Federal Register - July 2, 2021
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Source: Federal Register
35372
Federal Register / Vol. 86, No. 125 / Friday, July 2, 2021 / Notices
Number of respondents
Modality of completion
Average burden per response minutes
Frequency of response
Estimated total annual burden hours
Average theoretical hourly cost amount dollars
Total annual opportunity cost dollars
Respondents applying for or receiving Retirement, Survivors, or Health Insurance benefits
Respondents applying for or receiving Disability benefits
60,753
1
5
5,063
$10.95
$55,440
14,374
1
5
1,198
10.95
13,118
Totals
75,127
6,261
68,558
We based this figure on the average DI payments based on SSAs current FY 2021 data https www.ssa.gov/legislation/2021FactSheet.pdf.
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 Employer20 CFR
404.801404.80309600030. When workers report they were paid wages but cannot provide proof of those earnings, and the wages do not appear in SSAs records of earnings, SSA uses Form SSA7011F4, Statement of Employer,
to document the alleged wages.
Specifically, the agency uses the form to resolve discrepancies in the individuals Social Security earnings record and to process claims for Social Security benefits. We only send Form SSA
7011F4 to employers if we are unable
able to locate the earnings information within our own records. The respondents are employers who can verify wage allegations made by wage earners.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of respondents
Frequency of response
Average burden per response minutes
Estimated total annual burden hours
Average theoretical hourly cost amount dollars
Total annual opportunity cost dollars
SSA7011F4
500
1
30
250
$27.07
$6,768
We based this figure on average U.S. workers hourly wages, 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.
3. 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
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.
Modality of completion
Number of respondents
Frequency of response
Average burden per response minutes
Estimated total annual burden hours
Average theoretical hourly cost amount dollars
Total annual opportunity cost dollars
SSA788
134,000
1
10
22,333
$27.07
$604,554
lotter on DSK11XQN23PROD with NOTICES1
We based this figures on average U.S. citizens hourly salary, as reported by Bureau of Labor Statistics data https www.bls.gov/oes/current/
oes_nat.htm00-00000.
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. 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
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17:12 Jul 01, 2021
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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
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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.
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02JYN1
