[Federal Register: August 5, 1999 (Volume 64, Number 150)] [Notices] [Page 42747-42748] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr05au99-141] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION Agency Information Collection Activities: Proposed Request and Comment Request In compliance with Pub. L. 104-13, the Paperwork Reduction Act of 1995, SSA is providing notice of its information collections that require submission to the Office of Management and Budget (OMB). 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 on ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. I. The information collections listed below will be submitted to OMB within 60 days from the date of this notice. Therefore, comments and recommendations regarding the information collections would be most useful if received by the Agency within 60 days from the date of this publication. Comments should be directed to the SSA Reports Clearance Officer at the address listed at the end of this publication. You can obtain a copy of the collection instruments by calling the SSA Reports Clearance Officer on (410) 965-4145, or by writing to him at the address listed at the end of this publication. 1. Workers' Compensation/Public Disability Benefit Questionnaire-- 0960-0247. Form SSA-546 is used by the Social Security Administration (SSA) whenever an applicant for Title II (Disability Insurance Benefits (DIB)) indicates he or she has filed for, or intends to file for Workmen's Compensation/Public Disability Benefits (WC/PDB). The form consolidates all the information necessary to identify the WC/PDB applied for and/or received, determines whether offset is applicable under the statute and, when applicable, computes the offset. The respondents are applicants for Title II benefits (DIB). Number of Respondents: 100,000. Frequency of Response: 1. Average Burden Per Response: 15 minutes. Estimated Annual Burden: 25,000 hours. 2. Statement of Marital Relationship (by One of the Parties)--0960- 0038. SSA uses the information collected on Form SSA-754 to determine whether the conditions for establishing a common-law marriage under state law are met. The respondents are applicants for spouse's benefits. Number of Respondents: 30,000. Frequency of Response: 1. Average Burden Per Response: 30 minutes. Estimated Annual Burden: 15,000 hours. 3. Student Reporting Form--0960-0088. Form SSA-1383 is used by Social Security student beneficiaries to report events or changes that may affect continuing entitlement to these benefits. The respondents are Social Security Student Beneficiaries. Number of Respondents: 75,000. Frequency of Response: 1. Average Burden Per Response: 6 minutes. Estimated Annual Burden: 7,500 hours. 4. Reporting Changes that Affect Your Social Security Payment-0960- 0073. SSA uses the information collected on form SSA-1425 to determine continuing entitlement to Social Security Benefits and to determine the proper benefit amount. The respondents are Social Security beneficiaries who need to report an event which could affect payments. Number of Respondents: 70,000. Frequency of Response: 1. Average Burden Per Response: 5 minutes. Estimated Annual Burden: 5,833 hours. [[Page 42748]] 5. Black Lung Student's Statement Regarding Resumption of School Attendance and Report of Black Lung Student Beneficiary at End of School Year (two forms)--0960-0314. The information collected on forms SSA-2602 and SSA-2613 is used by SSA to determine whether or not an entitled student beneficiary will resume (or has resumed) full-time school attendance at an approved educational institution. If so, the student will be continuously entitled to benefits. The respondents are children of disabled or deceased coal miners and officials of schools they attend. ------------------------------------------------------------------------ SSA-2602 SSA-2613 ------------------------------------------------------------------------ Number of Respondents........................... 50 100 Frequency of Response........................... 1 1 Average Burden Per Response (minutes)........... 5 7\1/2\ Estimated Annual Burden (hours) 4 12 ------------------------------------------------------------------------ II. The information collection listed below has been submitted to OMB for clearance. Written comments and recommendations on the information collection would be most useful if received within 30 days from the date of this publication. Comments should be directed to the SSA Reports Clearance Officer and the OMB Desk Officer at the addresses listed at the end of this publication. You can obtain a copy of the OMB clearance package by calling the SSA Reports Clearance Officer on (410) 965-4145, or by writing to him. 1. Report on Individual with Mental Impairment--0960-0058. Form SSA-824 is used by the Social Security Administration to determine the claimant's medical status prior to making a disability determination. The respondents are physicians, medical directors, medical record librarians and other health professionals. Number of Respondents: 50,000. Frequency of Response: 1. Average Burden Per Response: 36 minutes. Estimated Annual Burden: 30,000 hours. 2. Report of Student Beneficiary at End of School Year--0960-0089. The information collected on Form SSA-1388 is used by SSA to verify a student's full-time attendance at an approved educational institution. The respondents are secondary school student beneficiaries or claimants who are enrolled full time. Number of Respondents: 200,000. Frequency of Response: 1. Average Burden Per Response: 10 minutes. Estimated Annual Burden: 33,333 hours. 3. Request for Claimant Conference--0960-NEW. As part of SSA's disability redesign effort, SSA is testing modifications to the disability determination procedures. One aspect of the tests includes notifying claimants when the initial determination of disability by the State agency will be less than fully favorable. The State agency making the determination must send a written notice to the claimant offering him or her the opportunity to have a conference with the Disability Adjudicator and to provide an opportunity to submit additional evidence. The claimant can respond by either completing and returning the form (SSA-378) enclosed with the notice or by telephoning the Disability Adjudicator. Based on the reply, the Disability Adjudicator can schedule a conference, request additional medical evidence, and/or await the receipt of additional evidence or complete the processing of the claim. The respondents are claimants for title II and title XVI disability benefits whose claims will receive a less than fully favorable determination. Number of Respondents: 163,000. Frequency of Response: 1. Average Burden Per Response: 1.5 minutes. Estimated Annual Burden: 4,075 hours. (SSA Address) Social Security Administration, DCFAM, Attn: Frederick W. Brickenkamp 6401 Security Blvd., 1-A-21 Operations Bldg., Baltimore, MD 21235 (OMB Address) Office of Management and Budget, OIRA, Attn: Desk Officer for SSA, New Executive Office Building, Room 10230, 725 17th St., NW, Washington, DC 20503 Dated: July 30, 1999. Nicholas E. Tagliareni, Reports Clearance Officer, Social Security Administration. [FR Doc. 99-20153 Filed 8-4-99; 8:45 am] BILLING CODE 4190-29-P