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Federal Register / Vol. 86, No. 160 / Monday, August 23, 2021 / Notices 0001. A parent of a deceased, fully insured worker may be entitled to Social Security Old-Age, Survivors, and Disability Insurance OASDI benefits based on the earnings record of the deceased worker under certain conditions. One of the conditions is when the parent receives at least one-

half support from the deceased worker at certain points in time. The one-half support requirement also applies to a spousal applicant in determining whether OASDI benefits are subject to Government Pension Offset GPO. SSA
uses Form SSA760, Certificate of Support, to determine if the parent of a
deceased worker or a spouse applicant meets the one-half support requirement.
Respondents are parents of deceased workers and spouses who may meet the GPO exception.
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

SSA760

18,000

1

15

4,500

$27.07

121,815

We based this figure on the 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.

2. Medical Source Opinion of Patients Capability to Manage Benefits20 CFR 404.2015 and 416.61509600024. SSA appoints a representative payee in cases where we determine beneficiaries are not capable of managing their own benefits. In these instances, we require medical evidence
to determine the beneficiaries capability of managing or directing their benefit payments. SSA collects medical evidence on Form SSA787, Medical Source Opinion of Patients Capability to Manage Benefits, to: 1 Determine beneficiaries capability or inability to handle their own benefits; and 2 assist
in determining the beneficiaries need for a representative payee. The respondents are the beneficiarys physicians, or medical officers of the institution in which the beneficiary resides.
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

SSA787

767,737

1

20

255,912

$105.22

$26,927,061

We based this figure on the national average medical professionals salaries as reported by the US Bureau of Labor Statistics data https
www.bls.gov/oes/current/oes291228.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.

3. Work Activity ReportEmployee 20 CFR 404.1520b, 404.1571404.1576, 404.1584404.1593, and 416.971
404.97609600059. SSA uses Form SSA821BK, Work Activity Report Employee, and its electronic version, the SSA821APP, to collect recipient employment information to determine whether recipients worked after
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Modality of completion
Number of respondents
becoming disabled and, if so, whether the work is substantial gainful activity.
SSA uses the SSA821BK and SSA
821APP to obtain work information during the initial claims process, the continuing disability review process, post-adjudicative work issue actions, and for Supplemental Security Income SSI claims involving work issues. SSA
Average burden per response minutes
Frequency of response
Estimated total annual burden hours
reviews and evaluates the data to determine if the applicant or recipient meets the disability requirements of the law. The respondents are applicants or recipients of Title II Social Security Disability, and Title XVI SSI applicants.
Type of Request: Revision of an OMBapproved information collection.
Average theoretical hourly cost amount dollars

Average wait time in field office or for teleservice Centers minutes

Total annual opportunity cost dollars

SSA-821-BK Paper
SSA821APP Electronic

319,900

1

30

159,950

$10.95

21

$2,977,469

91,400

1

30

45,700

10.95

500,415

Totals

411,300

205,650

3,477,884

We based this figure on the average DI payments based on SSAs current FY 2021 data https www.ssa.gov/legislation/2021FactSheet.pdf.
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.

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