Supporting Statement - 0013

Supporting Statement for Form SSA-8

Application For Lump-Sum Death Payment

20 CFR 404.390-404.392

OMB No. 0960-0013

A. Justification

1. Introduction/Authoring Laws and Regulations

Title II of the Social Security Act (Act) provides for payment of a lump-sum death payment (not to exceed $255) upon the death of an insured individual. Section 202(i) of the Act explains the conditions of eligibility for this payment, including the filing of an application. Regulations at 20 CFR 404.390-404.392 of the Code of Federal Regulations set the procedures and policies for implementing Section 202(i) of the Act. 20 CFR 404.392 requires individual applicants to file an application to collect the information needed to determine eligibility for the payment. The SSA-8 elicits the information about the applicant and the relationship to the deceased needed to make this determination of eligibility.

2. Description of Collection

The Social Security Administration (SSA) uses Form SSA-8 to collect information needed to authorize payment of the lump-sum death payment (LSDP) to a widow, widower, or children of the deceased, as defined in Section 202(i) of the Act. Respondents must complete the application for this one-time payment. They may complete the application via paper form, telephone, or during an in‑person interview with SSA employees. Respondents are applicants for the LSDP.

2. Use of Information Technology to Collect the Information

In accordance with the agency’s Government Paperwork Elimination Act plan, SSA created and uses the Modernized Claims System (MCS), and the Preliminary Claims System (PCS) screens to document information we obtain from individuals during an interview (telephone or in person). MCS is an internal electronic forms system available to SSA Claims Specialists, and the PCS screens are Intranet-based screens that allow technicians to collect the data to process applications. In accordance with the agency’s Government Paperwork Elimination Act plan, we estimate claims specialists take approximately 95% of the applications electronically. In addition, SSA created an Intranet-based PDF version of Form SSA-8. The PDF version allows the respondents to complete the form electronically using a personal computer, or other computing device, print the completed form, and mail it to SSA. We developed these electronic versions, as we want to ensure SSA provides effective communication and remains in compliance with the requirements of 45 CFR 85.51 of the Code of Federal Regulations and section 504 of the Rehabilitation Act of 1973.

2. Why We Cannot Use Duplicate Information

The nature of the information we collect and the manner in which we collect it precludes duplication. SSA does not use another collection instrument to obtain similar data.

5. Minimizing Burden on Small Respondents

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

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

If we did not use Form SSA-8, we would have no way to determine eligibility for LSDP, and would be unable to authorize payments to the widow, widower, or children of the deceased beneficiary. Because we collect the information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.

7. 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.

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

SSA published the 60-day advance Federal Register Notice on June 4, 2019 at 84 FR 25891, and we did not receive any public comments in response to this notice. We published the 30-day Federal Register Notice on August 7, 2019 at 84 FR 38714. If we receive any comments in response to the 30-day Notice, we will forward them to OMB. We did not consult with the public on the maintenance of this form.

8. Payment or Gifts to Respondents

SSA does not provide payments or gifts to the respondents.

8. 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.

8. Justification for Sensitive Questions

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

8. Estimates of Public Reporting Burden

Modality of Completion	Number of Respondents	Frequency of Response	Average Burden Per Response (minutes)	Estimated Total Annual Burden (hours)
SSA-8 – MCS/PCS Version	656,623	1	9	98,493
SSA-8 – Paper Version	5,484	1	10	914
Total	662,107			99,407

The total burden for this ICR is 99,407 hours. We based this figure on current management information data, and it represents burden hours. We did not calculate a separate cost burden.

13. Annual Cost to the Respondents (Other)

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

13. Annual Cost To Federal Government

The annual cost to the Federal government is approximately $2,085,465. This estimate accounts for costs from the following areas: (1) designing, printing, and distributing the form; (2) SSA employee (e.g., field office, 800 number, DDS staff) information collection and processing time; and (3) systems development, updating, and maintenance costs.

15. Program Changes or Adjustments to the Information Collection Request

When we last cleared this IC in 2016, the burden was 100,674 hours. However, we are currently reporting a burden of 99,407 hours. This change stems from a decrease in the number of responses from 670,248 to 662,107, which represents normal fluctuation in the respondent base. There is no change to the burden time per response. Although the number of respondents changed, SSA did not take any actions to cause this change.

16. Plans for Publication Information Collection Results

SSA will not publish the results of the information collection.

17. 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 usable forms with expired OMB approval dates, avoiding Government waste .

18. Exceptions to Certification Statement

SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).

B. Collections of Information Employing Statistical Methods

SSA does not use statistical methods for this information collection.

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