Supporting Statement (revised)

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Workers' Compensation/Public Disability Benefit Questionnaire

OMB: 0960-0247

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Supporting Statement for SSA-546

Workers' Compensation/Public Disability Benefit Questionnaire

20 CFR 404.408

OMB No. 0960-0247





A. Justification


  1. Introduction/Authoring Laws and Regulations

Section 224 of the Social Security Act (Act) provides for the reduction of disability insurance benefits (DIB) if the combination of DIB and any workers' compensation (WC) or certain federal, state, or local public disability benefits (PDB) exceeds 80 percent of the worker's average current earnings. Section 20 CFR 404.408 of the Code of Federal Regulations authorizes SSA to reduce an individual’s Social Security claim when they are potentially eligible for WC and PDB.


  1. Description of Collection

SSA field office staff conducts face-to-face interviews with applicants using the electronic WC/PDB screens in Modernized Claims System (MCS) to determine if the worker’s receipt of WC or PDB payments will cause a reduction of DIB. We are discontinuing the paper Form SSA-546. The Respondents are applicants for Title II DIB.


  1. Use of Information Technology to Collect the Information

SSA field office employees enter information through SSA’s Intranet system, MCS.

In accordance with the agency’s Government Paperwork Elimination Act plan, SSA created an electronic version of Form SSA-546. Based on our data, we estimate approximately 100% of technicians under this OMB number use the electronic version.


  1. Why We Cannot Use Duplicate Information

On the rare occasion that the MCS system is unavailable, the technician is able to access Interactive Computation Facility (ICF) common screens to input the information, therefore alleviating the need for the paper Form SSA-546.

  1. Minimizing Burden on Small Respondents

This collection does not affect small businesses or other small entities.


  1. Consequence of Not Collecting Information or Collecting it Less Frequently

If we did not use the electronic Form SSA-546, it could result in an inaccurate computation of Social Security disability insurance benefits. Because we collect the information on an as needed basis, we cannot collect it less frequently.


There are no technical or legal obstacles that prevent burden reduction.

  1. Special Circumstances

There are no special circumstances that would cause SSA to conduct this information collection in a manner inconsistent with 5 CFR 1320.5.


  1. Solicitation of Public Comment and Other Consultations with the Public

The 60-day advance Federal Register Notice published on August 28, 2014, at 79 FR 51387, and we received no public comments. The 30-day FRN published on October 31, 2014 at 79 FR 64872. If we receive any comments in response to his Notice, we will forward them to OMB.


  1. Payment or Gifts to Respondents

SSA provides no payments or gifts to the respondents.


  1. Assurances of Confidentiality

SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.


  1. Justification for Sensitive Questions

The information collection does not contain any questions of a sensitive nature.


  1. Estimates of Public Reporting Burden


Modality of Completion

Number of Responses

Frequency

of Response

Average

Burden Per Response

(minutes)

Total Estimated Annual

Burden

(hours)

MCS

248,000

1

15

62,000


The total burden for this ICR is 62,000. This figure represents burden hours, and we did not calculate a separate cost burden.


  1. Annual Cost to the Respondents (Other)

This collection does not impose a known cost burden on the respondents.


  1. Annual Cost To Federal Government

The estimated cost to the Federal Government to collect the information is negligible. Because the cost of maintaining the system which collects this information is accounted for within the cost of maintaining all of SSA’s automated systems, it is not possible to calculate the cost associated with just one Internet application.


  1. Program Changes or Adjustments to the Information Collection Request

There are no program changes to the public reporting burden.


  1. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.


  1. Displaying the OMB Approval Expiration Date

OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.


  1. Exceptions to Certification Statement

SSA is not requesting an exception to the requirement to display the OMB approval expiration date .


B. Collection of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.





File Typeapplication/msword
AuthorSue Shinsky
Last Modified By889123
File Modified2014-10-31
File Created2014-07-31

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