[Federal Register: February 20, 2007 (Volume 72, Number 33)]
[Notices]
[Page 7809-7811]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr20fe07-39]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages that will require clearance by the
Office of Management and Budget (OMB) in compliance with P.L. 104-13,
the Paperwork Reduction Act of 1995, effective October 1, 1995. The
information collection packages that may be included in this notice are
for new information collections, approval of existing information
collections, revisions to OMB-approved information collections, and
extensions (no change) 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 on ways to minimize
burden on respondents, including the use of automated collection
techniques or other forms of information technology. Written comments
and recommendations regarding the information collection(s) should be
submitted to the OMB Desk Officer and the SSA Reports Clearance
Officer. The information can be mailed, faxed or e-mailed to the
individuals at the addresses and fax numbers listed below:
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974, E-mail address: OIRA_Submission@omb.eop.gov.
(SSA) Social Security Administration, DCFAM, Attn: Reports
Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore,
MD 21235, Fax: 410-965-6400, E-mail address: OPLM.RCO@ssa.gov.
I. The information collections listed below are pending at SSA and
will be submitted to OMB within 60 days from the date of this notice.
Therefore, your comments should be submitted to SSA within 60 days from
the date of this publication. You can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
1. Application for Benefits under the Italy-U.S. International
Social Security Agreement--0960-0445--20 CFR 404.1925. The United
States and Italy entered into an agreement on November 1, 1978. Article
19.2 of that agreement provides that an applicant for benefits can file
his application with either country. Article 4.3 of the Protocol to the
Agreement provides that the country that receives the application will
forward agreed upon forms and applications to the other country. Form
SSA-2528 is the form agreed upon that is completed by individuals who
file an application for U.S. benefits directly with one of the Italian
Social Security Agencies. The information collected on Form SSA-2528 is
required by SSA in order to determine entitlement to benefits. The
respondents are applicants for old-age, survivors or disability
benefits, who reside in Italy.
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 200.
Frequency of Response: 1.
Average Burden Per Response: 20 minutes.
Estimated Annual Burden: 67 hours.
2. Social Security Benefits Applications--20 CFR Subpart D,
404.310-404.311 and 20 CFR Subpart F, 404.601-401.603--0960-0618. One
of the requirements for obtaining Social Security benefits is the
filing of an application so that a determination may be made on the
applicant's eligibility for monthly benefits. In addition to the
traditional paper application, SSA has developed various options for
the public to add convenience and operational efficiency to the
application process. The total estimated number of respondents to all
application collections formats is 3,843,369 with a cumulative total of
995,457 burden hours. The respondents are applicants for retirement
insurance benefits (RIB), disability insurance benefits (DIB), and/or
spouses' benefits.
Type of Request: Extension of an OMB-approved information
collection.
Internet Social Security Benefits Application (ISBA)
ISBA, which is available through SSA's Internet site, is one method
that an individual can choose to file an application for benefits.
Individuals can use ISBA to apply for retirement insurance benefits
RIB, DIB and spouse's insurance benefits based on age. SSA gathers only
information relevant to the individual applicant's circumstances and
will use the
[[Page 7810]]
information collected by ISBA to entitle individuals to RIB, DIB, and/
or spouses' benefits. The respondents are applicants for RIB, DIB, and/
or spouses benefits.
Number of Respondents: 169,000.
Frequency of Response: 1.
Average Burden Per Response: 21.4 minutes.
Estimated Annual Burden: 60,277 hours.
Paper Application Forms
Application for Retirement Insurance Benefits (SSA-1)
The SSA-1 is used by SSA to determine an individual's entitlement
to retirement insurance benefits. In order to receive Social Security
retirement insurance benefits, an individual must file an application
with the SSA. The SSA-1 is one application that the Commissioner of
Social Security prescribes to meet this requirement. The information
that SSA collects will be used to determine entitlement to retirement
benefits. The respondents are individuals who choose to apply for
Social Security retirement insurance.
Approximately 1,460,692 respondents complete the SSA-1 annually. Of
this total 97% (1,416,871) are completed through SSA's Modernized
Claims System (MCS) and 50% of the MCS respondents will use Signature
Proxy (708,435.5). The breakdown is displayed on the following chart.
----------------------------------------------------------------------------------------------------------------
Number of
Collection method respondents Estimated completion time Burden hours
----------------------------------------------------------------------------------------------------------------
MCS........................................... 708,436 10.5 minutes.................... 123,976
MCS/Signature Proxy........................... 708,435 9.5 minutes..................... 112,169
Paper......................................... 43,821 10.5 minutes.................... 7,669
-----------------------------------------------------------------
Totals.................................... 1,460,692 ................................ 243,814
----------------------------------------------------------------------------------------------------------------
Application for Wife's or Husband's Insurance Benefits (SSA-2)
SSA uses the information collected on Form SSA-2 to determine if an
applicant (including a divorced applicant) can be entitled to benefits
as the spouse of the worker and the amount of the spouse's benefits.
The respondents are applicants for wife's or husband's benefits,
including those who are divorced. Approximately 700,000 respondents
complete the SSA-2 annually. Of this total 95% (665,000) are completed
through MCS and 50% of the MCS respondents will use Signature Proxy
(332,500). The breakdown is displayed on the following chart:
----------------------------------------------------------------------------------------------------------------
Number of
Collection method respondents Estimated completion time Burden hours
----------------------------------------------------------------------------------------------------------------
MCS........................................... 332,500 15 minutes...................... 83,125
MCS/Signature Proxy........................... 332,500 14 minutes...................... 77,583
Paper......................................... 35,000 15 minutes...................... 8,750
-----------------------------------------------------------------
Totals.................................... 700,000 ................................ 169,458
----------------------------------------------------------------------------------------------------------------
Application for Disability Insurance Benefits (SSA-16)
Form SSA-16-F6 obtains the information necessary to determine
whether the provisions of the Act have been satisfied with respect to
an applicant for disability benefits, and detects whether the applicant
has dependents who would qualify for benefits on his or her earnings
record. The information collected on form SSA-16 helps to determine
eligibility for Social Security disability benefits. The respondents
are applicants for Social Security disability benefits.
Approximately 1,513,677 respondents complete the SSA-16 annually.
Of this total 97% (1,468,267) are completed through SSA's Modernized
Claims System (MCS) and 50% of the MCS respondents will use Signature
Proxy (734,133.5). The breakdown is displayed on the following chart:
----------------------------------------------------------------------------------------------------------------
Number of
Collection method respondents Estimated completion time Burden hours
----------------------------------------------------------------------------------------------------------------
MCS........................................... 734,134 20 minutes...................... 244,711
MCS/Signature Proxy........................... 734,133 19 minutes...................... 232,476
Paper......................................... 45,410 20 minutes...................... 15,137
-----------------------------------------------------------------
Totals.................................... 1,513,677 ................................ 492,324
----------------------------------------------------------------------------------------------------------------
II. The information collections listed below have been submitted to
OMB for clearance. Your comments on the information collections would
be most useful if received by OMB and SSA within 30 days from the date
of this publication. You can obtain a copy of the OMB clearance
packages by calling the SSA Reports Clearance Officer at 410-965-0454,
or by writing to the address listed above.
1. Pain Report Child--20 CFR 416.912 and 416.1512--0960-0540. The
information collected by form SSA-3371-BK will be used to obtain the
types of information specified in SSA's regulations, and to provide
disability interviewers (and applicants/claimants in self-help
situations) with a convenient means of recording the information. This
information is used by the State disability determination services
(DDS) adjudicators and administrative law judges to assess the effects
of symptoms on functionality for determining disability under the
Social Security Act. The respondents are applicants for Supplemental
Security Income (SSI) benefits.
[[Page 7811]]
Type of Request: Extension of an OMB-approved information
collection.
Number of Respondents: 250,000.
Frequency of Response: 1.
Average Burden Per Response: 15 minutes.
Estimated Annual Burden: 62,500 hours.
2. Request for Hearing by Administrative Law Judge--20 CFR 404.929,
404.933, 416.1429, 404.1433, 405.722, 418.1350--0960-0269. SSA uses
form HA-501 to document when applicants for Social Security benefits
have their claims denied and want to request an administrative hearing
to appeal SSA's decision. The scope of this form is now being expanded
to include people who wish to appeal the decision that has been made
regarding their obligation to pay a new Income-Related Monthly
Adjustment Amount (IRMAA) for Medicare Part B, as per the requirements
of the Medicare Modernization Act of 2003. Although this information
will be collected by SSA, the actual hearings will take place before
administrative law judges (ALJ) who are employed by the Department of
Health and Human Services (HHS). The current respondents include
applicants for various Social Security benefits programs who want to
request a hearing where they can appeal their denial; the new
additional respondents are Medicare Part B recipients whom SSA has
determined will have to pay the new Medicare Part B IRMAA and who wish
to appeal this decision at a hearing before an HHS ALJ.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 669,469.
Frequency of Response: 1.
Average Burden Per Response: 10 minutes.
Estimated Annual Burden: 111,578 hours.
3. Request to Resolve Questionable Quarters of Coverage (QC);
Request for QC History Based on Relationship--0960-0575. Form SSA-512
is used by states to request clarification from SSA on questionable QC
information. The Personal Responsibility and Work Opportunity
Reconciliation Act states that aliens admitted for lawful residence
that have worked and earned 40 qualifying QCs for Social Security
purposes can generally receive state benefits. Form SSA-513 is used by
states to request QC information for an alien's spouse or child in
cases where the alien does not sign a consent form giving permission to
access his/her Social Security records. QCs can also be allocated to a
spouse and/or to a child under age 18, if needed, to obtain 40
qualifying QCs for the alien. The respondents are state agencies that
require QC information in order to determine eligibility for benefits.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average
Number of Frequency of burden per Estimated
Collections respondents response response annual burden
(minute) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-512......................................... 200,000 1 2 6,667
SSA-513......................................... 350,000 1 2 11,667
---------------------------------------------------------------
Totals...................................... 550,000 .............. .............. 18,334
----------------------------------------------------------------------------------------------------------------
Dated: February 9, 2007.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E7-2662 Filed 2-16-07; 8:45 am]
BILLING CODE 4191-02-P