Effective Date: January 11, 2006
(71 F.R. 1844)
SOCIAL SECURITY ADMINISTRATION NOTICE OF SYSTEM OF RECORDS REQUIRED BY THE PRIVACY ACT OF 1974
SYSTEM NUMBER: 60-0228
System name:
Safety Management Information System (SSA Accident, Injury and Illness Reporting System), Social Security Administration, Deputy Commissioner for Finance, Assessment and Management, Office of Facilities Management.
Security classification:
None.
System Location:
Social Security Administration
Office of Facilities Management
Room 2-J-9
Categories of individuals covered by the system:
Social Security Administration (SSA) employees, who are involved in an accident which arises out of and in the course of their employment whether occurring on SSA premises or not and results in:
(a) A fatality;
(b) Lost workdays beyond the day in which the accident occurred;
(c) Nonfatal injuries which result in transfer to another job, termination of employment, medical treatment other than first aid, loss of consciousness or restriction of work or motion;
(d) A possible tort claim;
(e) A claim for compensation;
(f) Property damage in excess of $50;
(g) Interruption or interference with the orderly progress of work of other employees;
(h) Radiation overexposure;
(i) Biological exposure resulting in lost time or of accidental release of biologicals where the public may be over-exposed. It also covers visiting scientists, contractor personnel;
(j) Hospitalized patients, out-patients, employees of other Federal agencies, State or local governments or members of the public who suffer injury, illness or property damage on or in SSA premises or as a result of SSA activities.
Categories of Records in the system:
This system consists of a variety of information and supporting documentation resulting from the reporting and investigation of accidents which have resulted in injury, illness, property damage or the interruption or interference with the orderly progress of work.
The records contain information about individuals involved in, or experiencing, accidents including, but not limited to, the severity of the injury, whether consciousness was lost, the type of injury, culmination of any injury, days lost from work, if any, the nature of the injury, illness or disease, the body part affected, causal factors, weather factors, agency of accident, whether unsafe mechanical, physical, or personal acts or factors were involved, the accident's area of origin and if fire was involved, the type and form of materials involved.
Property damage (both public and private) is noted through the property sequence number, who owned the property involved, property damage and actual or estimated monetary loss, the SSA installation number, if appropriate, and the year of manufacture or construction if appropriate.
Identifiers relating to a particular accident include the organization, case number assigned, date and time of occurrence, State or territory, site, type and classification of accident, estimated amount of tort claims, if appropriate, name of individual(s) involved, the Social Security number (SSN), sex, age, grade series and level, Computer Sciences Corporation (CSC) series, address, other departments notified of accident, duty status, activity at time of accident and time on duty before accident. Management's evaluation and corrective action taken or proposed is also noted.
Authority for maintenance of the system:
Section 19 of the Occupational Safety and Health Act of 1970 (Pub. L. 91-596, 29 U.S.C. 651, et seq.); 5 U.S.C. 7902; 29 CFR part 1960; Executive Order (E.O.) No. 12196 (45 FR 12769 4/26/80).
Purpose(s):
The purpose of the system is to comply with the reporting and statistical analyses requirements of section 19 of the Occupational Safety and Health Act (OSHA) of 1970 (Pub. L. 91-596) as amended (29 U.S.C. 668); 5 U.S.C. 7902; 29 CFR Part 1960; E.O. 12196 and such other purposes as are described below. The Safety Management Information System is a SSA-wide system utilized by all organizational components of the Agency. Thus, in addition to the routine uses subsequently noted in this system notice, there may be other ad hoc disclosures within the Agency on an official business ``need-to-know'' basis. Some of the purposes are the following:
Information in these records is used by or may be disclosed to:
Routine uses of records maintained in the system, including categories of users and the purposes of such uses:
Disclosure may be made for routine uses as indicated below:
1. To a Federal, State, local agency or private sources to obtain information relevant to the investigation of an accident and/or corrective action.
2. To a congressional office in response to an inquiry from that office made at the request of the subject of the record.
3. To the Department of Justice (DOJ), a court or other tribunal, or another party before such tribunal, when:
(a) The Social Security Administration (SSA), or any component thereof; or
(b) Any SSA employee in his/her official capacity; or
(c) Any SSA employee in his/her individual capacity where DOJ (or SSA where it is authorized to do so) has agreed to represent the employee; or
(d) The United States or any agency thereof where SSA determines that the litigation is likely to affect the operations of SSA or any of its components, is a party to the litigation or has an interest in such litigation, and SSA determines that the use of such records by DOJ, a court or other tribunal, or another party before tribunal, is relevant and necessary to the litigation, provided, however, that in each case, SSA determines that such disclosure is compatible with the purpose for which the records were collected.
4. To Federal, State, or local law enforcement agencies if a record maintained by this agency to carry out its functions indicates a violation or potential violation of law, whether civil, criminal or regulatory in nature.
5. To student volunteers, individuals working under a personal services contract, and other workers who technically do not have the status of Federal employees, when they are performing work for the Social Security Administration (SSA), as authorized by law, and they need access to personally identifiable information in SSA records in order to perform their assigned Agency functions.
6. To the General Services Administration and the National Archives Records Administration (NARA) under 44 U.S.C. 2904 and 2906, as amended by the NARA Act of 1984, information which is not restricted from disclosure by Federal law for the use of those agencies in conducting records management studies.
Policies and practices for storing, retrieving, accessing, retaining, and disposing of records in the system:
Storage:
Records are maintained in automated format (e.g., on magnetic tapes, discs, computer storage,) and in paper form (e.g., punch cards, lists, forms, in file folders, binders and index cards).
Retrievability:
Records are retrieved by name, SSN, case number or cross reference.
Safeguards:
Access to, and use of, those records is limited to those persons whose official duties require such access. Personnel screening is employed to prevent unauthorized disclosure. Access http://www.socialsecurity.gov/foia/bluebook/app_g.htm for additional information relating to SSA data security measures.
Retention and disposal:
All accident reports, records, logs, and other information relating to an accident are retained by Headquarters and components for at least five years following the end of the calendar year in which the accident occurred. Specific occupational safety and health standards (such as the standards, covering the handling of carcinogenic chemicals) may be required to be kept for up to twenty years. Records may be retained indefinitely.
System manager(s) and address(es):
Safety Manager
Office of Facilities Management
Social Security Administration
Notification procedures:
An individual can determine if this system contains a record about him/her by writing to the system manager(s) at the above address and providing his/her name, SSN or other information that may be in the system of records that will identify him/her. An individual requesting notification of records in person should provide the same information, as well as provide an identity document, preferably with a photograph, such as a driver's license or some other means of identification. If an individual does not have any identification documents sufficient to establish his/her identity, the individual must certify in writing that he/she is the person claimed to be and that he/she understands that the knowing and willful request for, or acquisition of, a record pertaining to another individual under false pretenses is a criminal offense.
If notification is requested by telephone, an individual must verify his/her identity by providing identifying information that parallels information in the record to which notification is being requested. If it is determined that the identifying information provided by telephone is insufficient, the individual will be required to submit a request in writing or in person. If an individual is requesting information by telephone on behalf of another individual, the subject individual must be connected with SSA and the requesting individual in the same phone call. SSA will establish the subject individual's identity (his/her name, SSN, address, date of birth and place of birth, along with one other piece of information, such as mother's maiden name) and ask for his/her consent in providing information to the requesting individual.
If a request for notification is submitted by mail, an individual must include a notarized statement to SSA to verify his/her identity or must certify in the request that he/she is the person claimed to be and that he/she understands that the knowing and willful request for, or acquisition of, a record pertaining to another individual under false pretenses is a criminal offense. These procedures are in accordance with SSA Regulations (20 CFR 401.40(c)).
Record access procedures:
Same as Notification procedures. Requester should also reasonably identify the record, specify the record contents being sought, and state time and brief description of the accident in which they were involved. These procedures are in accordance with SSA Regulations (20 CFR 401.40(c)).
Contesting record procedures:
Same as Notification procedures. Requester should also reasonably identify the record, specify the information they are contesting and the corrective action sought, and the reasons for the correction, with supporting justification showing how the record is incomplete, untimely, inaccurate or irrelevant. These procedures are in accordance with SSA Regulations (20 CFR 401.65(a)).
Record source categories:
The information in this system is obtained from the following sources:
(1) The individual to whom the record pertains;
(2) witnesses to the accident;
(3) investigation officials (Federal, State, local);
(4) medical personnel seeing the individual as a result of the accident;
(5) supervisory personnel;
(6) reviewing officials;
(7) personnel offices;
(8) investigative material furnished by Federal, State, or local agencies; and
(9) on site observations.
Systems exempted from certain provisions of the Privacy Act:
None.