Notice2021-15898

Agency Information Collection Activities: Proposed Request

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Published
July 27, 2021

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Social Security Administration

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<title>Federal Register, Volume 86 Issue 141 (Tuesday, July 27, 2021)</title>
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[Federal Register Volume 86, Number 141 (Tuesday, July 27, 2021)]
[Notices]
[Pages 40221-40224]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-15898]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2021-0022]


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, and an extension 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-2021-0022].
    (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#561904780433263924222578153a333724373835331625253778313920"><span class="__cf_email__" data-cfemail="612e334f3304110e1315124f220d040013000f0204211212004f060e17">[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-2021-0022].
    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 
September 27, 2021. Individuals can obtain copies of the collection 
instruments by writing to the above email address.
    1. Application for Parent's Insurance Benefits--20 CFR 404.370, 
404.371, 404.373, 404.374 & 404.601-404.603--0960-0012. Section 202(h) 
of the Social Security Act (Act) establishes the conditions of 
eligibility a claimant must meet to receive monthly benefits as a 
parent of a deceased worker who was contributing at least one-half of 
the parent's support at the time of the worker's death or when the 
worker became disabled. SSA uses information from Form SSA-7-F6, 
Application for Parent's Insurance Benefits, to determine if the 
claimant meets the eligibility and application criteria. The 
respondents are applicants filing for Parent's Insurance Benefits.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                           Average wait
                                                                              Average                         Average     time in  field   Total annual
                                             Number of     Frequency of     burden per       Estimated      theoretical    office or for    opportunity
         Modality of completion             respondents      response        response      total annual     hourly cost     teleservice   cost (dollars)
                                                                             (minutes)    burden (hours)      amount          centers           ***
                                                                                                            (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-7-F6 (Paper)........................               4               1              15               1        * $27.07               0         *** $27
Interview (MCS).........................             325               1              15              81         * 27.07           ** 21       *** 5,279
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................             329  ..............  ..............              82  ..............  ..............       *** 5,306
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* We based this figure on 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 averaging both the average FY 2021 wait times for field offices and teleservice centers, 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. Employment Relationship Questionnaire--20 CFR 404.1007--0960-
0040. When SSA needs information to determine a worker's employment 
status to maintain a worker's earning records, the agency uses Form 
SSA-7160, Employment Relationship Questionnaire, to determine the 
existence of an employer-employee relationship. We use the information 
to develop the employment relationship; specifically, to determine 
whether a beneficiary is self-employed or an employee. The respondents 
are individuals, households, businesses, and state or local governments 
seeking to establish their status as employees, and their alleged 
employers.
    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-7160.........................              45                1               25               19         * $22.14            ** 24         *** $820
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* We based this figure on the average U.S. worker's hourly wages of $27.07 (<a href="https://www.bls.gov/oes/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</a>); the median hourly wage of
  $21.10 for public sector Information and Records Clerks (<a href="https://www.bls.gov/oes/current/oes434199.htm">https://www.bls.gov/oes/current/oes434199.htm</a>); and the median hourly wage of $18.25 for
  State and Local government Information and Records Clerks (<a href="https://www.bls.gov/oes/current/oes434199.htm">https://www.bls.gov/oes/current/oes434199.htm</a>), as reported by Bureau of Labor Statistics
  data. We used the average of these three wages to calculate the combined Average Theoretical Hourly Wage of $22.14.
** We based this figure on the average FY 2021 wait times for field offices, based on SSA's current management information data.

[[Page 40222]]

 
*** 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. Statement of Self-Employment Income--20 CFR 404.101, 404.110, & 
404.1096(a)(d)--0960-0046. To qualify for insured status, and collect 
Social Security benefits, self-employed individuals must demonstrate 
they earned the minimum amount of self-employment income (SEI) in a 
current year. SSA uses Form SSA-766, Statement of Self-Employment 
Income, to collect the information we need to determine if the 
individual earned at least the minimum amount of SEI needed for one or 
more quarters of coverage in the current year. Based on the information 
we obtain, we may credit additional quarters of coverage to give the 
individual insured status and expedite benefit payments. Respondents 
are self-employed individuals potentially eligible for Social Security 
benefits.
    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) *           **
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>SSA-766..........................................             910                1                5               76         * $27.07        ** $2,057
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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.

    4. Substitution of Party Upon Death of Claimant--20 CFR 
404.957(c)(4) & 416.1457(c)(4)--0960-0288. A judge may dismiss a 
request for a hearing on a pending claim of a deceased individual for 
Social Security benefits or Supplemental Security Income (SSI) 
payments. Individuals who believe the dismissal may adversely affect 
them may complete Form HA-539, Notice Regarding Substitution of Party 
Upon Death of Claimant, which allows them to request to become a 
substitute party for the deceased claimant. The judge and the hearing 
office support staff use the information from the HA-539 to: (1) 
Maintain a written record of request; (2) establish the relationship of 
the requester to the deceased claimant; (3) determine the substituted 
individual's wishes regarding an oral hearing or decision on the 
record; and (4) admit the data into the claimant's official record as 
an exhibit. The respondents are individuals requesting to be substitute 
parties for a deceased claimant.
    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) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-539............................................           4,000                1                5              333         * $10.95        ** $3,646
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* We based this figure 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>).
** 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. Claimant Statement about Loan of Food or Shelter; Statement 
about Food or Shelter Provided to Another--20 CFR 416.1130-416.1148--
0960-0529. SSA bases an SSI claimant's or recipient's eligibility on 
need, as measured by the amount of income an individual receives. Per 
our calculations, income includes other people providing in-kind 
support and maintenance in the form of food and shelter to SSI 
applicants or recipients. SSA uses Forms SSA-5062, Claimant Statement 
about Loan of Food or Shelter, and SSA-L5063, Statement about Food or 
Shelter Provided to Another, to obtain statements about food or shelter 
provided to SSI claimants or recipients. SSA uses this information to 
determine whether the food or shelter are bona fide loans or income for 
SSI purposes. This determination may affect claimants' or recipients' 
eligibility for SSI as well as the amounts of their SSI payments. The 
respondents are claimants and recipients for SSI payments, and 
individuals who provide loans of food or shelter to them.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                              Average
                                                                              Average        Estimated      theoretical    Average wait    Total annual
         Modality of completion              Number of     Frequency of     burden per     total annual     hourly cost    time in field    opportunity
                                            respondents      response        response     burden (hours)      amount          office      cost (dollars)
                                                                             (minutes)                      (dollars) *    (minutes) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-5062--Paper Version.................          29,026               1              10           4,838        * $19.01           ** 24    *** $312,676
SSA-L5063--Paper Version................          29,026               1              10           4,838         * 19.01           ** 24     *** 312,676

[[Page 40223]]

 
SSA-5062--SSI Claims System.............          29,026               1              10           4,838         * 19.01           ** 24     *** 312,676
SSA-L5063--SSI Claims System............          29,026               1              10           4,838         * 19.01           ** 24     *** 312,676
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         116,104  ..............  ..............          19,352  ..............  ..............   *** 1,250,704
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* 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/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</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. Application for Circuit Court Law--20 CFR 404.985 & 416.1485--
0960-0581. Individuals claiming that an acquiescence ruling (AR) would 
change SSA's prior determination or decision must submit a written 
readjudication request with specific information. SSA reviews the 
information in the requests to determine if the issues stated in the AR 
pertain to the claimant's case, and if the claimant is entitled to 
readjudication. If readjudication is appropriate, SSA considers the 
issues the AR covers. Any new determination or decision is subject to 
administrative or judicial review as specified in the regulations, and 
the claimants must provide information to request readjudication. The 
respondents are claimants for Social Security benefits and SSI 
payments, who request a readjudication of their claim based on an AR 
notice.
    Type of Request: Extension 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) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
AR-based Readjudication Requests..................          10,000                1               17            2,833         * $10.95       ** $31,021
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* We based this figure 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>).
** 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.

    7. Social Security Administration Health IT Partner Program 
Assessment--Participating Facilities and Available Content Form--20 CFR 
404.1614 & 416.1014--0960-0798. The Health Information Technology for 
Economic and Clinical Health (HITECH) Act promotes the adoption and 
meaningful use of health information technology (IT), particularly in 
the context of working with government agencies. Similarly, section 
3004 of the Public Health Service Act requires health care providers or 
health insurance issuers with government contracts to implement, 
acquire, or upgrade their health IT systems and products to meet 
adopted standards and implementation specifications. To support 
expansion of SSA's health IT initiative as defined under HITECH, SSA 
developed Form SSA-680, the Health IT Partner Program Assessment--
Participating Facilities and Available Content Form. The SSA-680 allows 
healthcare providers to provide the information SSA needs to determine 
their ability to exchange health information with the agency 
electronically. We evaluate potential partners (i.e., healthcare 
providers and organizations) on: (1) The accessibility of health 
information they possess; and (2) the content value of their electronic 
health records' systems for our disability adjudication processes. SSA 
reviews the completeness of organizations' SSA-680 responses as one 
part of our careful analysis of their readiness to enter into a health 
IT partnership with us. The respondents are healthcare providers and 
organizations exchanging information with the agency.
    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) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-680...........................................              30                1              300              150         * $41.30        ** $6,195
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* We based this figures on average Healthcare Practitioners and Technical Occupations, 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 40224]]

    8. Authorization for the Social Security Administration to Obtain 
Personal Information--20 CFR 404.704, 404.820 404.823, 404.1926, 
416.203, & 418.3001--0960-0801. SSA uses Form SSA-8510, Authorization 
for the Social Security Administration to Obtain Personal Information, 
to contact a public or private custodian of records on behalf of an 
applicant or recipient of an SSA program to request evidence 
information or proofs, which may support a benefit application or 
payment continuation. SSA also uses this form to obtain evidence or 
proofs to determine the claimant's payment amount. We ask for 
information such as the following:
    <bullet> Age requirements (e.g., birth certificate, court 
documents)
    <bullet> Insured status (e.g., earnings, employer verification)
    <bullet> Marriage or divorce
    <bullet> Pension offsets
    <bullet> Wages verification
    <bullet> Annuities
    <bullet> Dividends, royalties, or other similar payments
    <bullet> Property information
    <bullet> Benefit verification from a State agency or third party
    <bullet> Immigration status (rare instances)
    <bullet> Income verification from public agencies or private 
individuals
    <bullet> Unemployment benefits
    <bullet> Insurance policies
    <bullet> Alimony or Child Support payments.

    If the custodian of the records requires a signed authorization 
from the individual(s) whose information SSA requests, SSA may provide 
the custodian with a copy of the SSA-8510. Once the respondent 
completes the SSA-8510, either using the paper form or using the 
Personal Information Authorization Intranet version, SSA uses the form 
as the authorization to obtain personal information regarding the 
respondent from third parties until the authorizing person (respondent) 
withdraws their claim or revokes the permission of its use. The 
collection is voluntary; however, failure to verify the individuals' 
eligibility can prevent SSA from making an accurate and timely decision 
for their benefits. The respondents are individuals who may file for, 
or currently receive, Social Security benefits, SSI payments, or 
Medicare Part D subsidies.
    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) **         ***
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Paper SSA[dash]8510 for general evidence           8,226               1               5             686        * $19.01           ** 24     *** $75,584
 purposes...............................
Personal Information Authorization               192,235               1               5          16,020         * 19.01           ** 24   *** 1,766,295
 Intranet Screens for general evidence
 purposes (SSI Claims System)...........
    Totals..............................         200,461  ..............  ..............          16,706  ..............  ..............   *** 1,841,879
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* 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/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</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.


    Dated: July 21, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-15898 Filed 7-26-21; 8:45 am]
BILLING CODE 4191-02-P


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