82 FR 43804 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 82, Issue 180 (September 19, 2017)
Federal Register Volume 82, Issue 180 (September 19, 2017)
| Page Range | 43804-43806 | |
| FR Document | 2017-19865 |
[Federal Register Volume 82, Number 180 (Tuesday, September 19, 2017)] [Notices] [Pages 43804-43806] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-19865] [[Page 43804]] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2017-0052] 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 extensions 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: OIRA_Submission@omb.eop.gov. (SSA) Social Security Administration, OLCA, Attn: Reports Clearance Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410-966-2830, Email address: OR.Reports.Clearance@ssa.gov. Or you may submit your comments online through www.regulations.gov, referencing Docket ID Number [SSA-2017-0052]. I. The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than November 20, 2017. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Letter to Employer Requesting Information About Wages Earned By Beneficiary--20 CFR 404.1520, 20 CFR 404.1571-404.1576, 20 CFR 404.1584-404.1593, and 20 CFR 416.971-416.976--0960-0034. Social Security disability recipients receive payments based on their inability to engage in substantial gainful activity (SGA) because of a physical or mental condition. If the recipients work, SSA must evaluate and determine if they continue to meet the disability requirements of the law. Therefore, we use Form SSA-L725 to request monthly earnings information from the recipient's employer. We then use the earnings data to determine whether the recipient is engaging in SGA, since work after a recipient becomes entitled to benefits can cause a cessation of disability. The respondents are businesses that employ Social Security disability 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-L725.................................... 150,000 1 40 100,000 ---------------------------------------------------------------------------------------------------------------- 2. Certification of Low Birth Weight for SSI Eligibility of Funds You Provided to Another and Statement of Funds You Received--20 CFR 416.931, 416.926a(m), and 416.924--0960-0720. Hospitals and claimants use Form SSA-3380 to provide medical information to local field offices (FO) and the Disability Determination Services (DDS) on behalf of infants with low birth weight. FOs use the form as a protective filing statement, and the medical evidence respondents provide on the form to make presumptive disability findings, which allow expedited payment to eligible claimants. DDSs use the medical information to determine disability and continuing disability. The respondents are hospitals and claimants who have information identifying low birth weight babies and their medical conditions. 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-3380.................................... 28,125 1 15 7,031 ---------------------------------------------------------------------------------------------------------------- II. SSA submitted the information collections below to OMB for clearance. Your comments regarding these information collections would be most useful if OMB and SSA receive them 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than October 19, 2017. Individuals can obtain copies of the OMB clearance packages by writing to OR.Reports.Clearance@ssa.gov. 1. Statement of Marital Relationship (By one of the parties)--20 CFR 404.726--0960-0038. SSA must obtain a signed statement from a spousal applicant if the applicant claims a common-law marriage to the insured in a state in which such marriages are recognized, and no formal marriage documentation exists. SSA uses information we collect on Form SSA-754-F4 to determine if an individual applying for spousal benefits meets the criteria of common-law marriage under state law. The respondents are applicants for spouse's Social Security benefits or Supplemental Security Income (SSI) payments. Type of Request: Revision of an OMB-approved information collection. [[Page 43805]] ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-754-F4.................................. 30,000 1 30 15,000 ---------------------------------------------------------------------------------------------------------------- 2. Workers' Compensation/Public Disability Questionnaire--20 CFR 404.408--0960-0247. Section 224 of the Social Security Act (Act) provides for the reduction of disability insurance benefits (DIB) when the combination of DIB and any workers' compensation (WC) or certain Federal, State, or local public disability benefits (PDB) exceeds 80 percent of the worker's pre-disability earnings. SSA field office staff conduct face-to-face interviews with applicants using the electronic SSA-546 WC/PDB screens in the Modernized Claims System (MCS) to determine if the worker's receipt of WC or PDB payments will cause a reduction of DIB. Respondents are Title Title II disability applicants who receive both disability insurance benefits and worker's compensation. Type of Request: Extension 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-546 MCS Screens......................... 248,000 1 15 62,000 ---------------------------------------------------------------------------------------------------------------- 3. Medicaid Use Report--20 CFR 416.268--0960-0267. Section 20 CFR 416.268 of the Code of Federal Regulations requires SSA to determine eligibility for: (1) Special SSI cash payments and, (2) special SSI eligibility status for a person who works despite a disabling condition. Section 20 CFR 416.268 also provides that, to qualify for special SSI eligibility status, an individual must establish that termination of eligibility for benefits under Title XIX of the Act would seriously inhibit the ability to continue employment. SSA employees collect the information this regulation requires from respondents during a personal interview. We then use this information to determine if an individual is entitled to special Title XVI SSI payments and, consequently, to Medicaid. The respondents are SSI recipients for whom SSA has stopped payments based on earnings. Type of Request: Extension of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Regulation section Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- 20 CFR 416.268.............................. 60,000 1 3 3,000 ---------------------------------------------------------------------------------------------------------------- 4. Public Information Campaign--0960-0544. Periodically, SSA sends various public information materials, including public service announcements; news releases; and educational tapes, to public broadcasting systems so they can inform the public about various programs and activities SSA conducts. SSA frequently sends follow-up business reply cards for these public information materials to obtain suggestions for improving them. The respondents are broadcast sources. Type of Request: Revision 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 respondents (minutes) (hours) -------------------------------------------------------------------------------------------------------------------------------------------------------- Radio.............................................................. 5,000 2 10,000 1 167 -------------------------------------------------------------------------------------------------------------------------------------------------------- 5. Help America Vote Act--0960-0706. House Rule 3295, the Help America Vote Act of 2002, mandates that States verify the identities of newly registered voters. When newly registered voters do not have driver's licenses or State-issued ID cards, they must supply the last four digits of their Social Security number to their local State election agencies for verification. The election agencies forward this information to their State Motor Vehicle Administration (MVA), and the State MVA inputs the data into the American Association of MVAs, a central consolidation system that routes the voter data to SSA's Help America Vote Verification (HAVV) system. Once SSA's HAVV system confirms the identity of the voter, the information returns along the same route in reverse until it reaches the State election agency. The respondents are the State MVAs seeking to confirm voter identities. Correction Notice: SSA is updating the burden information for this collection, so it differs from the information we published at 82 FR 31132, on 7/5/17. We are also including the cost burden, which we inadvertently did not publish in the previous Notice. Type of Request: Revision of an OMB-approved information collection. [[Page 43806]] -------------------------------------------------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of Number of per response annual burden respondents response responses (minutes) (hours) -------------------------------------------------------------------------------------------------------------------------------------------------------- HAVV............................................................... 48 102,877 4,938,096 2 164,603 -------------------------------------------------------------------------------------------------------------------------------------------------------- Cost Burden: The 48 State MVAs participating in HAVA each pay an annual maintenance cost. Additionally, States pay .02 cents per verification request. Therefore, the total cost to respondents is $291,348. 6. Medicare Subsidy Quality Review Forms--20 CFR 418(b)(5)--0960- 0707. The Medicare Modernization Act of 2003 mandated the creation of the Medicare Part D prescription drug coverage program and provides certain subsidies for eligible Medicare beneficiaries to help pay for the cost of prescription drugs. As part of its stewardship duties of the Medicare Part D subsidy program, SSA must conduct periodic quality review checks of the information Medicare beneficiaries report on their subsidy applications (SSA-1020, OMB No. 0960-0696). SSA uses the Medicare Quality Review program to conduct these checks. The respondents are applicants for the Medicare Part D subsidy whom SSA chose to undergo a quality review. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Form No. and name Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- SSA-9301 (Medicare Subsidy Quality Review Case 3,500 1 30 1,750 Analysis Questionnaire)........................ SSA-9302 (Notice of Quality Review 3,500 1 15 875 Acknowledgement Form for those with Phones).... SSA-9303 (Notice of Quality Review 350 1 15 88 Acknowledgement Form for those without Phones). SSA-9308 (Request for Information).............. 7,000 1 15 1,750 SSA-9310 (Request for Documents)................ 3,500 1 5 292 SSA-9311 (Notice of Appointment--Denial-- 450 1 15 113 Reviewer Will Call)............................ SSA-9312 (Notice of Appointment--Denial--Please 50 1 15 13 Call Reviewer)................................. SSA-9313 (Notice of Quality Review 2,500 1 15 625 Acknowledgement Form for those with Phones).... SSA-9314 (Notice of Quality Review 500 1 15 125 Acknowledgement Form for those without Phones). --------------------------------------------------------------- Totals...................................... 21,350 .............. .............. 5,631 ---------------------------------------------------------------------------------------------------------------- 7. Electronic Records Express (Third Parties)--20 CFR 404.1700-- 404.1715--0960-0767. Electronic Records Express (ERE) is an online system which enables medical providers and various third party representatives to download and submit disability claimant information electronically to SSA as part of the disability application process. To ensure only authorized people access ERE, SSA requires third parties to complete a unique registration process if they wish to use this system. This information collection request (ICR) includes the third-party registration process; the burden for submitting evidence to SSA is part of other, various ICRs. The respondents are third party representatives of disability applicants or recipients who want to use ERE to electronically access clients' disability files online and submit information to SSA. Type of Request: Revision 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) -------------------------------------------------------------------------------------------------------------------------------------------------------- ERE--Third Parties................................................. 10,413 319 3,321,747 1 55,362 -------------------------------------------------------------------------------------------------------------------------------------------------------- Dated: September 13, 2017. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2017-19865 Filed 9-18-17; 8:45 am] BILLING CODE 4191-02-P
![43804 Federal Register / Vol. 82, No. 180 / Tuesday, September 19, 2017 / Notices
SOCIAL SECURITY ADMINISTRATION recommendations on the information 1. Letter to Employer Requesting
collection(s) to the OMB Desk Officer Information About Wages Earned By
[Docket No: SSA–2017–0052]
and SSA Reports Clearance Officer at Beneficiary—20 CFR 404.1520, 20 CFR
Agency Information Collection the following addresses or fax numbers. 404.1571–404.1576, 20 CFR 404.1584–
Activities: Proposed Request and (OMB) Office of Management and 404.1593, and 20 CFR 416.971–
Comment Request Budget, Attn: Desk Officer for SSA, 416.976—0960–0034. Social Security
Fax: 202–395–6974, Email address: disability recipients receive payments
The Social Security Administration OIRA_Submission@omb.eop.gov. based on their inability to engage in
(SSA) publishes a list of information (SSA) Social Security Administration, substantial gainful activity (SGA)
collection packages requiring clearance OLCA, Attn: Reports Clearance because of a physical or mental
by the Office of Management and Director, 3100 West High Rise, 6401 condition. If the recipients work, SSA
Budget (OMB) in compliance with Security Blvd., Baltimore, MD 21235, must evaluate and determine if they
Public Law 104–13, the Paperwork Fax: 410–966–2830, Email address: continue to meet the disability
Reduction Act of 1995, effective October OR.Reports.Clearance@ssa.gov. Or
requirements of the law. Therefore, we
1, 1995. This notice includes revisions you may submit your comments
use Form SSA–L725 to request monthly
and extensions of OMB-approved online through www.regulations.gov,
earnings information from the
information collections. referencing Docket ID Number [SSA–
2017–0052]. recipient’s employer. We then use the
SSA is soliciting comments on the
earnings data to determine whether the
accuracy of the agency’s burden I. The information collections below
estimate; the need for the information; recipient is engaging in SGA, since work
are pending at SSA. SSA will submit
its practical utility; ways to enhance its after a recipient becomes entitled to
them to OMB within 60 days from the
quality, utility, and clarity; and ways to date of this notice. To be sure we benefits can cause a cessation of
minimize burden on respondents, consider your comments, we must disability. The respondents are
including the use of automated receive them no later than November 20, businesses that employ Social Security
collection techniques or other forms of 2017. Individuals can obtain copies of disability recipients.
information technology. Mail, email, or the collection instruments by writing to Type of Request: Revision of an OMB-
fax your comments and the above email address. approved information collection.
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
SSA–L725 ........................................................................................................ 150,000 1 40 100,000
2. Certification of Low Birth Weight Determination Services (DDS) on behalf information to determine disability and
for SSI Eligibility of Funds You Provided of infants with low birth weight. FOs continuing disability. The respondents
to Another and Statement of Funds You use the form as a protective filing are hospitals and claimants who have
Received—20 CFR 416.931, statement, and the medical evidence information identifying low birth weight
416.926a(m), and 416.924—0960–0720. respondents provide on the form to babies and their medical conditions.
Hospitals and claimants use Form SSA– make presumptive disability findings,
Type of Request: Revision of an OMB-
3380 to provide medical information to which allow expedited payment to
local field offices (FO) and the Disability eligible claimants. DDSs use the medical approved information collection.
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
SSA–3380 ........................................................................................................ 28,125 1 15 7,031
II. SSA submitted the information by writing to OR.Reports.Clearance@ information we collect on Form SSA–
collections below to OMB for clearance. ssa.gov. 754–F4 to determine if an individual
Your comments regarding these 1. Statement of Marital Relationship applying for spousal benefits meets the
information collections would be most (By one of the parties)—20 CFR criteria of common-law marriage under
useful if OMB and SSA receive them 30 404.726—0960–0038. SSA must obtain a state law. The respondents are
days from the date of this publication. signed statement from a spousal applicants for spouse’s Social Security
To be sure we consider your comments, applicant if the applicant claims a benefits or Supplemental Security
we must receive them no later than common-law marriage to the insured in Income (SSI) payments.
asabaliauskas on DSKBBXCHB2PROD with NOTICES
a state in which such marriages are
October 19, 2017. Individuals can obtain Type of Request: Revision of an OMB-
recognized, and no formal marriage
copies of the OMB clearance packages approved information collection.
documentation exists. SSA uses
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![43806 Federal Register / Vol. 82, No. 180 / Tuesday, September 19, 2017 / Notices
Average Estimated
Number of Frequency Number of burden per total annual
Modality of completion respondents of response responses response burden
(minutes) (hours)
HAVV ................................................................................... 48 102,877 4,938,096 2 164,603
Cost Burden: The 48 State MVAs Medicare Part D prescription drug (SSA–1020, OMB No. 0960–0696). SSA
participating in HAVA each pay an coverage program and provides certain uses the Medicare Quality Review
annual maintenance cost. Additionally, subsidies for eligible Medicare program to conduct these checks. The
States pay .02 cents per verification beneficiaries to help pay for the cost of respondents are applicants for the
request. Therefore, the total cost to prescription drugs. As part of its Medicare Part D subsidy whom SSA
respondents is $291,348. stewardship duties of the Medicare Part chose to undergo a quality review.
6. Medicare Subsidy Quality Review D subsidy program, SSA must conduct
Forms—20 CFR 418(b)(5)—0960–0707. periodic quality review checks of the Type of Request: Revision of an OMB-
The Medicare Modernization Act of information Medicare beneficiaries approved information collection.
2003 mandated the creation of the report on their subsidy applications
Average Estimated
Number of Frequency burden per total annual
Form No. and name respondents of response response burden
(minutes) (hours)
SSA–9301 (Medicare Subsidy Quality Review Case Analysis Questionnaire) 3,500 1 30 1,750
SSA–9302 (Notice of Quality Review Acknowledgement Form for those with
Phones) ........................................................................................................ 3,500 1 15 875
SSA–9303 (Notice of Quality Review Acknowledgement Form for those
without Phones) ........................................................................................... 350 1 15 88
SSA–9308 (Request for Information) .............................................................. 7,000 1 15 1,750
SSA–9310 (Request for Documents) .............................................................. 3,500 1 5 292
SSA–9311 (Notice of Appointment—Denial—Reviewer Will Call) .................. 450 1 15 113
SSA–9312 (Notice of Appointment—Denial—Please Call Reviewer) ............. 50 1 15 13
SSA–9313 (Notice of Quality Review Acknowledgement Form for those with
Phones) ........................................................................................................ 2,500 1 15 625
SSA–9314 (Notice of Quality Review Acknowledgement Form for those
without Phones) ........................................................................................... 500 1 15 125
Totals ........................................................................................................ 21,350 ........................ ........................ 5,631
7. Electronic Records Express (Third only authorized people access ERE, SSA representatives of disability applicants
Parties)—20 CFR 404.1700—404.1715— requires third parties to complete a or recipients who want to use ERE to
0960–0767. Electronic Records Express unique registration process if they wish electronically access clients’ disability
(ERE) is an online system which enables to use this system. This information files online and submit information to
medical providers and various third collection request (ICR) includes the SSA.
party representatives to download and third-party registration process; the
submit disability claimant information burden for submitting evidence to SSA Type of Request: Revision of an OMB-
electronically to SSA as part of the is part of other, various ICRs. The approved information collection.
disability application process. To ensure respondents are third party
Average Estimated
Number of Frequency Number of burden per total annual
Modality of completion respondents of response responses response burden
(minutes) (hours)
ERE—Third Parties .............................................................. 10,413 319 3,321,747 1 55,362
Dated: September 13, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security
asabaliauskas on DSKBBXCHB2PROD with NOTICES
Administration.
[FR Doc. 2017–19865 Filed 9–18–17; 8:45 am]
BILLING CODE 4191–02–P
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Document Created: 2018-10-24 14:20:11
Document Modified: 2018-10-24 14:20:11
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| FR Citation | 82 FR 43804 |
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