82 FR 15412 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 82, Issue 58 (March 28, 2017)
Federal Register Volume 82, Issue 58 (March 28, 2017)
| Page Range | 15412-15414 | |
| FR Document | 2017-06025 |
[Federal Register Volume 82, Number 58 (Tuesday, March 28, 2017)] [Notices] [Pages 15412-15414] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-06025] [[Page 15412]] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2017-0013] 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 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-2017-0013]. 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 May 30, 2017. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Request for Waiver of Overpayment Recovery or Change in Repayment Notice--20 CFR 404.502-404.513, 404.515, 416.550-416.570, and 416.572--0960-0037. When Social Security beneficiaries and Supplemental Security Income (SSI) recipients receive an overpayment, they must return the extra money. These beneficiaries and recipients can use Form SSA-632-BK to take one of three actions: (1) Request an exemption from repaying, as recovery of the payment would cause financial hardship; (2) inform SSA they want to repay the overpayment at a monthly rate over a period longer than 36 months; or (3) request a different rate of recovery. In the latter two cases, the respondents must also provide financial information to help the agency determine how much the overpaid person can afford to repay each month. Respondents are overpaid beneficiaries or SSI recipients who are requesting: (1) A waiver of recovery of an overpayment, or (2) a lesser rate of withholding. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- Waiver of Overpayment (Completes Whole Paper 400,000 1 120 800,000 Form).......................................... Change in Repayment (Completes Partial Paper 100,000 1 45 75,000 Form).......................................... Regional Application (New York Debt Management). 44,000 1 120 88,000 Internet Instructions........................... 500,000 1 5 41,667 --------------------------------------------------------------- Totals...................................... 1,044,000 .............. .............. 1,004,667 ---------------------------------------------------------------------------------------------------------------- 2. RS/DI Quality Review Case Analysis: Sampled Number Holder; Auxiliaries/Survivors; Parent; and Stewardship Annual Earnings Test-- 0960-0189. Section 205(a) of the Social Security Act (Act) authorizes the Commissioner of SSA to conduct the quality review process, which entails collecting information related to the accuracy of payments made under the Old-Age, Survivors, and Disability Insurance Program (OASDI). Sections 228(a)(3), 1614(a)(1)(B), and 1836(2) of the Act require a determination of the citizenship or alien status of the beneficiary; this is only one item that we might question as part of the Annual Quality review. SSA uses Forms SSA-2930, SSA-2931, and SSA-2932 to establish a national payment accuracy rate for all cases in payment status, and to serve as a source of information regarding problem areas in the Retirement Survivors Insurance (RSI) and Disability Insurance (DI) programs. We also use the information to measure the accuracy rate for newly adjudicated RSI or DI cases. SSA uses Form SSA-4659 to evaluate the effectiveness of the annual earnings test, and to use the results in developing ongoing improvements in the process. About twenty-five percent of respondents will have in-person reviews and receive one of the following appointment letters: (1) SSA-L8550-U3 (Appointment Letter--Sample Individual); (2) SSA-L8551-U3 (Appointment Letter--Sample Family); or (3) the SSA-L8552-U3 (Appointment Letter-- Rep Payee). Seventy-five percent of respondents will receive a notice for a telephone review using the SSA-L8553-U3 (Beneficiary Telephone Contact) or the SSA-L8554-U3 (Rep Payee Telephone Contact). To help the beneficiary prepare for the interview, we include three forms with each notice: (1) SSA-85 (Information Needed to Review Your Social Security Claim) lists the information the beneficiary will need to gather for the interview; (2) SSA-2935 (Authorization to the Social Security Administration to Obtain Personal Information) verifies the beneficiary's correct payment amount, if necessary; and (3) SSA-8552 (Interview Confirmation) confirms or reschedules the interview if necessary. The respondents are a statistically valid sample of all OASDI beneficiaries in current pay status or their representative payees. Type of Request: Revision of an OMB-approved information collection. [[Page 15413]] ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-2930........................................ 1,500 1 30 750 SSA-2931........................................ 850 1 30 425 SSA-4659........................................ 325 1 10 54 SSA-L8550-U3.................................... 385 1 5 32 SSA-L8551-U3.................................... 95 1 5 8 SSA-L8552-U3.................................... 35 1 5 3 SSA-L8553-U3.................................... 4970 1 5 414 SSA-L8554-U3.................................... 705 1 5 59 SSA-8552........................................ 2350 1 5 196 SSA-85.......................................... 3850 1 5 321 SSA-2935........................................ 2350 1 5 196 SSA-8510 (also saved under OMB No. 0960-0707)... 800 1 5 67 --------------------------------------------------------------- Totals...................................... 17,700 .............. .............. 2,525 ---------------------------------------------------------------------------------------------------------------- 3. Electronic Records Express--20 CFR 404.1512 and 416.912--0960- 0753. Electronic Records Express (ERE) is a Web-based SSA program which allows medical and educational providers to electronically submit disability claimant data to SSA. Both medical providers and other third parties with connections to disability applicants or recipients (e.g., teachers and school administrators for child disability applicants) use this system once they complete the registration process. SSA employees and State agency employees request the medical and educational records collected through the ERE Web site. The agency uses the information collected through ERE to make a determination on an Application for Benefits. We also use the ERE Web site to order and receive consultative examinations when we are unable to collect enough medical records to determine disability findings. The respondents are medical providers who evaluate or treat disability claimants or recipients, and other third parties with connections to disability applicants or recipients (e.g., teachers and school administrators for child disability applicants), who voluntarily choose to use ERE for submitting information. 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) ---------------------------------------------------------------------------------------------------------------- ERE......................................... 5,376,998 1 10 896,166 ---------------------------------------------------------------------------------------------------------------- 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 April 27, 2017. Individuals can obtain copies of the OMB clearance packages by writing to [email protected]. 1. State Mental Institution Policy Review Booklet--20 CFR 404.2035, 404.2065, 416.635, & 416.665--0960-0110. SSA uses Form SSA-9584-BK: (1) To determine if the policies and practices of a state mental institution acting as a representative payee for SSA beneficiaries conform to SSA's regulations in the use of benefits; (2) to confirm institutions are performing other duties and responsibilities required of representative payees; and (3) as the basis for conducting onsite reviews of the institutions and preparing subsequent reports of findings. The respondents are state mental institutions serving as representative payees for Social Security beneficiaries and SSI recipients. 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-9584-BK................................. 69 1 60 69 ---------------------------------------------------------------------------------------------------------------- 2. Statement of Death by Funeral Director--20 CFR 404.715 and 404.720--0960-0142. When an SSA-insured worker dies, the funeral director or funeral home responsible for the worker's burial or cremation completes Form SSA-721 and sends it to SSA. SSA uses this information for three purposes: (1) To establish proof of death for the insured worker; (2) to determine if the insured individual was receiving any pre-death benefits SSA needs to terminate; and (3) to ascertain which surviving family member is eligible for the lump-sum death payment or for other death benefits. The respondents are funeral directors who handled death arrangements for the insured individuals. Type of Request: Revision of an OMB-approved information collection. [[Page 15414]] ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-721..................................... 703,638 1 4 46,909 ---------------------------------------------------------------------------------------------------------------- 3. Employee Identification Statement--20 CFR 404.702--0960-0473. When two or more individuals report earnings under the same Social Security Number (SSN), SSA collects information on Form SSA-4156 to credit the earnings to the correct individual and SSN. We send the SSA- 4156 to the employer to: (1) Identify the employees involved; (2) resolve the discrepancy; and (3) credit the earnings to the correct SSN. The respondents are employers involved in erroneous wage reporting for an employee. 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-4156.................................... 4,750 1 10 792 ---------------------------------------------------------------------------------------------------------------- 4. Employee Work Activity Questionnaire--20 CFR 404.1574, 404.1592--0960-0483. Social Security Disability Insurance (SSDI) beneficiaries and SSI recipients qualify for payments when a verified physical or mental impairment prevents them from working. If disability claimants attempt to return to work after receiving payments, but are unable to continue working, they submit the SSA-3033, Employee Work Activity Questionnaire, so SSA can evaluate their work attempt. SSA also uses this form to evaluate unsuccessful subsidy work and determine applicants' continuing eligibility for disability payments. The respondents are employers of SSDI beneficiaries and SSI recipients who unsuccessfully attempted to return to work. 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-3033-BK................................. 15,000 1 15 3,750 ---------------------------------------------------------------------------------------------------------------- 5. Request for Medical Treatment in an SSA Employee Health Facility: Patient Self-Administered or Staff Administered Care--0960- 0772. SSA operates onsite Employee Health Clinics (EHC) in eight different States. These clinics provide health care for all SSA employees including treatments of personal medical conditions when authorized through a physician. Form SSA-5072 is the employee's personal physician's order form. The information we collect on Form SSA-5072 gives the nurses the guidance they need by law to perform certain medical procedures and to administer prescription medications such as allergy immunotherapy. In addition, the form allows the medical officer to determine whether they can administer treatment safely and appropriately in the SSA EHCs. Respondents are physicians of SSA employees who need to have medical treatment in an SSA EHC. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average Number of Frequency of Number of burden per Estimated Modality of completion respondents response responses response total annual (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-5072........................ 25 1 25 5 2 Annually........................ SSA-5072........................ 75 2 150 5 13 Bi-Annually..................... ------------------------------------------------------------------------------- Totals...................... 100 .............. .............. .............. 15 ---------------------------------------------------------------------------------------------------------------- Dated: March 22, 2017. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2017-06025 Filed 3-27-17; 8:45 am] BILLING CODE 4191-02-P
![15412 Federal Register / Vol. 82, No. 58 / Tuesday, March 28, 2017 / Notices
SOCIAL SECURITY ADMINISTRATION collection(s) to the OMB Desk Officer Notice—20 CFR 404.502–404.513,
and SSA Reports Clearance Officer at 404.515, 416.550–416.570, and
[Docket No: SSA–2017–0013]
the following addresses or fax numbers. 416.572—0960–0037. When Social
Agency Information Collection (OMB), Office of Management and Security beneficiaries and Supplemental
Activities: Proposed Request and Budget, Attn: Desk Officer for SSA, Security Income (SSI) recipients receive
Comment Request Fax: 202–395–6974, Email address: an overpayment, they must return the
OIRA_Submission@omb.eop.gov extra money. These beneficiaries and
The Social Security Administration (SSA), Social Security Administration, recipients can use Form SSA–632–BK to
(SSA) publishes a list of information OLCA, Attn: Reports Clearance take one of three actions: (1) Request an
collection packages requiring clearance Director, 3100 West High Rise, 6401 exemption from repaying, as recovery of
by the Office of Management and Security Blvd., Baltimore, MD 21235, the payment would cause financial
Budget (OMB) in compliance with Fax: 410–966–2830, Email address:
Public Law 104–13, the Paperwork hardship; (2) inform SSA they want to
OR.Reports.Clearance@ssa.gov
Reduction Act of 1995, effective October repay the overpayment at a monthly rate
Or you may submit your comments
1, 1995. This notice includes revisions over a period longer than 36 months; or
online through www.regulations.gov,
of OMB-approved information (3) request a different rate of recovery.
referencing Docket ID Number [SSA–
collections. 2017–0013]. In the latter two cases, the respondents
SSA is soliciting comments on the I. The information collections below must also provide financial information
accuracy of the agency’s burden are pending at SSA. SSA will submit to help the agency determine how much
estimate; the need for the information; them to OMB within 60 days from the the overpaid person can afford to repay
its practical utility; ways to enhance its date of this notice. To be sure we each month. Respondents are overpaid
quality, utility, and clarity; and ways to consider your comments, we must beneficiaries or SSI recipients who are
minimize burden on respondents, receive them no later than May 30, requesting: (1) A waiver of recovery of
including the use of automated 2017. Individuals can obtain copies of an overpayment, or (2) a lesser rate of
collection techniques or other forms of the collection instruments by writing to withholding.
information technology. Mail, email, or the above email address. Type of Request: Revision of an OMB-
fax your comments and 1. Request for Waiver of Overpayment approved information collection.
recommendations on the information Recovery or Change in Repayment
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
Waiver of Overpayment (Completes Whole Paper Form) .............................. 400,000 1 120 800,000
Change in Repayment (Completes Partial Paper Form) ................................ 100,000 1 45 75,000
Regional Application (New York Debt Management) ...................................... 44,000 1 120 88,000
Internet Instructions ......................................................................................... 500,000 1 5 41,667
Totals ........................................................................................................ 1,044,000 ........................ ........................ 1,004,667
2. RS/DI Quality Review Case regarding problem areas in the Payee Telephone Contact). To help the
Analysis: Sampled Number Holder; Retirement Survivors Insurance (RSI) beneficiary prepare for the interview,
Auxiliaries/Survivors; Parent; and and Disability Insurance (DI) programs. we include three forms with each
Stewardship Annual Earnings Test— We also use the information to measure notice: (1) SSA–85 (Information Needed
0960–0189. Section 205(a) of the Social the accuracy rate for newly adjudicated to Review Your Social Security Claim)
Security Act (Act) authorizes the RSI or DI cases. SSA uses Form SSA– lists the information the beneficiary will
Commissioner of SSA to conduct the 4659 to evaluate the effectiveness of the need to gather for the interview; (2)
quality review process, which entails annual earnings test, and to use the SSA–2935 (Authorization to the Social
collecting information related to the results in developing ongoing Security Administration to Obtain
accuracy of payments made under the improvements in the process. About
Personal Information) verifies the
Old-Age, Survivors, and Disability twenty-five percent of respondents will
beneficiary’s correct payment amount, if
Insurance Program (OASDI). Sections have in-person reviews and receive one
228(a)(3), 1614(a)(1)(B), and 1836(2) of of the following appointment letters: (1) necessary; and (3) SSA–8552 (Interview
the Act require a determination of the SSA–L8550–U3 (Appointment Letter— Confirmation) confirms or reschedules
citizenship or alien status of the Sample Individual); (2) SSA–L8551–U3 the interview if necessary. The
beneficiary; this is only one item that (Appointment Letter—Sample Family); respondents are a statistically valid
we might question as part of the Annual or (3) the SSA–L8552–U3 (Appointment sample of all OASDI beneficiaries in
Quality review. SSA uses Forms SSA– Letter—Rep Payee). Seventy-five current pay status or their representative
2930, SSA–2931, and SSA–2932 to percent of respondents will receive a payees.
establish a national payment accuracy notice for a telephone review using the Type of Request: Revision of an OMB-
sradovich on DSK3GMQ082PROD with NOTICES
rate for all cases in payment status, and SSA–L8553–U3 (Beneficiary Telephone approved information collection.
to serve as a source of information Contact) or the SSA–L8554–U3 (Rep
VerDate Sep<11>2014 17:14 Mar 27, 2017 Jkt 241001 PO 00000 Frm 00099 Fmt 4703 Sfmt 4703 E:\FR\FM\28MRN1.SGM 28MRN1](https://thefederalregister.org/doc/82_FR_15470/page/1.svg)
![15414 Federal Register / Vol. 82, No. 58 / Tuesday, March 28, 2017 / Notices
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
SSA–721 .......................................................................................................... 703,638 1 4 46,909
3. Employee Identification credit the earnings to the correct employers involved in erroneous wage
Statement—20 CFR 404.702—0960– individual and SSN. We send the SSA– reporting for an employee.
0473. When two or more individuals 4156 to the employer to: (1) Identify the Type of Request: Revision of an OMB-
report earnings under the same Social employees involved; (2) resolve the approved information collection.
Security Number (SSN), SSA collects discrepancy; and (3) credit the earnings
information on Form SSA–4156 to to the correct SSN. The respondents are
Average Estimated
Number of Frequency of burden per total
Modality of completion respondents response response annual burden
(minutes) (hours)
SSA–4156 ........................................................................................................ 4,750 1 10 792
4. Employee Work Activity to return to work after receiving eligibility for disability payments. The
Questionnaire—20 CFR 404.1574, payments, but are unable to continue respondents are employers of SSDI
404.1592—0960–0483. Social Security working, they submit the SSA–3033, beneficiaries and SSI recipients who
Disability Insurance (SSDI) beneficiaries Employee Work Activity Questionnaire, unsuccessfully attempted to return to
and SSI recipients qualify for payments so SSA can evaluate their work attempt. work.
when a verified physical or mental SSA also uses this form to evaluate
Type of Request: Revision of an OMB-
impairment prevents them from unsuccessful subsidy work and
working. If disability claimants attempt determine applicants’ continuing approved information collection.
Average Estimated
Number of Frequency of burden per total
Modality of completion respondents response response annual burden
(minutes) (hours)
SSA–3033–BK ................................................................................................. 15,000 1 15 3,750
5. Request for Medical Treatment in authorized through a physician. Form officer to determine whether they can
an SSA Employee Health Facility: SSA–5072 is the employee’s personal administer treatment safely and
Patient Self-Administered or Staff physician’s order form. The information appropriately in the SSA EHCs.
Administered Care—0960–0772. SSA we collect on Form SSA–5072 gives the Respondents are physicians of SSA
operates onsite Employee Health Clinics nurses the guidance they need by law to employees who need to have medical
(EHC) in eight different States. These perform certain medical procedures and treatment in an SSA EHC.
clinics provide health care for all SSA to administer prescription medications
employees including treatments of such as allergy immunotherapy. In Type of Request: Revision of an OMB-
personal medical conditions when addition, the form allows the medical approved information collection.
Average Estimated
Number of Frequency of Number of burden per total
Modality of completion respondents response responses response annual burden
(minutes) (hours)
SSA–5072 ............................................................................
Annually ............................................................................... 25 1 25 5 2
SSA–5072 ............................................................................
Bi-Annually ........................................................................... 75 2 150 5 13
Totals ............................................................................ 100 ........................ ........................ ........................ 15
Dated: March 22, 2017.
sradovich on DSK3GMQ082PROD with NOTICES
Naomi R. Sipple,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2017–06025 Filed 3–27–17; 8:45 am]
BILLING CODE 4191–02–P
VerDate Sep<11>2014 17:14 Mar 27, 2017 Jkt 241001 PO 00000 Frm 00101 Fmt 4703 Sfmt 9990 E:\FR\FM\28MRN1.SGM 28MRN1](https://thefederalregister.org/doc/82_FR_15470/page/3.svg)
Document Created: 2017-03-28 00:31:42
Document Modified: 2017-03-28 00:31:42
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | (1) Request an exemption from repaying, as recovery of the payment would cause financial hardship; (2) inform SSA they want to repay the overpayment at a monthly rate over a period longer than 36 months; or (3) request a different rate of recovery. In the latter two cases, the respondents must also provide financial information to help the agency determine how much the overpaid person can afford to repay each month. Respondents are overpaid beneficiaries or SSI recipients who are requesting: (1) A waiver of recovery of an overpayment, or (2) a lesser rate of withholding. | |
| FR Citation | 82 FR 15412 |
2025 Federal Register | Disclaimer | Privacy Policy
USC | CFR | eCFR