner or custodian. I also determine that the exhibition or display of the exhibit objects at the Seattle Art Museum, Seattle, Washington, from on or about October 17, 2019, until on or about January 26, 2020; at the Kimbell Art Museum, Fort Worth, Texas, from on or about March 1, 2020, until on or about June 14, 2020; and at possible additional exhibitions or venues yet to be determined, is in the national interest. I have ordered that Public Notice of these determinations be published in the Federal Register. FOR FURTHER INFORMATION CONTACT: Chi D. Tran, Paralegal Specialist, Office of the Legal Adviser, U.S. Department of State (telephone: 202–632–6471; email: section2459@state.gov). The mailing address is U.S. Department of State, L/ PD, SA–5, Suite 5H03, Washington, DC 20522–0505. SUPPLEMENTARY INFORMATION: The foregoing determinations were made jspears on DSK3GMQ082PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:14 Sep 13, 2019 Jkt 247001 Marie Therese Porter Royce, Assistant Secretary, Bureau of Educational and Cultural Affairs, Department of State. [FR Doc. 2019–19995 Filed 9–13–19; 8:45 am] BILLING CODE 4710–05–P Marie Therese Porter Royce, Assistant Secretary, Bureau of Educational and Cultural Affairs, Department of State. DEPARTMENT OF STATE [Public Notice: 10877] [FR Doc. 2019–19996 Filed 9–13–19; 8:45 am] Notice of Determinations: Culturally Significant Objects Imported for Exhibition—Determinations: ‘‘Fe´lix Valloton: Painter of Disquiet’’ Exhibition Notice is hereby given of the following determinations: I hereby determine that certain objects to be included in the exhibition ‘‘Fe´lix Valloton: Painter of Disquiet,’’ imported from abroad for temporary exhibition within the United States, are of cultural significance. The objects are imported pursuant to agreements with the foreign owners or custodians. I also determine that the exhibition or display of the exhibit objects at The Metropolitan Museum of Art, New York, New York, from on or about October 29, 2019, until on or about January 26, 2020, and at possible additional exhibitions or venues yet to be determined, is in the national interest. I have ordered that Public Notice of these determinations be published in the Federal Register. FOR FURTHER INFORMATION CONTACT: Chi D. Tran, Paralegal Specialist, Office of the Legal Adviser, U.S. Department of State (telephone: 202–632–6471; email: section2459@state.gov). The mailing SUMMARY: PO 00000 Frm 00123 Fmt 4703 address is U.S. Department of State, L/ PD, SA–5, Suite 5H03, Washington, DC 20522–0505. SUPPLEMENTARY INFORMATION: The foregoing determinations were made pursuant to the authority vested in me by the Act of October 19, 1965 (79 Stat. 985; 22 U.S.C. 2459), Executive Order 12047 of March 27, 1978, the Foreign Affairs Reform and Restructuring Act of 1998 (112 Stat. 2681, et seq.; 22 U.S.C. 6501 note, et seq.), Delegation of Authority No. 234 of October 1, 1999, and Delegation of Authority No. 236–3 of August 28, 2000. Sfmt 4703 BILLING CODE 4710–05–P SURFACE TRANSPORTATION BOARD [Docket No. AB 1020 (Sub-No. 2X)] East Penn Railroad, LLC— Discontinuance of Service and Lease Operations—in Northeast Philadelphia, Pa. East Penn Railroad, LLC (ESPN), has filed a verified notice of exemption under 49 CFR 1152 subpart F—Exempt Abandonments and Discontinuances of Service to discontinue service and terminate its lease operations over approximately 1.8 miles of rail line owned by Norfolk Southern Railway Company (NSR) between milepost VE 0.00 and milepost VE 1.80 in Northeast Philadelphia, Pa. (the Line). The Line traverses U.S. Postal Service Zip Codes 19004 and 19127. ESPN has certified that: (1) It has not moved any local or overhead traffic over the Line for at least two years; (2) overhead traffic, if there were any, could be rerouted over other lines; (3) no formal complaint filed by a user of rail service on the Line (or by a state or local E:\FR\FM\16SEN1.SGM 16SEN1

Agencies

[Federal Register Volume 84, Number 179 (Monday, September 16, 2019)]
[Notices]
[Pages 48694-48701]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-19910]


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SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2019-0040]


Agency Information Collection Activities: Proposed Request and 
Comment Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions, extensions, and corrections 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-2019-0040].
    I. The information collections below are pending at SSA. SSA will 
submit them to OMB within 60 days from the date of this notice. To be 
sure we consider your comments, we must receive them no later than 
November 12, 2019. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Incorporation by Reference of Oral Findings of Fact and 
Rationale in Wholly Favorable Written Decisions (Bench Decision 
Regulation)--20 CFR 404.953 and 416.1453--0960-0694. If an 
administrative law judge (ALJ) makes a wholly favorable oral decision, 
including all the findings and rationale for the decision for a 
claimant of Title II or Title XVI payments, at an administrative 
appeals hearing, the ALJ sends a Notice of Decision (Form HA-82), as 
the records from the oral hearing preclude the need for a written 
decision. We call this the incorporation-by-reference process. In 
addition, the regulations for this process state that if the involved 
parties want a record of the oral decision, they may submit a written 
request for these records. SSA collects identifying information under 
the aegis of Sections 20 CFR 404.953 and 416.1453 of the Code of 
Federal Regulations to determine how to send interested individuals 
written records of a favorable incorporation-by-reference oral decision 
made at an administrative review hearing. Since there is no prescribed 
form to request a written record of the decision, the involved parties 
send SSA their contact information and reference the hearing for which 
they would like a record. The respondents are applicants for Disability 
Insurance Benefits and SSI payments, or

[[Page 48695]]

their representatives, to whom SSA gave a wholly favorable oral 
decision under the regulations cited above.
    Type of Request: Extension of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Average
                                                                                      Average  burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of    per  response    annual burden     hourly cost      opportunity
                                                      respondents        response        (minutes)         (hours)           amount      cost  (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-82.............................................           2,500                1                5              208         * $10.22        ** $2,126
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments, as reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    2. Request for Waiver of Special Veterans Benefits (SVB) 
Overpayment Recovery or Change in Repayment Rate--20 CFR 408.900-
408.950--0960-0698. Title VIII of the Act requires SSA to pay a monthly 
benefit to qualified World War II veterans who reside outside the 
United States. When an overpayment in this SVB occurs, the beneficiary 
can request a waiver of recovery of the overpayment or a change in the 
repayment rate. SSA uses the SSA-2032-BK to obtain the information 
necessary to establish whether the claimant meets the waiver of 
recovery provisions of the overpayment, and to determine the repayment 
rate if we do not waive repayment. Respondents are SVB 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: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Average
                                                                                       Average burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of     per response    annual burden     hourly cost      opportunity
                                                      respondents        response        (minutes)         (hours)           amount      cost  (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-2032-BK.......................................             134                1              120              268          * $7.67        ** $2,056
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average SVB payments, as per SSA's data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    3. Protection and Advocacy for Beneficiaries of Social Security 
(PABSS)--20 CFR 435.51-435.52--0960-0768. The PABSS projects are part 
of Social Security's strategy to increase the number of SSDI or SSI 
recipients who return to work and achieve financial independence and 
self-sufficiency as the result of receiving support, representation, 
advocacy, or other services. PABSS provides: (1) Information and advice 
about obtaining vocational rehabilitation and employment services; and 
(2) advocacy or other services a beneficiary with a disability may need 
to secure, maintain, or regain gainful employment. The PABSS Annual 
Program Performance Report collects statistical information from each 
of the PABSS projects in an effort to manage and capture program 
performance and quantitative data. Social Security uses the information 
to evaluate the efficiency of the program, and to ensure beneficiaries 
are receiving quality services. The project data is valuable to Social 
Security in its analysis of and future planning for the SSDI and SSI 
programs. The respondents are the 57 PABSS project sites, and 
recipients of SSDI and SSI programs.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
PABSS Program Grantees..................................              57               1              60              57         * 42.66       ** $2,432
Beneficiaries...........................................           8,284               1              30           4,142        * $10.22       ** 42,331
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................           8,341  ..............  ..............           4,199  ..............       ** 44,763
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on average Computer Systems Analyst hourly salary, as reported by Bureau of Labor Statistics data, and average DI payments, as
  reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    4. Methods for Conducting Personal Conferences When Waiver of 
Recovery of a Title II or Title XVI Overpayment Cannot Be Approved--20 
CFR 404.506(e)(3), 404.506(f)(8), 416.557(c)(3), and 416.557(d)(8)--
0960-0769. SSA conducts personal conferences when we cannot approve a 
waiver of recovery of a Title II or Title XVI overpayment. The Act and 
our regulatory citations require SSA to give overpaid Social Security 
beneficiaries

[[Page 48696]]

and SSI recipients the right to request a waiver of recovery and 
automatically schedule a personal conference if we cannot approve their 
request for waiver of overpayment. We conduct these conferences face-
to-face, via telephone, or through video teleconferences. Social 
Security beneficiaries and SSI recipients, or their representatives, 
may provide documents to demonstrate they are without fault in causing 
the overpayment and do not have the ability to repay the debt. They may 
submit these documents by completing Form SSA-632, Request for Waiver 
of Overpayment Recovery (OMB No. 0960-0037); Form SSA-795, Statement of 
Claimant or Other Person (OMB No. 0960-0045); or through a personal 
statement submitted by mail, telephone, personal contact, or other 
suitable method, such as fax or email. This information collection 
satisfies the requirements for request for waiver of recovery of an 
overpayment, and allows individuals to pursue further levels of 
administrative appeal via personal conference. Respondents are Social 
Security beneficiaries and SSI recipients or their representatives 
seeking reconsideration of an SSA waiver decision.
    Type of Request: Revision on an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Title II, Personal Conference, 404.506(e)(3) and 404-             30,271               1              45          22,703        * $22.50     ** $510,818
 506(f)(8): Submittal of documents, additional
 mitigating financial information, and verifications for
 consideration at personal conferences..................
                                                         -----------------------------------------------------------------------------------------------
Title XVI, Personal Conference, 416.557(c)(3) and 416-            51,192               1              45          38,394        * $10.22     ** $392,378
 557(d)(8): Submittal of documents, additional
 mitigating financial information, and verifications at
 personal conferences...................................
Totals..................................................          81,463  ..............  ..............          61,097  ..............      ** 903,205
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data; and and average DI payments, as
  reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    II. SSA submitted the information collections below to OMB for 
clearance. Your comments regarding these information collections would 
be most useful if OMB and SSA receive them 30 days from the date of 
this publication. To be sure we consider your comments, we must receive 
them no later than October 15, 2019. Individuals can obtain copies of 
the OMB clearance packages by writing to [email protected].
    1. Application for Child's Insurance Benefits--20 CFR 404.350-
404.368, 404.603, & 416.350--0960-0010. Title II of the 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.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                          Average burden     Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of    per response    total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)        burden          amount           cost
                                                                                                              (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Application for Child's Insurance Benefits/Death Claim/            1,204               1              12             241        * $22.50      ** $27,090
 Paper SSA-4-BK.........................................
Application for Child's Insurance Benefits/Death Claim/          204,777               1              11          37,542         * 22.50    ** 4,607,482
 Modernized Claims System (MCS) and Preliminary Claims
 System (PCS)...........................................
Application for Child's Insurance Benefits/Life Claim/             3,484               1              12             697         * 22.50       ** 78,390
 Paper..................................................
SSA-4-BK................................................
Application for Child's Insurance Benefits/Life Claim/           422,267               1              11          77,416         * 22.50    ** 9,501,007
 MCS and PCS............................................
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................         631,732  ..............  ..............         115,896  ..............   ** 14,213,969
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data.

[[Page 48697]]

 
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 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
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-501; MCS; SSI Claims System..........................          10,325               1              10           1,721        * $10.22      ** $17,589
i501 (Internet iAppeals)................................         653,318               1               5          54,443         * 10.22      ** 556,407
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................         663,643  ..............  ..............          56,164  ..............      ** 573,996
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments, as reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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.
    Correction Notice: SSA published the incorrect burden information 
for this collection at 84 FR 31972, on 7/3/19. We are correcting this 
error here.
    Type of Request: Extension of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
404.99(d) & 416.1499....................................          60,000               1              10          10,000        * $10.22     ** $613,200
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments, as reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 48698]]



--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Requests via Letter--Individuals (minus Denmark,                   5,833               1              40           3,889        * $22.50      ** $87,503
 Netherlands, Norway, Poland & Sweden)..................
Requests via Internet--Individuals (minus Denmark,                 9,761               1              40           6,507         * 22.50      ** 146,408
 Netherlands, Norway, Poland & Sweden)..................
Requests via Letter--Individuals in Denmark,                         284               1              44             208         * 22.50        ** 4,680
 Netherlands, Norway, & Sweden..........................
Requests via Letter--Individuals in Poland..............              16               1              41              11         * 22.50          ** 248
Requests via Internet--Individuals in Denmark,                       427               1              44             313         * 22.50        ** 7,043
 Netherlands, Norway, & Sweden..........................
Requests via Internet--Individuals in Poland............              25               1              41              17         * 22.50          ** 383
Requests via Letter--Employers (minus Denmark,                    26,047               1              40          17,365         * 22.50      ** 390,713
 Netherlands, Norway, Poland & Sweden)..................
Requests via Internet--Employers (minus Denmark,                  39,096               1              40          26,064         * 22.50      ** 586,440
 Netherlands, Norway, Poland, & Sweden).................
Requests via Letter--Employers in Denmark, Netherlands,            1,137               1              44             834         * 22.50       ** 18,765
 Norway, & Sweden.......................................
Requests via Letter--Employers in Poland................              57               1              41              39         * 22.50          ** 878
Requests via Internet--Employers in Denmark,                       1,704               1              44           1,250         * 22.50       ** 28,125
 Netherlands, Norway, & Sweden..........................
Requests via Internet--Employers in Poland..............              86               1              41              59         * 22.50        ** 1,328
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................          84,473  ..............  ..............          56,556  ..............    ** 1,272,514
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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.
    Correction Notice: SSA published this information collection as an 
extension on July 3, 2019 at 84 FR 3197. Since we are revising the 
Privacy Act Statement, this is now a revision of an OMB-approved 
information collection.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Access to Records.......................................          10,000               1              11           1,833        * $22.50      ** $41,243
Designating a Representative for Disclosure of Records..           3,000               1               2           6,000         * 22.50      ** 135,000
Amendment of Records....................................             100               1              10              17         * 22.50          ** 383
Consent of Release of Records...........................       3,000,760               1               3         150,038         * 22.50    ** 3,375,855
FOIA Requests for Records...............................          15,000               1               5           1,250         * 22.50       ** 28,125
Respondents who request access to an extract of their                 10               1             8.5               1         * 22.50        ** 22.50
 SSN record.............................................
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................       3,028,870  ..............  ..............         159,139  ..............    ** 3,580,629
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.


[[Page 48699]]

    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
                                                                                          Average burden     Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of    per response    total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)    burden (hours)      amount      cost (dollars)
                                                                                                                            (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3820................................................         177,572               1              90         266,358           10.22    ** 1,814,786
EDCS....................................................           1,000               1             120           2,000           10.22       ** 10,220
i3820...................................................         176,572               1             120         353,144           10.22    ** 1,804,566
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................         355,144  ..............  ..............         621,502  ..............    ** 3,629,572
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments, as reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 (SVB); 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
                                                                                          Average burden     Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of    per response    total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)    burden (hours)      amount      cost (dollars)
                                                                                                                            (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-561 and Modernized Claims System (MCS)..............         330,370               1               8          40,049         * 10.22      ** 409,301
I561 (Internet iAppeals)................................       1,161,300               1               5          96,775         * 10.22      ** 989,041
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................       1,461,670  ..............  ..............         136,824  ..............    ** 1,398,342
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments, as reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 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.

[[Page 48700]]



--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                          Average burden     Estimated      theoretical    Total annual
                   20 CFR section No.                        Number of     Frequency of    per response    total annual     hourly cost     opportunity
                                                            respondents      response        (minutes)    burden (hours)      amount      cost (dollars)
                                                                                                                            (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
404.961, 416.1461, 405.330, and 405.366.................          12,220               1              20           4,073           10.22       ** 41,626
404.950, 416.1450, and 405.332..........................           1,040               1              20             347           10.22        ** 3,546
404.949 and 416.1449....................................           2,868               1              60           2,868           10.22       ** 29,311
405.334.................................................              20               1              60              20           10.22          ** 204
404.957, 416.1457, and 405.380..........................          21,041               1              10           3,507           10.22       ** 35,842
405.381.................................................              37               1              30              19           10.22          ** 194
405.401.................................................           5,310               1              10             885           10.22        ** 9,045
404.971 and 416.1471 (HA-85; HA-86).....................           1,606               1              10             268           10.22        ** 2,739
404.982 and 416.1482....................................           1,687               1              30             844           10.22        ** 8,626
404.987 & 404.988 and 416.1487 & 416.1488 and 405.601...          12,425               1              30           6,213           10.22       ** 63,497
404.1740(b)(1)..........................................             150               1               2               5           22.50          ** 113
416.1540(b)(1)..........................................             150               1               2               5           22.50          ** 113
404.1512, 404.1740(c)(4), 416.912, and 416.1540(c)(4)...             150               1               2               5           22.50          ** 113
405.372(c)..............................................           5,310               1              10             885           10.22        ** 9,045
405.1(b)(5) and 405.372(b)..............................             833               1              30             417           10.22        ** 4,262
405.505.................................................             833               1              30             417           10.22        ** 4,262
405.1(c)(2).............................................           5,310               1              10             885           10.22        ** 9,045
405.20..................................................           5,310               1              10             885           10.22        ** 9,045
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................          76,300  ..............  ..............          22,548  ..............      ** 230,628
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on average DI payments, as reported in SSA's disability insurance payment data, and average U.S. citizen's hourly salary, as
  reported by Bureau of Labor Statistics data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 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
                                                                                       Average burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of     per response    annual burden     hourly cost      opportunity
                                                      respondents        response        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-9000/iAccommodate.............................           5,000                1               20            1,667         * $10.22       ** $51,100
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments, as reported in SSA's disability insurance payment data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 completes Form SSA-385-
BK, Report of Adult Functioning-Employer

[[Page 48701]]

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
                                                                                      Average  burden     Estimated       theoretical     Total  annual
              Modality of  completion                  Number of      Frequency  of     per  response   total  annual     hourly  cost     opportunity
                                                      respondents        response        (minutes)     burden  (hours)       amount      cost  (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3385-BK.......................................           3,601                1               20            1,200         * $22.50       ** $27,000
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on average U.S. citizen's hourly salary, as reported by Bureau of Labor Statistics data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.


    Dated: September 9, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-19910 Filed 9-13-19; 8:45 am]
 BILLING CODE 4191-02-P