Notice2021-13144

Agency Information Collection Activities: Proposed Request and Comment Request

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Published
June 23, 2021

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Social Security Administration

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<title>Federal Register, Volume 86 Issue 118 (Wednesday, June 23, 2021)</title>
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[Federal Register Volume 86, Number 118 (Wednesday, June 23, 2021)]
[Notices]
[Pages 33007-33011]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-13144]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2021-0020]


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 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, 
Comments: <a href="https://www.reginfo.gov/public/do/PRAMain">https://www.reginfo.gov/public/do/PRAMain</a>. Submit your 
comments online referencing Docket ID Number [SSA-2021-0020].

[[Page 33008]]

(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: <a href="/cdn-cgi/l/email-protection#59160b770b3c29362b2d2a771a353c382b38373a3c192a2a38773e362f"><span class="__cf_email__" data-cfemail="aee1fc80fccbdec1dcdadd80edc2cbcfdccfc0cdcbeeddddcf80c9c1d8">[email&#160;protected]</span></a>.

    Or you may submit your comments online through <a href="https://www.reginfo.gov/public/do/PRAMain">https://www.reginfo.gov/public/do/PRAMain</a>, referencing Docket ID Number [SSA-
2021-0020].
    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 
August 23, 2021. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Continuation of Supplemental Security Income Payments for the 
Temporarily Institutionalized--Certification of Period and Need to 
Maintain Home--20 CFR 416.212(b)(1)--0960-0516. When Supplemental 
Security Income (SSI) recipients: (1) Enter a public institution; or 
(2) enter a private medical treatment facility with Medicaid paying 
more than 50 percent of expenses, SSA reduces recipients' SSI payments 
to a nominal sum. However, if this institutionalization is temporary 
(defined as a maximum of three months), SSA may waive the reduction. 
Before SSA can waive the SSI payment reduction, the agency must receive 
the following documentation: (1) A physician's certification stating 
the SSI recipient will only be institutionalized for a maximum of three 
months; and (2) certification from the recipient, the recipient's 
family, or friends, confirming the recipient needs SSI payments to 
maintain the living arrangements to which the individual will return 
post-institutionalization. To obtain this information, SSA employees 
contact the recipient (or a knowledgeable source) to collect the 
required physician's certification and the statement of need. SSA does 
not require any specific format for these items, so long as we obtain 
the necessary attestations. The respondents are SSI recipients, their 
family or friends, as well as physicians or hospital staff members who 
treat the SSI recipient.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response         burden          amount           cost
                                                                                             (minutes)        (hours)       (dollars) *    (dollars) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Statement from other Respondents........................          26,793               1               5           2,233        * $10.95      ** $24,451
Physician's Certifications..............................          26,793               1               5           2,233         * 41.30       ** 92,223
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................          53,586  ..............  ..............           4,466  ..............      ** 116,674
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>), and the
  average Healthcare Practitioners and Technical Occupations hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes290000.htm">https://www.bls.gov/oes/current/oes290000.htm</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    2. Financial Disclosure for Civil Monetary Penalty (CMP) Debt--20 
CFR 498--0960-0776. When SSA imposes a CMP on individuals for various 
fraudulent conduct related to SSA-administrated programs, those 
individuals may request to pay the CMP through benefit withholding, or 
an installment agreement. To negotiate a monthly payment amount, fair 
to both the individual and the agency, SSA needs financial information 
from the individual. SSA uses Form SSA-640, to obtain the information 
necessary to determine a monthly installment repayment rate for 
individuals owing a CMP. The respondents are recipients of Social 
Security benefits and non-entitled individuals who must repay a CMP to 
the agency and choose to do so using an installment plan.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                           Average
                                                                     Average  burden     Estimated       theoretical     Average  wait     Total annual
      Modality of completion          Number of       Frequency of    per  response     total annual     hourly cost     time in  field    opportunity
                                     respondents        response        (minutes)     burden  (hours)       amount           office      cost  (dollars)
                                                                                                         (dollars) *      (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-640..........................              10                1              120               20         * $19.01            ** 24         *** $456
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on averaging both the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>), and the average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/">https://www.bls.gov/oes/</a> current/
  oes_nat.htm).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    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 July 23, 2021. Individuals can obtain copies of 
these OMB clearance packages by writing to 
<a href="/cdn-cgi/l/email-protection#266974087443564954525508654a434754474845436655554708414950"><span class="__cf_email__" data-cfemail="fcb3aed2ae998c938e888fd2bf90999d8e9d929f99bc8f8f9dd29b938a">[email&#160;protected]</span></a>.
    1. Application for Mother's or Father's Insurance Benefits--20 CFR 
404.339-404.342, 20 CFR 404.601-404.603--0960-0003. Section 202(g) of 
the Social Security Act (Act) provides for the payment of monthly 
benefits to the widow or widower of an insured individual if the 
surviving spouse is caring for the deceased worker's child (who is 
entitled to Social Security

[[Page 33009]]

benefits). SSA uses the information on Form SSA-5-BK to determine an 
individual's eligibility for mother's or father's insurance benefits. 
The respondents are individuals caring for a child of the deceased 
worker who is applying for mother's or father's insurance benefits 
under the Old Age, Survivors, and Disability Insurance (OASDI) program.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                              Average
                                                                          Average burden     Estimated      theoretical    Average wait    Total annual
         Modality of completion              Number of     Frequency of    per response    total annual     hourly cost    time in field    opportunity
                                            respondents      response        (minutes)    burden (hours)      amount          office      cost (dollars)
                                                                                                            (dollars) *    (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-5-BK (Paper)........................              28               1              15               7        * $27.07  ..............        *** $189
SSA-5 MCS Interview.....................          23,123               1              15           5,781         * 27.07           ** 24     *** 406,862
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................          23,151  ..............  ..............           5,788  ..............  ..............     *** 407,051
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* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    2. Claim for Amounts Due in the Case of a Deceased Beneficiary--20 
CFR 404.503(b)--0960-0101. Section 204(d) of the Act provides that if 
an individual dies before payment under Title II is complete, or before 
a Medicare premium refund is due, SSA will pay the amount due 
(including the amount of any check not negotiated) to people who meet 
specified qualifications under an order of priority. When a Social 
Security payment, or Medicare premium, was due to a deceased 
beneficiary at the time of death, and there is insufficient information 
in the file to identify the people entitled to the payment, or their 
addresses, SSA asks the surviving spouse, next of kin, or legal 
representative of the estate to complete Form SSA-1724. SSA collects 
the information when a surviving child(ren), parent(s), or spouse is 
not already entitled to a monthly benefit on the same earnings record, 
or is not filing for a lump-sum death payment as a former spouse. SSA 
uses the information Form SSA-1724 provides to ensure proper payment of 
an underpayment due to a deceased beneficiary. The respondents are 
applicants for Title II underpayments or Medicare premium refunds owed 
to deceased beneficiaries.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                           Average
                                                                      Average burden  Estimated total    theoretical      Average wait     Total annual
      Modality of completion          Number of       Frequency of     per response    annual burden     hourly cost     time in field     opportunity
                                     respondents        response        (minutes)         (hours)           amount           office       cost (dollars)
                                                                                                         (dollars) *      (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-1724.........................         250,000                1               10           41,667         * $27.07            ** 24   *** $3,834,926
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    3. Claimant's Recent Medical Treatment--20 CFR 404.1512 and 
416.912--0960-0292. When Disability Determinations Services (DDS) deny 
a claim at the reconsideration level, the claimant has a right to 
request a hearing before a judge. For the hearing, SSA asks the 
claimant to complete and return the HA-4631 if the claimant's file does 
not reflect a current, complete medical history as the claimant 
proceeds through the appeals process. A judge must obtain the 
information to update and complete the record and to verify the 
accuracy of the information. Through this process, the judge can 
ascertain whether the claimant's situation has changed. The judge and 
hearing office staff use the response to make arrangements for 
consultative examination(s) and the attendance of an expert 
witness(es), if appropriate. During the hearing, the judge offers any 
completed questionnaires as exhibits and may use them to: (1) Refresh 
the claimant's memory, and (2) shape their questions. The respondents 
are claimant's requesting hearings on entitlement to OASDI benefits or 
SSI payments.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                              Average
                                                                          Average burden     Estimated      theoretical    Average wait    Total annual
         Modality of completion              Number of     Frequency of    per response    total annual     hourly cost    time in field    opportunity
                                            respondents      response        (minutes)    burden (hours)      amount          office      cost (dollars)
                                                                                                            (dollars) *    (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-4631--PDF/paper version..............          53,200               1              10           8,867        * $10.95           ** 24    *** $330,110
Electronic Records Express Submissions..         136,800               1              10          22,800         * 27.07  ..............     *** 617,196
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         190,000  ..............  ..............          31,667  ..............  ..............     *** 947,306
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based these figures on the average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>), and the
  average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.


[[Page 33010]]

    4. Request for Reconsideration--Disability Cessation--20 CFR 
404.909, 404.1597(b), 416.995, & 416.1409--0960-0349. When SSA 
determines that claimants' disabilities medically improved; ceased; or 
are no longer sufficiently disabling, these claimants may ask SSA to 
reconsider that determination. SSA uses Form SSA-789 to arrange for a 
hearing or to prepare a decision based on the evidence of record. 
Specifically, claimants or their representatives use Form SSA-789 to: 
(1) Ask SSA to reconsider a determination; (2) indicate if they wish to 
appear at a disability hearing; (3) submit any additional information 
or evidence for use in the reconsidered determination; and (4) indicate 
if they will need an interpreter for the hearing. The respondents are 
disability claimants for Social Security benefits or SSI payments who 
wish to appeal an unfavorable disability cessation determination.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Average
                                                                                       Average burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of     per response    annual burden     hourly cost      opportunity
                                                      respondents        response        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-789...........................................          49,000                1               13           10,617         * $10.95      ** $116,256
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    5. Waiver of Right to Appear--Disability Hearing--20 CFR 404.913-
404.914, 404.916(b)(5), 416.1413-416.1414, 416.1416(b)(5)--0960-0534. 
Claimants for Social Security disability payments or their 
representatives can use Form SSA-773-U4 to waive their right to appear 
at a disability hearing. The disability hearing officer uses the signed 
form as a basis for not holding a hearing, and for preparing a written 
decision on the claimant's request for disability payments based solely 
on the evidence of record. The respondents are disability claimants for 
Social Security benefits or SSI payments, or their representatives, who 
wish to waive their right to appear at a disability hearing.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                           Average
                                                                      Average burden  Estimated total    theoretical      Average wait     Total annual
      Modality of completion          Number of       Frequency of     per response    annual burden     hourly cost     time in field     opportunity
                                     respondents        response        (minutes)         (hours)           amount           office       cost (dollars)
                                                                                                         (dollars) *      (minutes) **         ***
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SSA-773-U4.......................             200                1                3               10         * $10.95            ** 24         *** $986
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* We based this figure on average DI payments based on SSA's current FY 2021 data (<a href="https://www.ssa.gov/legislation/2021FactSheet.pdf">https://www.ssa.gov/legislation/2021FactSheet.pdf</a>).
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.
*** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.

    6. Prohibition of Payment of SSI Benefits to Fugitive Felons and 
Parole/Probation Violators--20 CFR 416.708(o)--0960-0617. Section 
1611(e)(4) of the Act precludes eligibility for SSI payments for 
certain fugitives and probation or parole violators. Our regulation at 
20 CFR 416.708(o) requires individuals applying for or receiving SSI to 
report to SSA that: (1) They are fleeing to avoid prosecution for a 
crime; (2) they are fleeing to avoid custody or confinement after 
conviction of a crime; or (3) they are violating a condition of 
probation or parole. In addition, due to the implementation of the 
Martinez v. Astrue and Clark v. Astrue cases, we changed our policy to 
deny eligibility or suspend payments for three fleeing codes. We use 
the information we receive to determine eligibility on an initial claim 
for SSI payments or a redetermination of existing recipients. The 
collection is mandatory to ensure that an applicant or recipient does 
not have a warrant for one of the three fleeing codes. If the 
respondent has a warrant for one of the three fleeing codes, SSA uses 
this information to deny payments. The respondents are SSI applicants 
and recipients, or their representative payees, who are reporting their 
status as a fugitive felon or probation or parole violator.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                            Average
                                                                                       Average burden  Estimated total    theoretical      Total annual
              Modality of completion                   Number of       Frequency of     per response    annual burden     hourly cost      opportunity
                                                      respondents        response        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Fugitive Felon and Parole or Probation Violation             1,000                1                1               17         * $27.07          ** $460
 screens within the SSI Claims System.............
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* We based this figure on average U.S. worker's hourly wages, as reported by Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes_nat.htm#00-0000">https://www.bls.gov/oes/current/oes_nat.htm#00-0000</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.


[[Page 33011]]

    7. Social Security Number Verification Services--20 CFR 401.45--
0960-0660. Internal Revenue Service regulations require employers to 
provide wage and tax data to SSA using Form W-2, or its electronic 
equivalent. As part of this process, the employer must furnish the 
employee's name and Social Security number (SSN). In addition, the 
employee's name and SSN must match SSA's records for SSA to post 
earnings to the employee's earnings record, which SSA maintains. SSA 
offers the Social Security Number Verification Service (SSNVS), which 
allows employers to verify the reported names and SSNs of their 
employees match those in SSA's records. SSNVS is a cost-free method for 
employers to verify employee information via the internet. The 
respondents are employers who need to verify SSN data using SSA's 
records.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                            Average
                                                                                       Average burden  Estimated total    theoretical      Total annual
      Modality of completion          Number of       Frequency of      Number of       per response    annual burden     hourly cost      opportunity
                                     respondents        response        responses        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSNVS............................          44,891               60        2,693,460                5          224,455         * $38.23    ** $8,580,915
--------------------------------------------------------------------------------------------------------------------------------------------------------
* We based this figure on the average hourly wage for Accountants and Auditors, as reported by the U.S. Bureau of Labor Statistics data (<a href="https://www.bls.gov/oes/current/oes132011.htm">https://www.bls.gov/oes/current/oes132011.htm</a>).
** This figure does not represent actual costs that SSA is imposing on recipients of Social Security payments to complete this application; rather,
  these are theoretical opportunity costs for the additional time respondents will spend to complete the application. There is no actual charge to
  respondents to complete the application.


    Dated: June 17, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-13144 Filed 6-22-21; 8:45 am]
BILLING CODE 4191-02-P


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