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Federal Register / Vol. 86, No. 186 / Wednesday, September 29, 2021 / Notices
implementation specifications. To support expansion of SSAs health IT
initiative as defined under HITECH, SSA developed Form SSA680, the Health IT Partner Program AssessmentParticipating 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 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 SSA680 responses as
Number of respondents
Modality of completion
SSA680

Frequency of response
30

Average burden per response minutes
1

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 OMBapproved information collection.

Estimated total annual burden hours
300

150

Average theoretical hourly cost amount dollars

Total annual opportunity cost dollars

$41.30

$6,195

We based this figures on average Healthcare Practitioners and Technical Occupations, as reported by Bureau of Labor Statistics data.
https www.bls.gov/oes/current/oes_nat.htm00-0000.
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.

9. Authorization for the Social Security Administration to Obtain Personal Information20 CFR 404.704, 404.820 404.823, 404.1926, 416.203, &
418.300109600801. SSA uses Form SSA8510, 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 claimants payment amount. We ask for information such as the following:
Age requirements e.g., birth certificate, court documents
Insured status e.g., earnings, employer verification Marriage or divorce Pension offsets Wages verification Annuities Dividends, royalties, or other similar payments Property information Benefit verification from a State agency or third party Immigration status rare instances Income verification from public agencies or private individuals Unemployment benefits Insurance policies Alimony or Child Support payments.
If the custodian of the records requires a signed authorization from the individuals whose information SSA
requests, SSA may provide the
Number of respondents
Modality of completion
Average burden per response minutes
Frequency of response
custodian with a copy of the SSA8510.
Once the respondent completes the SSA8510, 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 OMBapproved information collection.

Estimated total annual burden hours
Paper SSA-8510 for general evidence purposes
Personal Information Authorization Intranet Screens for general evidence purposes
SSI Claims System

192,235

1

5

16,020

Totals

200,461

16,706

8,226

1

5

Average theoretical hourly cost amount dollars

686

$19.01

Average wait time in field office minutes

Total annual opportunity cost dollars

24

$75,584

19.01

24

1,766,295

1,841,879

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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 the average FY 2021 wait times for field offices, 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.

Dated: September 24, 2021.
Naomi Sipple, Reports Clearance Officer, Social Security Administration.

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