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Federal Register / Vol. 86, No. 168 / Thursday, September 2, 2021 / Notices
Number of respondents
Modality of completion
SSA1709

I

Average burden per response minutes
Frequency of response
I

120,000

I

1

I

15

Average theoretical hourly cost amount dollars

Estimated total annual burden hours 30,000

I

$26.65

Total annual opportunity cost dollars

I

$799,500

We based this figure by averaging both the average Federal, State, and Local Government hourly wages https www.bls.gov/oes/current/naics3_999000.htm, and the average Insurance Claims and Policy Processing Clerks hourly wages, as reported by Bureau of Labor Statistics data https www.bls.gov/oes/current/
oes439041.htm.
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. A Statement of Care and Responsibility for Beneficiary20 CFR
404.2020, 404.2025, 408.620, 408.625, 416.620, and 416.62509600109. SSA
uses the information from Form SSA
788, Statement of Care and Responsibility for Beneficiary, to verify payee applicants statements of concern, and to identify other potential payees.
SSA is concerned with selecting the
most qualified representative payee who will use Social Security benefits in the beneficiarys best interest. SSA
considers factors such as the payee applicants capacity to perform payee duties; awareness of the beneficiarys situation and needs; demonstration of past, and current concern for the beneficiarys well-being. If the payee applicant does not have custody of the Number of respondents
Modality of completion
SSA788

I

Average burden per response minutes
Frequency of response
I

134,000

I

1

beneficiary, SSA obtains information from the custodian for evaluation against information the applicant provides. Respondents are individuals who have custody of the beneficiary in cases where someone else has filed to be the beneficiarys representative payee.
Type of Request: Revision of an OMBapproved information collection.

I

10

Average theoretical hourly cost amount dollars

Estimated total annual burden hours 22,333

I

$27.07

Total annual opportunity cost dollars

I

$604,554

We based this figure on average U.S. citizens hourly salary, as reported by Bureau of Labor Statistics data https www.bls.gov/oes/current/oes_nat.htm0000000.
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. Third Party Liability Information Statement42 CFR 433.136433.139
09600323. To reduce Medicaid costs, Medicaid state agencies identify third party insurers liable for medical care or services for Medicaid beneficiaries.
Regulations at 42 CFR 433.136433.139
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 SSA8019U2, Third Party
Number of respondents
Modality of completion
Average burden per response minutes
Frequency of response
Estimated total annual burden hours
Liability Information Statement, 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 OMBapproved information collection.
Average wait time in field office or for teleservice centers minutes

Average theoretical hourly cost amount dollars

Total annual opportunity cost dollars

SSA8019U2 Paper
SSI Claims System Intranet

200
35,257

1
1

6
6

20
3,526

$19.01
19.01

21

$380
301,613

Totals

35,457

3,546

301,993

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We based this figure on averaging both the average DI payments based on SSAs current FY 2021 data https www.ssa.gov/legislation/2021FactSheet.pdf, and the average U.S. workers hourly wages, as reported by Bureau of Labor Statistics data https www.bls.gov/oes/current/oes_nat.htm.
We based this figure on averaging both the average FY 2021 wait times for field offices and teleservice centers, based on SSAs 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. Certificate of Election for Reduced Spouses Benefits20 CFR 404.421
09600398. SSA cannot pay reduced Social Security benefits to an already entitled spouse unless the spouse elects to receive reduced benefits and is 1 at
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least age 62, but under full retirement age; and 2 no longer caring for a child.
In this situation, spouses who decide to elect reduced benefits must file Form SSA25, Certificate of Election for Reduced Spouses Benefits. SSA uses
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the information to pay qualified spouses who elect to receive reduced benefits.
Respondents are entitled spouses seeking reduced Social Security benefits.

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