[Federal Register Volume 75, Number 119 (Tuesday, June 22, 2010)]
[Notices]
[Pages 35512-35513]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-15045]
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SOCIAL SECURITY ADMINISTRATION
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, e-mail, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer to the following
addresses or fax numbers.
(OMB), Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974, E-mail address: [email protected].
(SSA), Social Security Administration, DCBFM, Attn: Reports
Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore,
MD 21235, Fax: 410-965-0454, E-mail address: [email protected].
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, 2010. Individuals can obtain copies of the collection
instruments by calling the SSA Reports Clearance Officer at 410-965-
8783 or by writing to the above email address.
1. Medical Report (General)--20 CFR 404.1512-404.1515, 416.912-
416.915--0960-0052. Using the state Disability Determination Services
(DDS) as agents, SSA uses Form SSA-3826-F4 to make accurate
determinations in disability claims cases. SSA uses the information
from this form to determine the claimant's physical and mental status
prior to making a disability determination, and to document the
disability claims folder with the medical evidence. The form provides
disability adjudicators and reviewers with a narrative record and
history of the alleged disability and with the objective medical
findings necessary to make a disability determination. SSA uses the
medical evidence from this form to determine if an individual's
impairment meets the severity and duration requirements for disability
benefits. The respondents are members of the medical community,
including individual physicians, hospital doctors, medical records
librarians, and other medical sources.
Type of Request: Revision of an OMB-approved information
collection.
Number of Respondents: 150,000.
Frequency of Response: 1.
Average Burden Per Response: 30 minutes.
Estimated Annual Burden: 75,000 hours.
2. Letter to Custodian of Birth Records/Letter to Custodian of
School Records--20 CFR 404.704, 404.716, 416.802, and 422.107--0960-
0693. SSA prepares Form SSA-L106 and SSA-L706 for individuals who need
help in obtaining evidence of their age in connection with Social
Security number (SSN) card applications and claims for benefits. SSA
uses the SSA-L706 to determine the existence of primary evidence of age
for SSN applicants. SSA also uses both letters to verify with the
issuing entity, when necessary, the authenticity of the record
submitted by the SSN applicant or claimant. The respondents are
schools, state and local bureaus of vital statistics, and religious
entities.
Type of Request: Revision of an OMB-approved information
collection.
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Average burden Estimated
Form Number of Frequency of per response annual burden
respondents response (minutes) (hours)
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SSA-L106........................................ 3,600 1 10 600
SSA-L706........................................ 3,600 1 10 600
Totals.......................................... 7,200 .............. .............. 1,200
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II. SSA has submitted the information collection listed below to
OMB for clearance. Your comments on the information collection would be
most useful if OMB and SSA receive them within 30 days from the date of
this publication. To be sure we consider your comments, we must receive
them no later than July 22, 2010. You can
[[Page 35513]]
obtain a copy of the OMB clearance package by calling the SSA Reports
Clearance Officer at 410-965-8783 or by writing to the above email
address.
Disability Report-Appeal--20 CFR 404.1512, 416.912, 404.916(c),
416.1416(c), 405 Subpart C, 422.140--0960-0144. SSA requires disability
claimants who are appealing an unfavorable disability determination to
complete Form SSA-3441-BK. This form allows claimants to disclose any
changes to their disability or resources that might influence SSA's
unfavorable determination. SSA may use the information to: (1)
Reconsider and review an initial disability determination; (2) review a
continuing disability; and (3) evaluate a request for a hearing. This
information assists the state DDSs and administrative law judges (ALJ)
in: (1) Preparing for the appeals and hearings; and (2) issuing a
determination or decision on an individual's entitlement (initial or
continuing) to disability benefits. Respondents are individuals who
appeal denial, reduction, or cessation of Social Security Disability
Income and Supplemental Security Income payments, or who are requesting
a hearing before an ALJ.
*Note: This is a correction notice. SSA inadvertently published
incorrect burden information for this collection at 75 FR 27036 on
May 13, 2010. We provide the correct burden information below.
Type of Request: Revision of an OMB-approved information
collection.
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Estimated
Collection method Number of Frequency of Average burden annual burden
respondents response per response: hours
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SSA-3441 (Paper Form)........................... 12,604 1 45 minutes 9,453
Electronic Disability Collect System (EDCS)..... 843,090 1 45 minutes 632,318
I3441 (Internet Form)........................... 417,268 1 30 minutes 208,634
Totals.......................................... 1,272,962 .............. .............. 850,405
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Dated: June 17, 2010.
Liz Davidson,
Director, Center for Reports Clearance, Social Security Administration.
[FR Doc. 2010-15045 Filed 6-21-10; 8:45 am]
BILLING CODE 4191-02-P