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[Federal Register: April 1, 2003 (Volume 68, Number 62)]
[Notices]
[Page 15784-15789]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr01ap03-102]
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SOCIAL SECURITY ADMINISTRATION
Privacy Act of 1974; Alteration to an Existing System of Records
AGENCY: Social Security Administration (SSA).
ACTION: Notice of alteration to an existing Privacy Act system of
records.
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SUMMARY: In accordance with the Privacy Act (5 U.S.C. 552a(e)(4)) we
are issuing public notice of our intent to alter an existing system of
records, the Claims Folders System, 60-0089, by expanding the
categories of records mentioned in the System. We discuss this proposed
change in the SUPPLEMENTARY INFORMATION section below.
We invite public comments on these proposals.
DATES: We filed a report of the proposed alteration with the Chairwoman
of the Senate Committee on Governmental Affairs, the Chairman of the
House Government Reform Committee, and the Director, Office of
Information and Regulatory Affairs, Office of Management and Budget
(OMB) on March 25, 2003. The proposed alteration will become effective
on May 8, 2003, unless we receive comments on or before that date that
would warrant our not implementing the proposed alteration.
ADDRESSES: Interested individuals may comment on this publication by
writing to the Executive Director, Office of Public Disclosure, Office
of the General Counsel, Social Security Administration, 3-A-6
Operations Building, 6401 Security Boulevard, Baltimore, Maryland
21235-6401. All comments received will be available for public
inspection at the above address.
FOR FURTHER INFORMATION CONTACT: Ms. Linda Thibodeaux, Social Insurance
Specialist, Social Security Administration, Room 3-C-2 Operations
Building, 6401 Security Boulevard, Baltimore, Maryland 21235-6401,
telephone (410) 965-9821, e-mail: linda.thibodeaux@ssa.gov.
SUPPLEMENTARY INFORMATION:
I. Background and Purpose of the Proposed Alteration to Existing
Privacy Act System of Records, the Claims Folders System, 60-0089
A. General Background
The Social Security Administration (SSA) plans to conduct several
pilot projects designed to test and gather information on the use of
photographic identification to address the issue of complicit
impersonation in the disability and blindness claims process. The part
of the disability and blindness determination process used by SSA to
supplement existing medical evidence from treatment sources when there
is not enough information to make a disability or blindness
determination or decision is the consultative examination (CE).
Complicit impersonation is accomplished when an individual posing as
the intended claimant, and with the consent of the claimant, responds
to a CE appointment in order to misrepresent the claimant's true
medical condition or provides false or misleading information that
affects eligibility during interviews with SSA field office employees.
SSA is promulgating temporary regulations that will provide the
authority for us to require individuals filing for title II or title
XVI disability and blindness benefits in the pilot sites to have their
photograph taken. Once these regulations are promulgated, failure to
comply with the pilot requirements will result in denial of benefits.
The claimant identification pilot projects will be in effect for a
six-month period of time that will begin 30 days after final rules
providing regulatory authority for the pilots are published in the
Federal Register. The pilot sites include all SSA field offices in the
States of South Carolina and Kansas; the Augusta, Georgia SSA field
office; and nine SSA field offices located in New York City: Uptown
(Manhattan); East Bronx (Bronx); Parkway (Bronx); West Farms (Bronx);
Bushwick (Brooklyn); East New York (Brooklyn); Avenue X (Brooklyn);
Flatbush (Brooklyn) and Flushing (Queens).
[[Page 15785]]
B. Pilot Methodology
Individuals filing for title II and title XVI disability and
blindness benefits at a Social Security office in the pilot sites will
be required to participate in the claimant identification pilots. In
addition, individuals filing via the Internet or by telephone and who
are later required to undergo CEs will be included in the pilots. Each
individual will be asked to provide some form of photographic
identification. This identification will be photocopied and the copy
will be made part of his/her SSA claims folder. If the individual does
not have photographic identification available or does not wish to
provide it, SSA personnel will not require it but will follow
identification procedures already in place.
Next, as part of the claimant identification pilots, individuals
will be required to have a photograph taken by SSA personnel,
regardless of whether the individual provides photographic
identification for photocopying. (An exception to the photograph
requirement will be permitted when an individual has a sincere
religious objection.) A copy will be made of the image and placed in
the individual's SSA claims folder. Images also will be stored
electronically and accessed by authorized SSA and Disability
Determination Service (DDS) personnel. If DDS personnel request a CE
for the individual, a hard copy image of the photograph will be made
available to the person conducting the CE. This will help to determine
whether the individual appearing for the CE is the same individual who
presented himself or herself as the individual filing for disability
benefits. When the CE physician has not been provided with a photograph
or a copy of a photographic identification previously made by SSA
personnel, e.g., the claim was filed via the Internet or by telephone,
the CE physician will copy the individual's photographic identification
and place it in the claims folder.
Additionally, this same requirement will be used to verify the
identity of pilot participants during the duration of the pilots if
they are required to appear for subsequent interviews including
Continuing Disability Reviews, SSI Redeterminations, and appeals
associated with a denial of a claim including any CEs associated with
those appeals.
II. Impact of the Collection, Maintenance and Use of Pilot Data on SSA
Privacy Act System of Records: The Claims Folders System
The Claims Folders System contains information that constitutes the
basic record for payments and determinations made for program benefits
under the Social Security Act. Included in claim folder records is
identifying information about claimants for Social Security benefits.
We are proposing to revise the description of the categories of
records maintained in the Claims Folders System. In connection with the
claimant identification pilot projects SSA is conducting, records
specifically collected for the pilot projects will be maintained in the
claims folders of those individuals who file for title II or title XVI
disability and blindness benefits for the duration of the pilot. The
records include: photocopies of identification documents, photographs
taken by field office personnel or a report of contact or other
documentation explaining why an individual refused to allow SSA to take
their photograph, flag on the folder indicating the case is part of the
pilot, and the evaluation forms developed for the pilot.
III. Effect of the Proposed Alteration on the Rights of Individuals
SSA's implementation of the claimant identification pilots will
result in the collection and maintenance of information to test the use
of photograph identification to address the issue of complicit
impersonation in the disability and blindness claims process. SSA will
maintain photocopies of identification documents and photographs. We
will afford individuals suspected of fraudulent activities all due
process and other rights to which they are entitled. There is potential
for an adverse effect on those individuals who refuse to be
photographed for reasons other than a sincere religious objection.
Failure to comply with the mandatory requirements of the pilot will
result in denial of benefits.
Dated: March 25, 2003.
Jo Anne B. Barnhart,
Commissioner.
60-0089
System name:
Claims Folders System, Social Security Administration, Office of
the General Counsel, Office of Public Disclosure.
Security classification:
None.
System location:
The claims folders initially are established and maintained in
Social Security field offices when claims for benefits are filed or a
lead is expected to result in a claim. Telephone and address
information for Social Security field offices may be found in local
telephone directories under Social Security Administration (SSA). This
information can also be found on the Agency's Web site, Social Security
Online. The claims folders are retained in field offices until all
development has been completed, and then transferred to the appropriate
processing center as set out below. In addition, the information
provided by Social Security claimants on the application for benefits
is maintained as a computerized record. The computerized records are
maintained at the following address: Social Security Administration,
Office of Systems, 6401 Security Boulevard, Baltimore, MD 21235.
Supplemental Security Income (SSI) claims folders are held in
Social Security field offices pending establishment of a payment
record, or until the appeal period in a denied claim situation has
expired. The folders are then transferred to a folder-staging facility
(FSF) in Wilkes-Barre, Pennsylvania. The address is:
Social Security Administration, SSI Folder Staging Operations,
Wilkes-Barre Data Operations Center, PO Box 7000, Wilkes-Barre, PA
18703.
Retirement and Survivors Insurance (RSI) claims folders are
maintained primarily in the SSA's PSCs (contact the system manager at
the address below for PSC address information). If the individual to
whom the claim pertains resides outside the United States or any of its
possessions, the folder is maintained in the Office of Central
Operations (OCO) Rolling Heights Building (Megasite). The address for
the Megasite is: 2255 Rolling Road, Baltimore, MD 21244.
Disability Insurance (DI) claims folders for individuals under age
55 are maintained primarily in the OCO Megasite (see the address
above).
DI claims folders for disabled individuals age 55 and over are
maintained in SSA's National Records Center (NRC). The address for the
NRC is: 601 S. 291 Hwy., 6000 E. Geospace Dr., Independence, MO 64056.
If the individual to whom the claim pertains resides outside the
United States or any of its possessions, DI claims folders for
individuals are maintained in the OCO Megasite (see the address above).
Special Veterans Benefits (SVB) claims folders are held in Social
[[Page 15786]]
Security field offices and the Veterans Affairs Regional Office (VARO),
Philippines pending establishment of a payment record or until the
appeal period in a denied claim situation has expired. Contact the
system manager for address information for SVB claims folders
maintained in the VARO, Philippines. The VA data file associated with
SVB claims is located in SSA's San Francisco Regional Office. The
address is: Center for Infrastructure, Systems Support Staff, Frank
Hagel Federal Building, 1221 Nevin Avenue, Richmond, California 94801.
In addition, claims folders are transferred to the General Services
Administration and on occasion may be temporarily transferred to other
Federal agencies. The DI claims folders also are transferred to State
agencies for disability and vocational rehabilitation determinations.
Contact the system manager for address information.
Categories of individuals covered by the system:
Claimants, applicants, beneficiaries and potential claimants for
benefits and payments administered by the Social Security
Administration (e.g., title II RSI and DI benefits; and title VIII SVB
and title XVI SSI payments). Folders also are maintained on claims that
have been denied.
Categories of records in the system:
The claims folder contains the name and Social Security number of
the claimant or potential claimant; the application for benefits;
earnings record information established and maintained by SSA;
documents supporting findings of fact regarding factors of entitlement
and continuing eligibility; payment documentation; correspondence to
and from claimants and/or representatives; information about
representative payees; and leads information from third parties such as
social service agencies, IRS, VA and mental institutions. There is also
a VA data file associated with SVB claims. This data includes potential
beneficiaries for title VIII SVB and will be used to help determine
individuals' eligibility.
The claims folder also may contain data collected as a result of
inquiries or complaints, and evaluation and measurement studies of the
effectiveness of claims policies. Separate files may be maintained of
certain actions, which are entered directly into the computer
processes. These relate to reports of changes of address, work status,
and other post-adjudicative reports. Separate files also temporarily
may be maintained for the purpose of resolving problem cases. Separate
abstracts also are maintained for statistical purposes (i.e.,
disallowances, technical denials, and demographic and statistical
information relating to disability decisions).
In addition, the claims folder may contain information collected in
connection with SSA's Claimant Identification Pilot Projects. This
information includes: photocopies of identification documents,
photographs taken by field office personnel or a report of contact or
other documentation explaining why an individual refused to allow SSA
to take their photograph, flag on the folder indicating the case is
part of the pilot, and the evaluation forms developed for the pilot.
Authority for maintenance of the system:
Sections 202-205, 223, 226, 228, 1611, 1631, 1818, 1836, and 1840
(42 U.S.C. Sections 402-405, 423, 426, 428, 1382, 1383, 1395i-2, 1395o
and 1395s and title VIII of the Social Security Act.
Purpose(s):
Each claim constitutes a basic record for payments and
determinations under the Social Security Act. The information in the
claims folder is used to produce and maintain the Master Beneficiary
Record (60-0090), which is the automated payment system for RSI and DI
benefits; the Supplemental Security Income Record (60-0103), which is
the automated payment system for SSI payments for the aged, blind,
disabled and SVB payments under title VIII of the Act; the Black Lung
Payment System (60-0045), which is the payment system for BL claims;
and the Health Insurance Billing and Collection Master Record system
(70-0522) which is the payment system for HI and Supplementary Medical
Insurance (Medicare) benefits.
Claims folders information is used throughout SSA for purposes of
pursuing claims; determining, organizing and maintaining documents for
making determinations of eligibility for benefits, the amount of
benefits, the appropriate payee for benefits; reviewing continuing
eligibility; holding hearings or administrative review processes;
ensuring that proper adjustments are made based on events affecting
entitlement; and answering inquiries.
Claims folders may be referred to State disability determination
services agencies or vocational rehabilitation agencies in disability
cases. They may also be used for quality review, evaluation, and
measurement studies, and other statistical and research purposes.
Extracts may be maintained as interviewing tools, activity logs,
records of claims clearance, and records of type or nature of actions
taken.
Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
Disclosure may be made for routine uses as indicated below.
However, disclosure of any information defined as ``return or return
information'' under 26 U.S.C. 6103 of the Internal Revenue Code (IRC)
will not be disclosed unless authorized by a statute, the Internal
Revenue Service (IRS), or IRS regulations.
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