Notice2021-23273

Agency Information Collection Activities: Comment Request

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Published
October 26, 2021

Issuing agencies

Social Security Administration

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<title>Federal Register, Volume 86 Issue 204 (Tuesday, October 26, 2021)</title>
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[Federal Register Volume 86, Number 204 (Tuesday, October 26, 2021)]
[Notices]
[Pages 59262-59265]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-23273]


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SOCIAL SECURITY ADMINISTRATION

[Docket No: SSA-2021-0044]


Agency Information Collection Activities: 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, and one 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-2021-0044].
(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#cb8499e599aebba4b9bfb8e588a7aeaab9aaa5a8ae8bb8b8aae5aca4bd"><span class="__cf_email__" data-cfemail="82cdd0acd0e7f2edf0f6f1acc1eee7e3f0e3ece1e7c2f1f1e3ace5edf4">[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-2021-0044].

    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 November 26, 2021. Individuals can obtain copies of 
these OMB clearance packages by writing to 
<a href="/cdn-cgi/l/email-protection#125d403c4077627d6066613c517e777360737c7177526161733c757d64"><span class="__cf_email__" data-cfemail="e2adb0ccb087928d909691cca18e878390838c8187a2919183cc858d94">[email&#160;protected]</span></a>.
    1. Request for Waiver of Overpayment Recovery and Request for 
Change in Overpayment Recovery Rate--20 CFR 404.502, 404.506-404.512, 
416.550-416.558, 416.570-416.571--0960-0037.
    When Social Security beneficiaries and Supplemental Security Income 
(SSI) recipients receive an overpayment, they must return the extra 
money. These beneficiaries and recipients can use Form SSA-632-BK, 
Request for Waiver of Overpayment Recovery, to request a waiver from 
repaying their overpayment. Beneficiaries and recipients can also use 
Form SSA-634, Request for Change in Overpayment Recovery, to request a 
change to the monthly recovery rate of their overpayment. The 
respondents must provide financial information to help the agency 
determine how much the overpaid person can afford to repay each month. 
The respondents are individuals who are overpaid Social Security or SSI 
payments who are requesting:
    (1) A waiver of recovery of an overpayment, or (2) a lesser rate of 
withholding.
    Type of Request: Revision of an OMB-approved information 
collection.

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                                                                                                                        Average wait
                                                                                                           Average      time in field
                                          Number of     Frequency of   Average burden     Estimated      theoretical    office or for     Total annual
        Modality of completion           respondents      response      per response    total annual     hourly cost     teleservice    opportunity cost
                                                                          (minutes)    burden (hours)      amount          centers       (dollars) ***
                                                                                                         (dollars) *    (minutes) **
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SSA-632--Request for Waiver of                400,000               1             120         800,000        * $10.95           ** 21    *** $10,293,000
 Overpayment Recovery (If completing
 entire paper form, including the AFI
 authorization)......................
SSA-634--Request for Change in                100,000               1              45          75,000         * 10.95           ** 21      *** 1,204,500
 Overpayment Recovery Rate
 (Completing paper form).............
                                      ------------------------------------------------------------------------------------------------------------------
    Totals...........................         500,000  ..............  ..............         875,000  ..............  ..............     *** 11,497,500
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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>).
** 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. Statement of Claimant or Other Person--20 CFR 404.702 & 
416.570--0960-0045. SSA uses Form SSA-795, Statement of Claimant or 
Other Person, in special situations where there is no authorized form 
or questionnaire, yet we require a signed statement from the applicant, 
claimant, or other individuals who have knowledge of facts, in 
connection with claims for Social Security benefits or SSI. The 
information we request on the SSA-795 is of sufficient importance that 
we need both a signed statement and a penalty clause. SSA uses this 
information to process, in addition to claims for benefits, issues 
about continuing eligibility; ongoing benefit amounts; use of funds by 
a representative payee; fraud investigation; and a myriad of other 
program-related matters. The most common respondents are applicants for 
Social Security, SSI, or recipients of these programs. However, 
respondents also include friends and relatives of the involved parties, 
coworkers, neighbors, or anyone else in a position to provide 
information pertinent to the issue(s).
    Type of Request: Revision of an OMB-approved information 
collection.

[[Page 59263]]



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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-795 (paper version).................         207,239               1              15          51,810        * $10.95           ** 24  *** $1,475,031
SSA-795 (Person Statement) electronic             24,583               1              15           6,146         * 27.07  ..............     *** 166,372
 version................................
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         231,822  ..............  ..............          57,956  ..............  ..............   *** 1,641,403
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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 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 the average FY 2021 wait time 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 Medication--20 CFR 404.1512, 416.912--0960-0289. In 
cases where claimants request a hearing after denial of their 
disability claim for Social Security, SSA uses Form HA-4632, Claimant's 
Medications, to request information from the claimant regarding the 
medications they use. This information helps the judge overseeing the 
case to fully investigate: (1) The claimant's medical treatment and (2) 
the effects of the medications on the claimant's medical impairments 
and functional capacity. The judge makes the completed form a part of 
the documentary evidence of record, placing it in the official record 
of the proceedings as an exhibit. The respondents are applicants (or 
their representatives) for Old Age Survivors and Disability Insurance 
(OASDI) benefits or SSI payments who request a hearing to contest an 
agency denial of their claim.
    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) **         ***
--------------------------------------------------------------------------------------------------------------------------------------------------------
HA-4632 (PDF/paper version).............          53,200               1              15          13,300        * $10.95           ** 24    *** $378,651
Electronic Records Express Submissions..         136,800               1              15          34,200         * 27.07  ..............     *** 925,794
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................         190,000  ..............  ..............          47,500  ..............  ..............   *** 1,304,445
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 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 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 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.

    4. Disability Report--Adult--20 CFR 404.1512 and 416.912--0960-
0579. State Disability Determination Services (DDS) use the SSA-3368, 
Disability Report-Adult, and its electronic versions to determine if 
adult disability applicants' impairments are severe and, if so, how the 
impairments affect the applicants' ability to work. This determination 
dictates whether the DDSs and SSA will find the applicant to be 
disabled and entitled to SSI payments. The respondents are applicants 
for Title II disability benefits or Title XVI SSI payments.
    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
                                                                             (minutes)    burden (hours)      amount          centers      (dollars) ***
                                                                                                            (dollars) *    (minutes) **
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3368 (Paper)........................           6,045               1              90           9,068        * $10.95           ** 21    *** $122,465
EDCS 3368 (Intranet)....................       1,263,104               1              90       1,894,656         * 10.95           ** 21  *** 25,587,325
i3368 (Internet)........................         989,361               1              90       1,484,042         * 10.95  ..............  *** 16,250,260
                                         ---------------------------------------------------------------------------------------------------------------
    Totals..............................       2,258,510  ..............  ..............       3,387,766  ..............  ..............  *** 41,960,050
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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>).
** 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.

    5. Request for Internet Services and 800# Automated Telephone 
Services Knowledge-Based Authentication (RISA-KBA)--20 CFR 401.45--
0960-0596. The Request for Internet Services and 800# Automated 
Telephone Services (RISA) Knowledge-Based Authentication (KBA) is one 
of the authentication methods SSA uses to allow individuals access to 
their personal information through our Internet and Automated Telephone 
Services. SSA asks individuals and third parties who seek personal 
information from SSA records, or who register to participate in SSA's 
online business services, to provide certain identifying information. 
As an extra

[[Page 59264]]

measure of protection, SSA asks requestors who use the Internet and 
Automated Telephone Services to provide additional identifying 
information unique to those individuals so SSA can authenticate their 
identities before releasing personal information. The respondents are 
current beneficiaries who are requesting personal information from SSA, 
and individuals and third parties who are registering for SSA's online 
business services.
    Type of Request: Revision of an OMB-approved information 
collection.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                              Average
                                                                                              Average        Estimated      theoretical    Total annual
                 Modality of completion                      Number of     Frequency of     burden per     total annual     hourly cost     opportunity
                                                            respondents      response        response     burden (hours)      amount      cost (dollars)
                                                                                             (minutes)                      (dollars) *         **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Internet Requestors.....................................       2,921,795               1               3         146,090        * $27.07   ** $3,954,656
Telephone Requestors....................................       1,157,833               1               4          77,189         * 27.07    ** 2,089,506
                                                         -----------------------------------------------------------------------------------------------
    Totals..............................................       4,079,628  ..............  ..............         198,930  ..............    ** 6,044,162
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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>).
** 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. Testimony by Employees and the Production of Records and 
Information in Legal Proceedings--20 CFR 403.100-403.155--0960-0619. 
Regulations at 20 CFR 403.100-403.155 of the Code of Federal 
Regulations establish SSA's policies and procedures for an individual; 
organization; or government entity to request official agency 
information, records, or testimony of an agency employee in a legal 
proceeding when the agency is not a party. The request, which 
respondents submit in writing to SSA, must: (1) Fully set out the 
nature and relevance of the sought testimony; (2) explain why the 
information is not available by other means; (3) explain why it is in 
SSA's interest to provide the testimony; and (4) provide the date, 
time, and place for the testimony. Respondents are individuals or 
entities who request testimony from SSA employees in connection with a 
legal proceeding.
    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) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
20 CFR 403.100-403.155............................             100                1               60              100         * $27.07        ** $2,707
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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>).
** 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. Function Report--Adult-Third Party--20 CFR 404.1512 & 416.912--
0960-0635. Individuals receiving or applying for Social Security 
Disability Insurance (SSDI) or SSI provide SSA with medical evidence 
and other proof SSA requires to prove their disability. SSA, and DDS on 
our behalf, collect this information using Form SSA-3380-BK, Function 
Report--Adult-Third Party. We use the information to document how 
claimant's disabilities affect their ability to function, and to 
determine eligibility for SSI and SSDI claims. The respondents are 
third parties familiar with the functional limitations (or lack 
thereof) of claimants who apply for SSI and SSDI benefits.
    Type of Request: Revision of an OMB approved information 
collection.

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                                                                                                                      Average
                                                                                Average  burden     Estimated       theoretical         Total annual
           Modality of completion                Number of      Frequency  of    per  response    annual burden     hourly cost       opportunity cost
                                                respondents        response        (minutes)         (hours)      amount (dollar)       (dollars) **
                                                                                                                         *
--------------------------------------------------------------------------------------------------------------------------------------------------------
SSA-3380-BK.................................         709,700                1               61          721,528         * $27.07         ** $19,531,763
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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>).
** 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.

    8. Certification of Prisoner Identity Information--20 CFR 422.107--
0960-0688. Inmates of Federal, State, or local prisons may need a 
Social Security card as verification of their Social Security number 
for school or work programs, or as proof of employment eligibility upon 
release from incarceration. Before SSA can issue a replacement Social 
Security card, applicants must show SSA proof of their identity. People 
who are in prison for an extended period typically do not have current 
identity documents. Therefore, under written agreement with the 
correctional institution, SSA allows prison officials to verify the 
identity of certain incarcerated U.S. citizens who need replacement 
Social Security cards. Prison officials provide SSA information from 
the official prison files, sent on correctional facility letterhead. 
SSA uses this information to establish the applicant's identity in the 
replacement Social Security card process. The respondents are prison 
officials who certify the identity of

[[Page 59265]]

prisoners applying for replacement Social Security cards.
    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      Number of       per response    annual burden     hourly cost      opportunity
                                     respondents        response        responses        (minutes)         (hours)           amount       cost (dollars)
                                                                                                                          (dollars) *           **
--------------------------------------------------------------------------------------------------------------------------------------------------------
Verification of Prisoner Identity           1,000              200          200,000                3           10,000         * $28.80         $288,000
 Statements......................
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* We based this figure on average Probation Officers and Correctional Treatment Specialists hourly salary, as reported by Bureau of Labor Statistics
  data (<a href="https://www.bls.gov/oes/current/oes211092.htm">https://www.bls.gov/oes/current/oes211092.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: October 21, 2021.
Naomi Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2021-23273 Filed 10-25-21; 8:45 am]
BILLING CODE 4191-02-P


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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.