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 and an extension of OMB-approved information collections, and one new information collection.

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-2015-0015].

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 June 29, 2015. Individuals can obtain copies of the collection instruments by writing to the above email address.

1. Application for a Social Security Number Card, the Social Security Number Application Process (SSNAP), and Internet SSN Replacement Card (iSSNRC) Application--20 CFR 422.103-422.110--0960-0066. SSA collects information on the SS-5 (used in the United States) and SS-5-FS (used outside the United States) to issue original or replacement Social Security cards. SSA also enters the application data into the Social Security Number Application Process (SSNAP) when applicants request a new or replacement card via telephone or in person. In addition, hospitals collect the same information on SSA's behalf for newborn children through the Enumeration-at-Birth process. In this process, parents of newborns provide hospital birth registration clerks with information required to register these newborns. Hospitals send this information to State Bureaus of Vital Statistics (BVS), and they send the information to SSA's National Computer Center. SSA then uploads the data to the SSA mainframe along with all other enumeration data, and we assign the newborn a Social Security number (SSN) and issue a Social Security card. Respondents can also use these modalities to request a change in their SSN records. Additionally, the iSSNRC application will collect information similar to the paper SS-5 for no-change replacement SSN cards for adult U.S. citizens.

A new iSSNRC modality included in the current clearance will allow certain applicants for an SSN replacement card to apply by completing an internet application and submitting the required evidence online rather than completing a paper Form SS-5, Application for a Social Security Card.

The respondents for this collection are applicants for original and replacement Social Security cards, or individuals who wish to change information in their SSN records, who use any of the modalities described above.

Type of Request: Revision of an OMB-approved information collection.

Application....Number of......Frequency of.. Average........Estimated

scenario...... respondents....response...... burden per.... total annual

............................................ response...... burden (hours)

............................................ (minutes)

Respondents....10,500,000.... 1..............8.5............1,487,500

who do not

have to

provide

parents' SSNs

* Adult U.S... 1,500,000......1..............5..............125,000

Citizens

requesting a

replacement

card with no

changes

through new

iSSNRC

modality

Respondents....400,000........1..............9..............60,000

whom we ask to

provide

parents' SSNs

(when applying

for original

SSN cards for

children under

age 18)

Applicants age 1,500,000......1..............9.5............237,500

12 or older

who need to

answer

additional

questions so

SSA can

determine

whether we

previously

assigned an

SSN

Applicants.... 900............1..............60............ 900

asking for a

replacement

SSN card

beyond the new

allowable

limits (i.e.,

who must

provide

additional

documentation

to accompany

the

application)

Authorization..500............1..............15............ 125

to SSA to

obtain

personal

information

cover letter

Authorization..500............1..............15............ 125

to SSA to

obtain

personal

information

follow-up

cover letter

Totals........ 13,901,900.................................. 1,911,150

.. * The total timeline for complete national coverage of the iSSNRC application is two years from the date of initial implementation and is dependent on the contractor enrolling each State into the network. By FY 2018, we would expect to issue about 1.5 million replacement cards annually via the iSSNRC application. However, the estimated volume could vary based on the date of implementation, when the contractor acquires States, and our marketing efforts to the public.

Cost Burden: The state BVSs incur costs of approximately $11 million for transmitting data to SSA's mainframe. However, SSA reimburses the states for these costs.

2. Third Party Liability Information Statement--42 CFR 433.136-433.139--0960-0323. To reduce Medicaid costs, Medicaid state agencies must identify third party insurers liable for medical care or services for Medicaid beneficiaries. Regulations at 42 CFR 433.136-433.139 require Medicaid state agencies to obtain this information on Medicaid applications and redeterminations as a condition of Medicaid eligibility. States may enter into agreements with the Commissioner of Social Security to make Medicaid eligibility determinations for aged, blind, and disabled beneficiaries in those states. Applications for and redeterminations of Supplemental Security Income (SSI) eligibility in jurisdictions with such agreements are applications and redeterminations of Medicaid eligibility. Under these agreements, SSA obtains third party liability information using Form SSA-8019, and provides that information to the Medicaid state agencies. The Medicaid state agencies use the information to bill third parties liable for medical care, support, or services for a beneficiary to guarantee that Medicaid remains the payer of last resort. The respondents are SSI claimants and recipients.

Type of Request: Revision of an OMB-approved information collection.

Modality of....Number of......Frequency of.. Average........Estimated

completion.... respondents....response...... burden per.... total annual

............................................ response...... burden (hours)

............................................ (minutes)

SSA-8012 Paper 200............1..............5..............17

form

Modernized SSI 51,381........ 1..............5..............4,282

Claims System

(MSSICS)

Totals........ 51,581...................................... 4,299

3. Request for Deceased Individual's Social Security Record--20 CFR 402.130--0960-0665. When a member of the public requests an individual's Social Security record, SSA needs the name and address of the requestor as well as a description of the requested record to process the request. SSA uses the information the respondent provides on Form SSA-711, or via an Internet request through SSA's electronic Freedom of Information Act (eFOIA) Web site, to (1) verify the wage earner is deceased and (2) access the correct Social Security record. Respondents are members of the public requesting deceased individuals' Social Security records.

Type of Request: Revision of an OMB-approved information collection.

Modality of....Number of......Frequency of.. Average........Estimated

completion.... respondents....response...... burden per.... total annual

............................................ response...... burden (hours)

............................................ (minutes)

Internet...... 49,800........ 1..............7..............5,810

Request

through eFOIA

SSA-711........200............1..............7..............23

(paper)

Total..........50,000...................................... 5,833

Cost Burden *: In addition, SSA charges fees to the respondent for this information. The following chart shows the fees per transaction based on the information the respondent provides on the SSA-711 (or in eFOIA):

Modality of completion....Information provided (or..Cost per

..........................not provided)............ transaction

SSA-711 (paper).......... SSN of decedent is not.... $29

..........................provided

SSA-711 (paper).......... SSN of decedent is........ $27

..........................provided

eFOIA (Internet)..........SSN of decedent is not.... $18

..........................provided

* As these costs are dependent on the respondent's provided information, we charge them on an as needed basis, and cannot provide a total annual estimate of the cost burden. We do not know whether the respondent provided the decedent's SSN until we manually review and process each SSA-711.

4. Function Report Adult--20 CFR 404.1512 & 416.912--0960-0681. Individuals receiving or applying for Social Security disability insurance (SSDI) or SSI must provide medical evidence and other proof SSA requires to prove their disability. SSA, and State disability determinations services on our behalf, collect the information using Form SSA-3373. We use the information to document how claimants' disabilities affect their ability to function, and to determine eligibility for SSI and SSDI claims. The respondents are Title II and Title XVI applicants (or current recipients undergoing redeterminations) for disability payments.

Type of Request: Revision of an OMB-approved information collection.

--This is a summary of a Federal Register article originally published on the page number listed below--

Citation: "80 FR 24307"

Document Number: "Docket No: SSA-2015-0027"

Federal Register Page Number: "24307"

"Notices"