Supporting Statement--0434

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Supporting Statement for Travel Expense Reimbursement

20 CFR 404.999(d) and 416.1499

OMB Control No. 0960-0434

A. Justification

1. Sections 201(j), 1631(h) and 1817(i) of the Social Security Act, provide the authority to pay certain travel expenses incurred by a claimant to appear at a medical examination, or to a claimant and his/her representative and unsubpoenaed witnesses traveling over 75 miles to a medical examination or a hearing before an administrative law judge. These regulations require the claimant to submit proof of travel costs in order to be reimbursed. This is a request for clearance of the information collection requirements contained in 20 CFR 404.999 (d) and 416.1499 of the Code of Federal Regulations.

2. The claimant is required to submit an itemized list of actual travel expenses and supporting receipts which were incurred in order to attend a hearing or medical examination. The State agency or Federal agency will review the list and receipts to determine the amount to be reimbursed. Without this reporting requirement we would be unable to reimburse the claimant for his travel expenses. The respondents are claimants for Title II benefits and Title XVI payments.

3. Since this is not a form, and the respondents are required to submit the original receipts for the travel expenses, we are not able to make this collection available electronically at this time. Should improved technology become available which would allow the original receipts to be fully electronic, SSA will reconsider the possibility of collecting this information electronically.

4. The nature of the information being collected and the manner in which it is collected preclude duplication. While the SSA-104 (currently pending approval at OMB) requests similar information to that which is collected through these regulations, it is used only in specific cases pertaining to Consultative Examinations which are arranged by SSA and is voluntary for claimants to use (they may still submit their request as stated in these regulations and not through use of a form). Also, the SSA-104 only covers travel reimbursement as stated in 20 CFR 404.999 and does not cover those regulations at 20 CFR 416.1499. Because we are not able to use the SSA-104 for those claimants who are traveling to a hearing, we still require the use of this collection.

5. This collection does not impact small businesses or other small entities.

6. To collect this information less frequently would delay reimbursement and would result in financial hardship to the claimant. In advance payment cases, it would prevent the claimant from appearing at a medical examination or disability hearing, thus preventing adjudication of the claim. Since the information is only collected when necessary, it cannot be collected less frequently. There are no technical or legal obstacles that prevent burden reduction.

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

8. The 60-day advance Federal Register Notice was published on August 6, 2007 at 72 FR 43674, and SSA has received no public comments. The second Notice was published on October 18, 2007 at 72 FR 59132. There have been no outside consultations with members of the public.

9. SSA provides no payment or gifts to the respondents.

10. The information provided via this process is protected and held confidential 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 A-130.

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

12. The average frequency of response has been shown as once per year, but an individual may be required to provide this information more than once in connection with his or her claim. This has been considered in estimating the total number of responses at 50,000 per year. Since each response takes approximately 10 minutes, the annual hour burden is estimated to be 8,333 hours. The total burden is reflected as burden hours and no separate cost burden has been calculated.

13. There is no known cost burden to the respondents.

14. The annual cost to the Federal Government is approximately $208,800. This estimate is based on the knowledge that it will take 10 minutes per response to process these requests, for a total of 8,333 hours. Based on quarters one and two, fiscal year 2007 cost data for the disability determination services (DDS), this processing will cost approximately $208,800. This is cost to the Federal government, since the DDSs are 100% Federally funded.

15. There have been no program changes or adjustments in this form, and there is no change in the public reporting burden.

16. The results of this information collection will not be published.

17. SSA is not requesting an exemption to display the expiration date for OMB approval of the information collection since there is no form involved in this collection.

18. 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. Collection of Information Employing Statistical Methods

Statistical methods are not used for this information collection.