82 FR 11293 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 82, Issue 33 (February 21, 2017)
Federal Register Volume 82, Issue 33 (February 21, 2017)
| Page Range | 11293-11297 | |
| FR Document | 2017-03308 |
[Federal Register Volume 82, Number 33 (Tuesday, February 21, 2017)] [Notices] [Pages 11293-11297] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-03308] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2017-0006] 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 and one extension 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-2017-0006]. 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 April 24, 2017. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Government Pension Questionnaire--20 CFR 404.408a--0960-0160. The basic Social Security benefits application (OMB No. 0960-0618) contains a lead question asking if the applicants are qualified (or will qualify) to receive a government pension. If the respondent is qualified, or will qualify, to receive a government pension, the applicant completes Form SSA-3885 either on paper or through a personal interview with an SSA claims representative. If the applicants are not entitled to receive a government pension at the time they apply for Social Security benefits, SSA requires them to provide the government pension information as beneficiaries when they become eligible to receive their pensions. Regardless of the timing, at some point the applicants or beneficiaries must complete and sign Form SSA-3885 to report information about their government pensions before the pensions begin. SSA uses the information to: (1) Determine whether the Government Pension Offset provision applies; (2) identify exceptions as stated in 20 CFR 404.408a; and (3) determine the benefit reduction amount and effective date. If the applicants and beneficiaries do not respond using this questionnaire, SSA offsets their entire benefit amount. The respondents are applicants or recipients of spousal benefits who are eligible for or already receiving a Government pension. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-3885.................................... 76,000 1 13 16,467 ---------------------------------------------------------------------------------------------------------------- 2. Modified Benefit Formula Questionnaire--0960-0395. SSA collects information on Form SSA-150 to determine which formula to use in computing the Social Security benefit for someone who receives a pension from employment not covered by Social Security. The Windfall Elimination Provision (WEP) requires use of a benefit formula replacing a smaller percentage of a worker's pre-retirement earnings. However, the resulting amount cannot show a difference in the benefit computed using the modified and regular formulas greater than one-half the amount of the pension received in the first month an individual is entitled to both the pension and the Social Security benefit. The SSA- 150 collects the information needed to make all the necessary benefit computations. SSA requires respondents to furnish the information on Form SSA-150 so we can calculate their benefits using the data they supply. SSA calculates the benefits of applicants who do not respond to this questionnaire using the full WEP reduction. SSA employees collect this information once from the applicant at the time they file their claim. The respondents are applicants for old age and disability benefits. [[Page 11294]] Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-150..................................... 90,000 1 8 12,000 ---------------------------------------------------------------------------------------------------------------- 3. Modified Benefit Formula Questionnaire-Employer--20 CFR 401 & 402--0960-0477. Sections 215(a)(7) and 215(d)(3) of the Social Security Act (Act) require SSA to use a modified benefit formula to compute Social Security retirement or disability benefits for persons first eligible (after 1985) for both a Social Security benefit and a pension or annuity, based on employment not covered by Social Security. This method is the Windfall Elimination Provision (WEP). SSA makes a determination regarding whether the WEP is applicable and when to apply it to a person's benefit. SSA uses Form SSA-58 to verify the claimant's allegations on Form SSA-150 (OMB #0906-0395, Modified Benefits Formula Questionnaire). SSA also uses Form SSA-58 to determine if the modified benefit formula is applicable and when to apply it to a person's benefits. SSA sends Form SSA-58 to an employer for pension related information, if the claimant is unable to provide it. The respondents are employers of people who are eligible after 1985 for both Social Security benefits and a pension based on work not covered by SSA. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-58...................................... 30,000 1 20 10,000 ---------------------------------------------------------------------------------------------------------------- 4. Questionnaire for Children Claiming Supplemental Security Income (SSI) Benefits--0960-0499. Section 1631(d)(2) 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 applicants who appeal SSI childhood disability decisions or recipients undergoing a continuing disability review. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-3881-BK (Paper Version)..................... 84,500 1 30 42,250 SSA-3881-BK (Electronic Disability Collect 45,500 1 30 22,750 System)........................................ --------------------------------------------------------------- Totals...................................... 130,000 .............. .............. 65,000 ---------------------------------------------------------------------------------------------------------------- 5. Work History Report--20 CFR 404.1515, 404.1560, 404.1565, 416.960 and 416.3965--0960-0578. Under certain circumstances, SSA asks individuals applying for disability about work they have performed in the past. Applicants use Form SSA-3369, Work History Report, to provide detailed information about jobs held prior to becoming unable to work. State Disability Determination Services evaluate the information, together with medical evidence, to determine eligibility for disability payments. Respondents are disability applicants and third parties assisting applicants. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-3369 (Paper Version)........................ 1,553,900 1 60 1,553,900 SSA-3369 (Electronic Disability Collect System). 38,049 1 60 38,049 --------------------------------------------------------------- Totals...................................... 1,591,949 .............. .............. 1,591,949 ---------------------------------------------------------------------------------------------------------------- 6. Authorization to Obtain Earnings Data From the Social Security Administration--0960-0602. On occasion, public and private organizations and agencies need to obtain detailed earnings information [[Page 11295]] about specific Social Security number (SSN) holding wage earners for business purposes (e.g. pension funds, State agencies, etc.). Respondents use Form SSA-581 to identify the SSN holder whose information they are requesting, and provide authorization from the SSN holder, when applicable. SSA uses the information provided on Form SSA- 581 to: (1) Identify the wage earner; (2) establish the period of earnings information requested; (3) verify the wage earner authorized SSA to release this information to the requesting party; and (4) produce the Itemized Statement of Earnings (SSA-1826). The respondents are private businesses, state or local agencies, and other federal agencies. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-581..................................... 24,000 1 2 800 ---------------------------------------------------------------------------------------------------------------- 7. Appeal of Determination for Help with Medicare Prescription Drug Plan Costs--0960-0695. Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), established the Medicare Part D program for voluntary prescription drug coverage for certain low-income individuals. The MMA stipulates the provision of subsidies for individuals who are eligible for the program and who meet eligibility criteria for help with premium, deductible, and co-payment costs. SSA uses Form SSA-1021, Appeal of Determination for Help with Medicare Prescription Drug Plan Costs, to obtain information from individuals who appeal SSA's decisions regarding eligibility or continuing eligibility for a Medicare Part D subsidy. The respondents are Medicare beneficiaries, or proper applicants acting on behalf of a Medicare beneficiary, who do not agree with the outcome of an SSA subsidy eligibility determination, and are filing an appeal. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-1021 (Paper Version)........................ 3,283 1 10 547 SSA-1021 (Internet Version; Medicare Application 11,037 1 10 1,840 Processing System)............................. --------------------------------------------------------------- Totals...................................... 14,320 .............. .............. 2,387 ---------------------------------------------------------------------------------------------------------------- 8. Social Security Administration Eligible Non-Attorney Representative--20 CFR 404.1717, 404.1745-404.1799, 416.1517, and 416.1545-416.1599--0960-0699. Section 3 of the Social Security Disability Applicants Access to Professional Representation Act (PRA) of 2010, Public Law 111-142, permanently extends the direct payment provision of Section 303 of the Social Security Protection Act (SSPA) of 2004, Public Law 108-203. The PRA permits SSA to extend direct payment of approved fees from claimants' past-due benefits to certain non-attorney representatives. Prior to the enactment of the SSPA and PRA, only attorneys could receive direct payment of SSA-approved fees. Under the PRA, non-attorneys must meet certain prerequisites to be eligible for direct payment of fees. These prerequisites include: (1) A bachelor's degree from an accredited institution of higher education, or four years of relevant professional experience and a high school diploma or General Education Development certificate; (2) passing a written examination administered by SSA testing the knowledge of relevant provisions of the Act under Titles II and XVI; (3) securing and maintaining continuous professional liability insurance, or equivalent, to protect claimants from malpractice; (4) passing a criminal background check; (5) demonstrating ongoing completion of continuing education courses. The PRA requires SSA to collect the information needed to determine if applicants have satisfied these prerequisites. SSA uses the information we collect on Form SSA-1691 to determine whether an applicant fulfilled the statutory prerequisites and regulatory requirements as listed above. To verify this information, we also request the five required items listed above from each new applicant, and we request items #3 and #5 from all non- attorney representatives (new and existing) on a yearly basis. Every year, SSA evaluates the applications; conducts verification investigations; and issues recommendations regarding applicants' eligibility to sit for the examination and eligibility to receive direct payment. The respondents are non-attorneys who want to receive direct payment of their fees for representational services before SSA. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- New Respondents--Paper Application (complete and 200 1 45 547 submit)--404.1717(b) & (c); 416.1517(b) & (c).. New Respondents Examination--404.1717(a)(5); 200 1 120 400 416.1517(a)(5)................................. New Respondents--Submission of proof of 200 1 10 33 Bachelor's Degree or Equivalent Qualifications-- 404.1717(a)(3); 416.1517(a)(3)................. [[Page 11296]] New and Existing Respondents--CE Submission via 710 1 20 237 email/mail/or FAX of training courses taken as prescribed by SSA--404.1717(a)(7); 416.1517(a)(7)................................. New and Existing Respondents--Proof of 672 1 10 112 Continuous Professional or Business Liability Insurance Coverage (Scan and Email)-- 404.1717(a)(6); 416.1517(a)(6)................. New and Existing Respondents--Proof of 38 1 15 10 Continuous Professional or Business Liability Insurance Coverage (Copy and Mail)-- 404.1717(a)(6); 416.1517(a)(6)................. New and Existing Respondents--Written Protests-- 45 1 45 34 404.1717(d); 416.1517(d)....................... --------------------------------------------------------------- Totals...................................... 2,065 .............. .............. 976 ---------------------------------------------------------------------------------------------------------------- 9. Sheltered Workshop Wage Reporting--0960-0771. Sheltered workshops are 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 the SSI recipient's record. 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: Extension of an OMB-approved information collection. -------------------------------------------------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of (Number of per response annual burden respondents response responses) (minutes) (hours) -------------------------------------------------------------------------------------------------------------------------------------------------------- Sheltered Workshop Wage Reporting.................................. 800 12 (9,600) 15 2,400 -------------------------------------------------------------------------------------------------------------------------------------------------------- 10. Medicare Income-Related Monthly Adjustment Amount--Life- Changing Event Form--0960-0784. Federally mandated reductions in the Federal Medicare Part B and prescription drug coverage subsidies result in selected Medicare recipients paying higher premiums with income above a specific threshold. The amount of the premium subsidy reduction is an income-related monthly adjustment amount (IRMAA). The Internal Revenue Service (IRS) transmits income tax return data to SSA for SSA to determine the IRMAA. SSA uses the Form SSA-44 to determine if a recipient qualifies for a reduction in the IRMAA. If affected Medicare recipients believe SSA should use more recent tax data because of a life-changing event that significantly reduces their income, they can report these changes to SSA and ask for a new initial determination of their IRMAA. The respondents are Medicare Part B and prescription drug coverage recipients and enrollees with modified adjusted gross income over a high-income threshold who experience one of eight significant life-changing events. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-44 (Personal Interview in SSA field office). 140,378 1 30 70,189 SSA-44 (Paper Version).......................... 60,162 1 45 45,122 --------------------------------------------------------------- Totals...................................... 200,540 .............. .............. 115,311 ---------------------------------------------------------------------------------------------------------------- II. SSA submitted the information collection below to OMB for clearance. Your comments regarding the information collection 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 March 23, 2017. Individuals can obtain copies of the OMB clearance package by writing to [email protected]. Statement of Agricultural Employer (Year Prior to 1988; and 1988 and later)--20 CFR 404.702, 404.802, 404.1056--0960-0036. If agricultural workers believe their employers (1) did not report their wages, or (2) reported incorrect wage amounts, SSA will assist them in resolving this issue. Specifically, SSA will send Forms SSA-1002-F3 or SSA-1003-F3 to the agricultural employers to collect evidence of wages paid. The respondents are agricultural employers whose workers request wage verification or correction for their earnings records. Type of Request: Revision of an OMB-approved information collection. [[Page 11297]] ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) -------------------------------------------------------------------------------------------------- SSA-1002.......................... 7,500 1 30 3,750 SSA-1003.......................... 25,000 1 30 12,500 ----------------------------------------------------------------------------- Totals........................ 32,500 .............. .............. 16,250 ---------------------------------------------------------------------------------------------------------------- Dated: February 15, 2017. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2017-03308 Filed 2-17-17; 8:45 am] BILLING CODE 4191-02-P
![Federal Register / Vol. 82, No. 33 / Tuesday, February 21, 2017 / Notices 11293
subject line if email is used. To help the SOCIAL SECURITY ADMINISTRATION them to OMB within 60 days from the
Commission process and review your date of this notice. To be sure we
[Docket No: SSA–2017–0006] consider your comments, we must
comments more efficiently, please use
only one method. The Commission will receive them no later than April 24,
Agency Information Collection
post all comments on the Commission’s 2017. Individuals can obtain copies of
Activities: Proposed Request and
Internet Web site (http://www.sec.gov/ the collection instruments by writing to
Comment Request
rules/sro.shtml). Copies of the the above email address.
submission, all subsequent The Social Security Administration 1. Government Pension
amendments, all written statements (SSA) publishes a list of information Questionnaire—20 CFR 404.408a—
with respect to the proposed rule collection packages requiring clearance 0960–0160. The basic Social Security
change that are filed with the by the Office of Management and benefits application (OMB No. 0960–
Commission, and all written Budget (OMB) in compliance with 0618) contains a lead question asking if
communications relating to the Public Law 104–13, the Paperwork the applicants are qualified (or will
Reduction Act of 1995, effective October qualify) to receive a government
proposed rule change between the
1, 1995. This notice includes revisions pension. If the respondent is qualified,
Commission and any person, other than
and one extension of OMB-approved or will qualify, to receive a government
those that may be withheld from the pension, the applicant completes Form
information collections.
public in accordance with the SSA is soliciting comments on the SSA–3885 either on paper or through a
provisions of 5 U.S.C. 552, will be accuracy of the agency’s burden personal interview with an SSA claims
available for Web site viewing and estimate; the need for the information; representative. If the applicants are not
printing in the Commission’s Public its practical utility; ways to enhance its entitled to receive a government
Reference Room, 100 F Street NE., quality, utility, and clarity; and ways to pension at the time they apply for Social
Washington, DC 20549, on official minimize burden on respondents, Security benefits, SSA requires them to
business days between the hours of including the use of automated provide the government pension
10:00 a.m. and 3:00 p.m. Copies of the collection techniques or other forms of information as beneficiaries when they
filing also will be available for information technology. Mail, email, or become eligible to receive their
inspection and copying at the principal fax your comments and pensions. Regardless of the timing, at
office of the Exchange. All comments recommendations on the information some point the applicants or
received will be posted without change; collection(s) to the OMB Desk Officer beneficiaries must complete and sign
the Commission does not edit personal and SSA Reports Clearance Officer at Form SSA–3885 to report information
identifying information from the following addresses or fax numbers. about their government pensions before
submissions. You should submit only (OMB), Office of Management and the pensions begin. SSA uses the
information that you wish to make Budget, Attn: Desk Officer for SSA, Fax: information to: (1) Determine whether
available publicly. All submissions 202–395–6974, Email address: OIRA_ the Government Pension Offset
should refer to File Number SR–CBOE– Submission@omb.eop.gov. provision applies; (2) identify
2017–014, and should be submitted on (SSA), Social Security exceptions as stated in 20 CFR 404.408a;
or before March 14, 2017. Administration, OLCA, Attn: Reports and (3) determine the benefit reduction
Clearance Director, 3100 West High amount and effective date. If the
For the Commission, by the Division of Rise, 6401 Security Blvd., Baltimore, applicants and beneficiaries do not
Trading and Markets, pursuant to delegated MD 21235, Fax: 410–966–2830, Email respond using this questionnaire, SSA
authority.17 address: OR.Reports.Clearance@ssa.gov. offsets their entire benefit amount. The
Eduardo A. Aleman, Or you may submit your comments respondents are applicants or recipients
Assistant Secretary. online through www.regulations.gov, of spousal benefits who are eligible for
[FR Doc. 2017–03302 Filed 2–17–17; 8:45 am] referencing Docket ID Number [SSA– or already receiving a Government
BILLING CODE 8011–01–P
2017–0006]. pension.
I. The information collections below Type of Request: Revision of an OMB-
are pending at SSA. SSA will submit approved information collection.
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
SSA–3885 ........................................................................................................ 76,000 1 13 16,467
2. Modified Benefit Formula earnings. However, the resulting amount information on Form SSA–150 so we
Questionnaire—0960–0395. SSA cannot show a difference in the benefit can calculate their benefits using the
collects information on Form SSA–150 computed using the modified and data they supply. SSA calculates the
to determine which formula to use in regular formulas greater than one-half benefits of applicants who do not
computing the Social Security benefit the amount of the pension received in respond to this questionnaire using the
sradovich on DSK3GMQ082PROD with NOTICES
for someone who receives a pension the first month an individual is entitled full WEP reduction. SSA employees
from employment not covered by Social to both the pension and the Social collect this information once from the
Security. The Windfall Elimination Security benefit. The SSA–150 collects applicant at the time they file their
Provision (WEP) requires use of a the information needed to make all the claim. The respondents are applicants
benefit formula replacing a smaller necessary benefit computations. SSA
for old age and disability benefits.
percentage of a worker’s pre-retirement requires respondents to furnish the
17 17 CFR 200.30–3(a)(12).
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![Federal Register / Vol. 82, No. 33 / Tuesday, February 21, 2017 / Notices 11297
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
SSA–1002 ........................................................................................................ 7,500 1 30 3,750
SSA–1003 ........................................................................................................ 25,000 1 30 12,500
Totals ........................................................................................................ 32,500 ........................ ........................ 16,250
Dated: February 15, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2017–03308 Filed 2–17–17; 8:45 am]
BILLING CODE 4191–02–P
sradovich on DSK3GMQ082PROD with NOTICES
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Document Created: 2018-02-01 15:04:37
Document Modified: 2018-02-01 15:04:37
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| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
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| FR Citation | 82 FR 11293 |
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