Agency Information Collection Activities: Proposed Request, 74351-74354 [2024-20713]

Download as PDF 74351 Federal Register / Vol. 89, No. 177 / Thursday, September 12, 2024 / Notices For the Commission, by the Division of Trading and Markets, pursuant to delegated authority.25 Sherry R. Haywood, Assistant Secretary. [FR Doc. 2024–20638 Filed 9–11–24; 8:45 am] BILLING CODE 8011–01–P SOCIAL SECURITY ADMINISTRATION [Docket No: SSA–2024–0031] Agency Information Collection Activities: Proposed Request The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104–13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes revisions of OMB-approved information collections. SSA is soliciting comments on the accuracy of the agency’s burden estimate; the need for the information; its practical utility; ways to enhance its quality, utility, and clarity; and ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or Modality of completion Number of respondents SSA–821–BK In Office SSA–821–BK Phone .... SSA–821–BK Returned Via Mail ..................... SSA–821–BK Electronic ......................... Totals .................... 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. You may submit your comments online through https://www.reginfo.gov/public/ do/PRAMain, referencing Docket ID Number [SSA–2024–0031]. (SSA) Social Security Administration, OLCA, Attn: Reports Clearance Director, Mail Stop 3253 Altmeyer, 6401 Security Blvd., Baltimore, MD 21235, Fax: 833– 410–1631. Email address: OR.Reports.Clearance@ssa.gov. Or you may submit your comments online through https://www.reginfo.gov/public/ do/PRAmain by clicking on Currently under Review—Open for Public Comments and choosing to click on one of SSA’s published items. Please reference Docket ID Number [SSA–2024–0031] in your submitted response. 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, 2024. Individuals can obtain copies of the collection instruments by writing to the above email address. Average burden per response (minutes) Frequency of response Estimated total annual burden (hours) 1. Work Activity Report— Employee—20 CFR 404.1520(b), 404.1571–404.1576, 404.1584–404.1593, and 416.971–404.976—0960–0059. Section 223(d) of the Social Security Act (Act) defines the term ‘‘disability’’ as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment which one expects to result in death, or which lasted or is expected to last for a continuous period of not less than 12 months. Social Security Disability (SSDI) and Supplemental Security Income (SSI) applicants or recipients can become entitled to payments based on their inability to engage in SGA because of a physical or mental condition. SSA uses Form SSA–821–BK to obtain work information during the initial claims process; the continuing disability review process; post-adjudicative work issue actions; and for Supplemental Security Income (SSI) claims involving work issues. SSA reviews and evaluates the data to determine if the applicant or recipient meets the disability requirements of the law. The respondents are applicants or recipients of Title II Social Security Disability, and Title XVI SSI applicants. Type of Request: Revision of an OMBapproved information collection. Average theoretical hourly cost amount (dollars) * Average wait time in field office or for teleservice centers (minutes) ** Total annual opportunity cost (dollars) *** 64,330 128,660 1 1 30 30 32,165 64,330 * $13.30 * 13.30 ** 24 ** 19 *** 770,030 *** 1,397,458 192,990 1 40 128,660 * 13.30 ........................ *** 1,710,380 25,320 411,300 1 ........................ 45 ........................ 18,990 244,145 * 13.30 ........................ ........................ ........................ *** 252,567 *** 4,130,435 ddrumheller on DSK120RN23PROD with NOTICES1 * We based this figure on the average of both DI payments based on SSA’s current FY 2024 data (https://mwww.ba.ssa.gov/legislation/ 2024FactSheet.pdf), and U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_ nat.htm). ** We based this figure on averaging the average FY 2024 wait times for field offices, based on SSA’s current management information 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. Claimant’s Medication—20 CFR 404.1512, 416.912—0960–0289. To receive Old Age Survivors and Disability Insurance (OASDI) and SSI payments, the relevant State Disability Determination Service (DDS) or field office (FO) must first adjudicate claimants’ applications. If the DDS or FO denies an initial application, the claimants may request for 25 17 reconsideration of the initial denial. At that time, the claimants may submit addition documentation to further justify their claims. If the DDS denies the claim at the reconsideration level, the claimant may then request a hearing before a judge. Before the hearing, SSA allows the claimant to submit additional evidence to support their claim. In addition, since judges must obtain information from the claimant to update and complete their medical record and to verify the accuracy of the information, SSA also sends the claimant Form HA–4632, Claimant’s Medications, to request information from the claimant regarding the current medications they use. This information helps the judge overseeing the case to fully investigate: (1) the claimant’s CFR 200.30–3(a)(12). VerDate Sep<11>2014 20:43 Sep 11, 2024 Jkt 262001 PO 00000 Frm 00152 Fmt 4703 Sfmt 4703 E:\FR\FM\12SEN1.SGM 12SEN1 74352 Federal Register / Vol. 89, No. 177 / Thursday, September 12, 2024 / Notices medical treatment and (2) the effects of the medications on the claimant’s medical impairments and functional capacity. The judge makes the completed form a part of the Modality of completion Number of respondents documentary evidence of record, placing it in the official record of the proceedings as an exhibit. The respondents are applicants (or their representatives) for OASDI or SSI Average burden per response (minutes) Frequency of response payments who request a hearing to contest an agency denial of their claim. Type of Request: Revision of an OMBapproved information collection. Average theoretical hourly cost amount (dollars) * Estimated total annual burden (hours) Average wait time in field office (minutes) ** Total annual opportunity cost (dollars) *** HA–4632—PDF/paper version ...................... Electronic Records Express Submissions ... 51,000 1 20 17,000 * $13.30 ** 21 *** $463,505 249,000 1 20 83,000 * 31.48 ........................ *** 2,612,840 Totals .................... 300,000 ........................ ........................ 100,000 ........................ ........................ *** 3,076,345 * We based this figure on the average DI payments based on SSA’s current data (https://www.ssa.gov/legislation/2024FactSheet.pdf) and on the average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm). ** We based this figure on averaging both the average FY 2024 wait times for field offices and teleservice centers, based on SSA’s current management information 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. children use Form SSA–3881–BK to provide SSA with the addresses of nonmedical sources such as schools, counselors, agencies, organizations, or therapists who would have information about a child’s functioning. SSA uses this information to help determine a child’s claim or continuing eligibility 3. Questionnaire for Children Claiming SSI Benefits—20 CFR 416.912(a)—0960–0499. Sections 1614 and 1631 of the Act allows SSA to determine the eligibility of an applicant’s claim for SSI payments. Parents or legal guardians seeking to obtain or retain SSI eligibility for their Modality of completion Number of respondents SSA–3881–BK (Paper Version) .................... SSA–3881–BK (Intranet Version) .................... Totals .................... Average burden per response (minutes) Frequency of response for SSI. The respondents are the parents, guardians, or other caretakers of: (1) applicants who appeal SSI childhood disability decisions; or (2) recipients undergoing a continuing disability review. Type of Request: Revision of an OMBapproved information collection. Average theoretical hourly cost amount (dollars) * Estimated total annual burden (hours) Average wait time in field office (minutes) ** Total annual opportunity cost (dollars) *** 98,307 1 30 49,154 * $31.48 ** 24 *** $2,785,256 52,936 1 30 26,468 * 31.48 ** 21 *** 1,416,474 151,243 ........................ ........................ 75,622 ........................ ........................ *** 4,201,730 * We based this figure on average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/ oes_nat.htm). ** We based this figure on the average FY 2024 wait times for field offices and hearings office, as well as by averaging both the average FY 2024 wait times for field offices (24 minutes) and teleservice centers (19 minutes), based on SSA’s current management information 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. ddrumheller on DSK120RN23PROD with NOTICES1 4. Requests for Self-Employment Information, Employee Information, and Employer Information—20 CFR 422.120—0960–0508. When SSA cannot identify Form W–2 wage data for an individual, we place the data in an earnings suspense file and contact the individual (and certain instances the Modality of completion Number of respondents SSA–L2765 * ................ SSA–L3365 * ................ SSA–L4002 * ................ VerDate Sep<11>2014 20:43 Sep 11, 2024 employer) to obtain the correct information. If the respondent furnishes the name and Social Security Number (SSN) information that agrees with SSA’s records, or provides information that resolves the discrepancy, SSA adds the reported earnings to the respondent’s Social Security record. We Average burden per response (minutes) Frequency of response 1 1 1 Jkt 262001 1 1 1 PO 00000 Frm 00153 Fmt 4703 Average theoretical hourly cost amount (dollars) ** Estimated total annual burden (hours) 10 10 10 Sfmt 4703 use Forms SSA–L2765, SSA–L3365, and SSA–L4002 for this purpose. The respondents are self-employed individuals and employees whose name and SSN information do not agree with their employer’s and SSA’s records. Type of Request: Revision of an OMB approved information collection. 1 1 1 ** $31.48 ** 31.48 ** 31.48 E:\FR\FM\12SEN1.SGM 12SEN1 Total annual opportunity cost (dollars) *** ........................ ........................ ........................ *** $31.48 *** 31.48 *** 31.48 Federal Register / Vol. 89, No. 177 / Thursday, September 12, 2024 / Notices Modality of completion Number of respondents Totals .................... 1 Frequency of response Average burden per response (minutes) ........................ ........................ Average theoretical hourly cost amount (dollars) ** Estimated total annual burden (hours) 3 ........................ 74353 Total annual opportunity cost (dollars) *** ........................ *** 94 * SSA does not currently send out any of these collections; however, we included 1 hour burden placeholders for each collection, in the event we need to send these notices out in the near future. ** We based this figure on average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm). *** 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. Function Report—Child (Birth to 1st Birthday, Age 1 to 3rd Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th Birthday)—20 CFR 416.912 and 416.924a(a)(2)—0960– 0542. As part of SSA’s disability determination process, we use Forms SSA–3375–BK through SSA–3379–BK to request information from a child’s parent or guardian for children applying for SSI. The five different versions of the form contain questions about the child’s Modality of completion (paper & Intranet versions) SSA–3375 SSA–3376 SSA–3377 SSA–3378 SSA–3379 Totals Number of respondents .................... .................... .................... .................... .................... .................... 26,864 53,347 108,745 193,800 142,006 524,762 day-to-day functioning appropriate to a particular age group; thus, respondents use only one version of the form for each child. The adjudicative team (disability examiners and medical or psychological consultants) of State disability determination services offices collect the information on the appropriate version of this form (in conjunction with medical and other evidence) to form a complete picture of the children’s ability to function and Frequency of response Average burden per response (minutes) 1 1 1 1 1 ........................ 20 20 20 20 20 ........................ their impairment-related limitations. The adjudicative team uses the completed profile to determine: (1) if each child’s impairment(s) results in marked and severe functional limitations; and (2) whether each child is disabled. The respondents are parents and guardians of child applicants for SSI. Type of Request: Revision of an OMBapproved information collection. Average theoretical hourly cost amount (dollars) * Average wait time in field office or teleservice center (minutes) ** Total annual opportunity cost (dollars) *** * $31.48 * 31.48 * 31.48 * 31.48 * 31.48 ........................ ** 21 ** 21 ** 21 ** 21 ** 21 ........................ *** $577,878 *** 1,147,540 *** 2,339,247 *** 4,168,896 *** 3,054,725 *** 11,288,286 Estimated total annual burden (hours) 8,955 17,782 36,248 64,600 47,335 174,921 * We based this figure on the average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm). ** We based this figure on the average FY 2024 wait times for field offices (24 minutes) and Teleservice Centers (19 minutes), based on SSA’s current management information 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. ddrumheller on DSK120RN23PROD with NOTICES1 6. Representative Payee Report of Benefits and Dedicated Account—20 CFR 416.546, 416.635, 416.640, and 416.665—0960–0576. SSA requires representative payees (RPs) to manage the dedicated account in accordance with our rules, including using the funds for permitted expenditures and reporting on the use of funds. When the SSI recipient requires a dedicated account, SSA notifies the RP to inform them of the need to open the dedicated VerDate Sep<11>2014 20:43 Sep 11, 2024 Jkt 262001 account and of the rules for managing a dedicated account, including the required submission of a written report accounting for the use of money paid to Social Security or Supplemental Security Income (SSI) recipients into the dedicated account. SSA allows the respondent to submit their own written report, or use Form SSA–6233, which simplifies the process for the respondents. SSA uses Form SSA–6233 to: (1) ensure the RPs use the payments PO 00000 Frm 00154 Fmt 4703 Sfmt 4703 for the recipient’s current maintenance and personal needs and properly conserves the remainder; and (2) confirm the funds paid into the dedicated account are spent and saved in compliance with the law. Respondents are RPs for SSI and Social Security recipients. Type of Request: Revision of an OMBapproved information collection. E:\FR\FM\12SEN1.SGM 12SEN1 74354 Federal Register / Vol. 89, No. 177 / Thursday, September 12, 2024 / Notices Modality of completion Number of respondents SSA–6233 .................... Average burden per response (minutes) Frequency of response 68,000 1 Estimated total annual burden (hours) 20 Average theoretical hourly cost amount (dollars) * 22,667 Average wait time in field office or for teleservice centers (minutes) ** * $31.48 ** 21 Total annual opportunity cost (dollars) *** *** $1,462,781 * We based this figure on average U.S. worker’s hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/ oes_nat.htm#00-0000). ** We based this figure on averaging both the average FY 2024 wait times for field offices (24 minutes) and teleservice centers (19 minutes), based on SSA’s current management information 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. Sheltered Workshop Wage Reporting—0960–0771. Sheltered workshops are private non-profit organizations or institutions that implement a recognized program of rehabilitation for handicapped workers or provide such workers with remunerative employment or other occupational rehabilitating activity of an Modality of completion educational or therapeutic nature. Sheltered workshops perform a service for their clients by reporting monthly wages directly to SSA. SSA uses the information these workshops provide to verify and post monthly wages to SSI recipient’s records. Most workshops report monthly wage totals to their local SSA office, so we can adjust the client’s Number of respondents Frequency of response 244 12 Sheltered Workshop Wage Reporting ........... Total number of responses Average burden per response (minutes) 2,928 SSI payment amount in a timely manner and prevent overpayments. Sheltered workshops are motivated to report wages voluntarily as a service to their clients. Respondents are sheltered workshops that report monthly wages for services performed in the workshop. Type of Request: Revision of an OMBapproved information collection. Estimated total annual burden (hours) 15 Average theoretical hourly cost amount (dollars) * 732 Average wait time in field office (minutes) ** Total annual opportunity cost (dollars) *** ** 24 *** $19,322 * $23.28 * We based this on average Rehabilitation Counselors hourly salary, as reported in Bureau of Labor Statistics data (https://www.bls.gov/oes/ current/oes211015.htm) ** We based this figure on the average FY 2024 wait times for field offices, based on SSA’s current management information 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, 2024. Naomi Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2024–20713 Filed 9–11–24; 8:45 am] BILLING CODE 4191–02–P DEPARTMENT OF STATE [Public Notice: 12534] Notice of Determinations; Additional Culturally Significant Object Being Imported for Exhibition— Determinations: ‘‘Tamara de Lempicka’’ Exhibition On July 10, 2024, notice was published in the Federal Register of determinations pertaining to certain objects to be included in an exhibition entitled ‘‘Tamara de Lempicka.’’ Notice is hereby given of the following determinations: I hereby determine that a certain additional object being imported from abroad pursuant to an agreement with its foreign owner or ddrumheller on DSK120RN23PROD with NOTICES1 SUMMARY: VerDate Sep<11>2014 20:43 Sep 11, 2024 Jkt 262001 custodian for temporary display in the aforesaid exhibition at the Fine Arts Museums of San Francisco, de Young Museum, San Francisco, California; the Museum of Fine Arts, Houston, in Houston, Texas; and at possible additional exhibitions or venues yet to be determined, is of cultural significance, and, further, that its temporary exhibition or display within the United States as aforementioned is in the national interest. I have ordered that Public Notice of these determinations be published in the Federal Register. FOR FURTHER INFORMATION CONTACT: Reed Liriano, Program Coordinator, 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, 2200 C Street, NW (SA–5), Suite 5H03, Washington, DC 20522–0505. 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, Delegation of Authority No. 236–3 of August 28, 2000, and Delegation of Authority No. 523 of December 22, 2021. The notice of determinations published on July 10, 2024, appears at 89 FR 56784. Nicole L. Elkon, Deputy Assistant Secretary for Professional and Cultural Exchanges, Bureau of Educational and Cultural Affairs, Department of State. [FR Doc. 2024–20647 Filed 9–11–24; 8:45 am] BILLING CODE 4710–05–P The foregoing determinations were made pursuant to the authority vested in me SUPPLEMENTARY INFORMATION: PO 00000 Frm 00155 Fmt 4703 Sfmt 9990 E:\FR\FM\12SEN1.SGM 12SEN1

Agencies

[Federal Register Volume 89, Number 177 (Thursday, September 12, 2024)]
[Notices]
[Pages 74351-74354]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-20713]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2024-0031]


Agency Information Collection Activities: Proposed Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages requiring clearance by the Office of 
Management and Budget (OMB) in compliance with Public Law 104-13, the 
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice 
includes revisions of OMB-approved information collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information; its practical utility; ways to 
enhance its quality, utility, and clarity; and ways to minimize burden 
on respondents, including the use of automated collection techniques or 
other forms of information technology. Mail, email, or fax your 
comments and recommendations on the information collection(s) to the 
OMB Desk Officer and SSA Reports Clearance Officer at the following 
addresses or fax numbers.
    (OMB) Office of Management and Budget, Attn: Desk Officer for SSA. 
You may submit your comments online through https://www.reginfo.gov/public/do/PRAMain, referencing Docket ID Number [SSA-2024-0031].
    (SSA) Social Security Administration, OLCA, Attn: Reports Clearance 
Director, Mail Stop 3253 Altmeyer, 6401 Security Blvd., Baltimore, MD 
21235, Fax: 833-410-1631. Email address: [email protected]. 
Or you may submit your comments online through https://www.reginfo.gov/
public/do/PRAmain by clicking on Currently under Review--Open for 
Public Comments and choosing to click on one of SSA's published items.
    Please reference Docket ID Number [SSA-2024-0031] in your submitted 
response.
    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, 2024. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Work Activity Report--Employee--20 CFR 404.1520(b), 404.1571-
404.1576, 404.1584-404.1593, and 416.971-404.976--0960-0059. Section 
223(d) of the Social Security Act (Act) defines the term ``disability'' 
as the inability to engage in any substantial gainful activity (SGA) by 
reason of any medically determinable physical or mental impairment 
which one expects to result in death, or which lasted or is expected to 
last for a continuous period of not less than 12 months. Social 
Security Disability (SSDI) and Supplemental Security Income (SSI) 
applicants or recipients can become entitled to payments based on their 
inability to engage in SGA because of a physical or mental condition. 
SSA uses Form SSA-821-BK to obtain work information during the initial 
claims process; the continuing disability review process; post-
adjudicative work issue actions; and for Supplemental Security Income 
(SSI) claims involving work issues. SSA reviews and evaluates the data 
to determine if the applicant or recipient meets the disability 
requirements of the law. The respondents are applicants or recipients 
of Title II Social Security Disability, and Title XVI SSI applicants.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                           Average wait
                                                                                                              Average      time in field   Total annual
                                             Number of     Frequency of   Average burden     Estimated      theoretical    office or for    opportunity
         Modality of completion             respondents      response      per response    total annual     hourly cost     teleservice   cost (dollars)
                                                                             (minutes)    burden (hours)      amount          centers           ***
                                                                                                            (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-821-BK In Office....................          64,330               1              30          32,165        * $13.30           ** 24     *** 770,030
SSA-821-BK Phone........................         128,660               1              30          64,330         * 13.30           ** 19   *** 1,397,458
SSA-821-BK Returned Via Mail............         192,990               1              40         128,660         * 13.30  ..............   *** 1,710,380
SSA-821-BK Electronic...................          25,320               1              45          18,990         * 13.30  ..............     *** 252,567
    Totals..............................         411,300  ..............  ..............         244,145  ..............  ..............   *** 4,130,435
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average of both DI payments based on SSA's current FY 2024 data (https://mwww.ba.ssa.gov/legislation/2024FactSheet.pdf),
  and U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on averaging the average FY 2024 wait times for field offices, based on SSA's current management information 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. Claimant's Medication--20 CFR 404.1512, 416.912--0960-0289. To 
receive Old Age Survivors and Disability Insurance (OASDI) and SSI 
payments, the relevant State Disability Determination Service (DDS) or 
field office (FO) must first adjudicate claimants' applications. If the 
DDS or FO denies an initial application, the claimants may request for 
reconsideration of the initial denial. At that time, the claimants may 
submit addition documentation to further justify their claims. If the 
DDS denies the claim at the reconsideration level, the claimant may 
then request a hearing before a judge. Before the hearing, SSA allows 
the claimant to submit additional evidence to support their claim. In 
addition, since judges must obtain information from the claimant to 
update and complete their medical record and to verify the accuracy of 
the information, SSA also sends the claimant Form HA-4632, Claimant's 
Medications, to request information from the claimant regarding the 
current medications they use. This information helps the judge 
overseeing the case to fully investigate: (1) the claimant's

[[Page 74352]]

medical treatment and (2) the effects of the medications on the 
claimant's medical impairments and functional capacity. The judge makes 
the completed form a part of the documentary evidence of record, 
placing it in the official record of the proceedings as an exhibit. The 
respondents are applicants (or their representatives) for OASDI or SSI 
payments who request a hearing to contest an agency denial of their 
claim.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                              Average
                                                                          Average burden     Estimated      theoretical    Average wait    Total annual
         Modality of completion              Number of     Frequency of    per response    total annual     hourly cost    time in field    opportunity
                                            respondents      response        (minutes)    burden (hours)      amount          office      cost (dollars)
                                                                                                            (dollars) *    (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-4632--PDF/paper version..............          51,000               1              20          17,000        * $13.30           ** 21    *** $463,505
Electronic Records Express Submissions..         249,000               1              20          83,000         * 31.48  ..............   *** 2,612,840
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         300,000  ..............  ..............         100,000  ..............  ..............   *** 3,076,345
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average DI payments based on SSA's current data (https://www.ssa.gov/legislation/2024FactSheet.pdf) and on the average
  U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on averaging both the average FY 2024 wait times for field offices and teleservice centers, based on SSA's current management
  information 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. Questionnaire for Children Claiming SSI Benefits--20 CFR 
416.912(a)--0960-0499. Sections 1614 and 1631 of the Act allows SSA to 
determine the eligibility of an applicant's claim for SSI payments. 
Parents or legal guardians seeking to obtain or retain SSI eligibility 
for their children use Form SSA-3881-BK to provide SSA with the 
addresses of non-medical sources such as schools, counselors, agencies, 
organizations, or therapists who would have information about a child's 
functioning. SSA uses this information to help determine a child's 
claim or continuing eligibility for SSI. The respondents are the 
parents, guardians, or other caretakers of: (1) applicants who appeal 
SSI childhood disability decisions; or (2) recipients undergoing a 
continuing disability review.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                              Average
                                                                          Average burden     Estimated      theoretical    Average wait    Total annual
         Modality of completion              Number of     Frequency of    per response    total annual     hourly cost    time in field    opportunity
                                            respondents      response        (minutes)    burden (hours)      amount          office      cost (dollars)
                                                                                                            (dollars) *    (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3881-BK (Paper Version).............          98,307               1              30          49,154        * $31.48           ** 24  *** $2,785,256
SSA-3881-BK (Intranet Version)..........          52,936               1              30          26,468         * 31.48           ** 21   *** 1,416,474
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         151,243  ..............  ..............          75,622  ..............  ..............   *** 4,201,730
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on the average FY 2024 wait times for field offices and hearings office, as well as by averaging both the average FY 2024 wait
  times for field offices (24 minutes) and teleservice centers (19 minutes), based on SSA's current management information 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. Requests for Self-Employment Information, Employee Information, 
and Employer Information--20 CFR 422.120--0960-0508. When SSA cannot 
identify Form W-2 wage data for an individual, we place the data in an 
earnings suspense file and contact the individual (and certain 
instances the employer) to obtain the correct information. If the 
respondent furnishes the name and Social Security Number (SSN) 
information that agrees with SSA's records, or provides information 
that resolves the discrepancy, SSA adds the reported earnings to the 
respondent's Social Security record. We use Forms SSA-L2765, SSA-L3365, 
and SSA-L4002 for this purpose. The respondents are self-employed 
individuals and employees whose name and SSN information do not agree 
with their employer's and SSA's records.
    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-L2765 *.............................               1               1              10               1       ** $31.48  ..............      *** $31.48
SSA-L3365 *.............................               1               1              10               1        ** 31.48  ..............       *** 31.48
SSA-L4002 *.............................               1               1              10               1        ** 31.48  ..............       *** 31.48

[[Page 74353]]

 
    Totals..............................               1  ..............  ..............               3  ..............  ..............          *** 94
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* SSA does not currently send out any of these collections; however, we included 1 hour burden placeholders for each collection, in the event we need to
  send these notices out in the near future.
** We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
*** 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. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd 
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th 
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of 
SSA's disability determination process, we use Forms SSA-3375-BK 
through SSA-3379-BK to request information from a child's parent or 
guardian for children applying for SSI. The five different versions of 
the form contain questions about the child's day-to-day functioning 
appropriate to a particular age group; thus, respondents use only one 
version of the form for each child. The adjudicative team (disability 
examiners and medical or psychological consultants) of State disability 
determination services offices collect the information on the 
appropriate version of this form (in conjunction with medical and other 
evidence) to form a complete picture of the children's ability to 
function and their impairment-related limitations. The adjudicative 
team uses the completed profile to determine: (1) if each child's 
impairment(s) results in marked and severe functional limitations; and 
(2) whether each child is disabled. The respondents are parents and 
guardians of child applicants for SSI.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                           Average wait
                                                                                                              Average      time in field   Total annual
Modality of completion (paper & Intranet     Number of     Frequency of   Average burden     Estimated      theoretical      office or      opportunity
                versions)                   respondents      response      per response    total annual     hourly cost     teleservice   cost (dollars)
                                                                             (minutes)    burden (hours)      amount          center            ***
                                                                                                            (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3375................................          26,864               1              20           8,955        * $31.48           ** 21    *** $577,878
SSA-3376................................          53,347               1              20          17,782         * 31.48           ** 21   *** 1,147,540
SSA-3377................................         108,745               1              20          36,248         * 31.48           ** 21   *** 2,339,247
SSA-3378................................         193,800               1              20          64,600         * 31.48           ** 21   *** 4,168,896
SSA-3379................................         142,006               1              20          47,335         * 31.48           ** 21   *** 3,054,725
    Totals..............................         524,762  ..............  ..............         174,921  ..............  ..............  *** 11,288,286
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm).
** We based this figure on the average FY 2024 wait times for field offices (24 minutes) and Teleservice Centers (19 minutes), based on SSA's current
  management information 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.

    6. Representative Payee Report of Benefits and Dedicated Account--
20 CFR 416.546, 416.635, 416.640, and 416.665--0960-0576. SSA requires 
representative payees (RPs) to manage the dedicated account in 
accordance with our rules, including using the funds for permitted 
expenditures and reporting on the use of funds. When the SSI recipient 
requires a dedicated account, SSA notifies the RP to inform them of the 
need to open the dedicated account and of the rules for managing a 
dedicated account, including the required submission of a written 
report accounting for the use of money paid to Social Security or 
Supplemental Security Income (SSI) recipients into the dedicated 
account. SSA allows the respondent to submit their own written report, 
or use Form SSA-6233, which simplifies the process for the respondents. 
SSA uses Form SSA-6233 to: (1) ensure the RPs use the payments for the 
recipient's current maintenance and personal needs and properly 
conserves the remainder; and (2) confirm the funds paid into the 
dedicated account are spent and saved in compliance with the law. 
Respondents are RPs for SSI and Social Security recipients.
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 74354]]



--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                           Average wait
                                                                                                              Average      time in field   Total annual
                                             Number of     Frequency of   Average burden     Estimated      theoretical    office or for    opportunity
         Modality of completion             respondents      response      per response    total annual     hourly cost     teleservice   cost (dollars)
                                                                             (minutes)    burden (hours)      amount          centers           ***
                                                                                                            (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-6233................................          68,000               1              20          22,667        * $31.48           ** 21  *** $1,462,781
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes_nat.htm#00-0000).
** We based this figure on averaging both the average FY 2024 wait times for field offices (24 minutes) and teleservice centers (19 minutes), based on
  SSA's current management information 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. Sheltered Workshop Wage Reporting--0960-0771. Sheltered 
workshops are private non-profit organizations or institutions that 
implement a recognized program of rehabilitation for handicapped 
workers or provide such workers with remunerative employment or other 
occupational rehabilitating activity of an educational or therapeutic 
nature. Sheltered workshops perform a service for their clients by 
reporting monthly wages directly to SSA. SSA uses the information these 
workshops provide to verify and post monthly wages to SSI recipient's 
records. Most workshops report monthly wage totals to their local SSA 
office, so we can adjust the client's SSI payment amount in a timely 
manner and prevent overpayments. Sheltered workshops are motivated to 
report wages voluntarily as a service to their clients. Respondents are 
sheltered workshops that report monthly wages for services performed in 
the workshop.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                                  Average       Total
                                                                                           Average     Estimated     Average     wait time      annual
                                                   Number of    Frequency      Total      burden per     total     theoretical    in field   opportunity
             Modality of completion               respondents  of response   number of     response      annual    hourly cost     office        cost
                                                                             responses    (minutes)      burden       amount     (minutes)    (dollars)
                                                                                                        (hours)    (dollars) *       **          ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
Sheltered Workshop Wage Reporting...............          244           12        2,928           15          732     * $23.28        ** 24  *** $19,322
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this on average Rehabilitation Counselors hourly salary, as reported in Bureau of Labor Statistics data (https://www.bls.gov/oes/current/oes211015.htm)
** We based this figure on the average FY 2024 wait times for field offices, based on SSA's current management information 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, 2024.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2024-20713 Filed 9-11-24; 8:45 am]
BILLING CODE 4191-02-P


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