Agency Information Collection Activities: Proposed Request
| Citation | 84 FR 18913 |
| Record Number | 2019-08946 |
| Published date | 02 May 2019 |
| Section | Notices |
| Court | Social Security Administration |
Federal Register, Volume 84 Issue 85 (Thursday, May 2, 2019)
[Federal Register Volume 84, Number 85 (Thursday, May 2, 2019)]
[Notices]
[Pages 18913-18915]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-08946]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2019-0014]
Agency Information Collection Activities: Proposed 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-2019-0014].
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 July
1, 2019. Individuals can obtain copies of the collection instruments by
writing to the above email address.
1. Real Property Current Market Value Estimate--0960-0471. SSA
considers an individual's resources when evaluating eligibility for
Supplemental Security Income (SSI) payments. The value of an
individual's resources, including non-home real property, is one of the
eligibility requirements for SSI payments. SSA obtains current market
value estimates of the claimant's real property through Form SSA-L2794.
We allow respondents to use readily available records to complete the
form, or we can accept their best estimates. We use this form as part
of initial applications and in post-entitlement situations. The
respondents are small business operators in real estate; state and
local government employees tasked with assessing real property values;
and other individuals knowledgeable about local real estate values.
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-L2794................................... 300 1 20 100
----------------------------------------------------------------------------------------------------------------
2. Child Care Dropout Questionnaire--20 CFR 404.211(e)(4)--0960-
0474. If individuals applying for Title II disability benefits care for
their own or their spouse's children under age 3, and have no steady
earnings during the time they care for those children, they may exclude
that period of care from the disability computation period. We call
this the child-care dropout exclusion. SSA uses the information from
Form SSA-4162 to determine if an individual qualifies for this
exclusion. Respondents are applicants for Title II disability benefits.
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-4162.................................... 2,000 1 5 167
----------------------------------------------------------------------------------------------------------------
3. Medical Report on Adult with Allegation of Human
Immunodeficiency Virus Infection; Medical Report on Child with
Allegation of Human Immunodeficiency Virus Infection--20 CFR 416.933-20
CFR 416.934--0960-0500. Section 1631(e)(i) of the Social Security Act
(Act) authorizes the Commissioner of SSA to gather information to make
a determination about an applicant's claim for SSI payments; this
procedure is the Presumptive Disability (PD). SSA uses Forms SSA-4814-
F5 and SSA-4815-F6 to collect information necessary to determine if an
individual with human immunodeficiency virus infection, who is applying
for SSI disability benefits, meets the requirements for PD. The
respondents are the medical sources of
[[Page 18914]]
the applicants for SSI disability payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4814-F5..................................... 9,600 1 8 1,280
SSA-4815-F6..................................... 80 1 10 13
---------------------------------------------------------------
Totals...................................... 9,680 .............. .............. 1,293
----------------------------------------------------------------------------------------------------------------
4. Beneficiary Recontact Report--20 CFR 404.703 & 404.705--0960-
0502. SSA investigates recipients of disability payments to determine
their continuing eligibility for payments. Research indicates
recipients may fail to report circumstances that affect their
eligibility. Two such cases are: (1) When parents receiving disability
benefits for their child marry; and (2) the removal of an entitled
child from parents' care. SSA uses Form SSA-1588-SM to ask mothers or
fathers about both their marital status and children under their care,
to detect overpayments and avoid continuing payment to those are no
longer entitled. Respondents are recipients of mothers' or fathers'
Social Security benefits.
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-1588-SM................................. 76,944 1 5 6,412
----------------------------------------------------------------------------------------------------------------
5. Certification of Contents of Document(s) or Record(s)--20 CFR
404.715--0960-0689. SSA established procedures for individuals to
provide the evidence necessary to establish their rights to Social
Security benefits. Examples of such evidence categories include age,
relationship, citizenship, marriage, death, and military service. Form
SSA-704 allows SSA employees; State record custodians; and other
custodians of evidentiary documents to certify and record information
from original documents and records under their custodial ownership to
establish these types of evidence. SSA uses Form SSA-704 in situations
where individuals cannot produce the original evidentiary documentation
required to establish benefits eligibility. The respondents are State
record custodians and other custodians of evidentiary documents.
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-704..................................... 293 1 10 49
----------------------------------------------------------------------------------------------------------------
6. Registration for Appointed Representative Services and Direct
Payment--0960-0732. SSA uses Form SSA-1699 to register appointed
representatives of claimants before SSA who:
Want to register for direct payment of fees;
Registered for direct payment of fees prior to 10/31/09,
but need to update their information;
Registered as appointed representatives on or after 10/31/
09, but need to update their information; or
Received a notice from SSA instructing them to complete
this form.
By registering these individuals, SSA: (1) Authenticates and
authorizes them to do business with us; (2) allows them to access our
records for the claimants they represent; (3) facilitates direct
payment of authorized fees to appointed representatives; and, (4)
collects the information we need to meet Internal Revenue Service (IRS)
requirements to issue specific IRS forms if we pay an appointed
representative in excess of a specific amount ($600). The respondents
are appointed representatives who want to use Form SSA-1699 for any of
the purposes cited in this Notice.
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-1699.................................... 17,700 1 20 5,900
----------------------------------------------------------------------------------------------------------------
7. Certificate of Incapacity--5 CFR 890.302(d)--0960-0739. Rules
governing the Federal Employee Health Benefits (FEHB) plan require a
physician to verify the disability of Federal employees' children ages
26 and
[[Page 18915]]
over for these children to retain health benefits under their employed
parents' plans. The physician must verify the adult child's disability:
(1) Pre-dates the child's 26th birthday; (2) is very serious; and (3)
will continue for at least one year. Physicians use Form SSA-604, the
Certificate of Incapacity, to document and certify this information,
and the Social Security Administration uses the information provided to
determine the eligibility for these children, ages 26 and over, for
coverage under a parent's FEHB plan. The respondents are physicians of
SSA employees' children ages 26 or over who are seeking to retain
health benefits under their parent's FEHB coverage.
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-604..................................... 50 1 45 38
----------------------------------------------------------------------------------------------------------------
Dated: April 29, 2019.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2019-08946 Filed 5-1-19; 8:45 am]
BILLING CODE 4191-02-P
