Effective Date: January 11, 2006
(71 F.R. 1844)
SOCIAL SECURITY ADMINISTRATION NOTICE OF SYSTEM OF RECORDS REQUIRED BY
THE PRIVACY ACT OF 1974
SYSTEM NUMBER: 60-0228
System name:
Safety
Management Information System (SSA Accident, Injury and Illness Reporting
System), Social Security Administration, Deputy Commissioner for Finance,
Assessment and Management, Office of Facilities Management.
Security classification:
None.
System Location:
Social Security Administration
Office
of Facilities Management
Room 2-J-9
Categories of individuals covered by the system:
Social Security
Administration (SSA) employees, who are involved in an accident which arises
out of and in the course of their employment whether occurring on SSA premises
or not and results in:
(a) A fatality;
(b) Lost workdays beyond the day in which
the accident occurred;
(c) Nonfatal injuries which result in
transfer to another job, termination of employment, medical treatment other
than first aid, loss of consciousness or restriction of work or motion;
(d) A possible tort claim;
(e) A claim for compensation;
(f) Property damage in excess of $50;
(g) Interruption or interference with the
orderly progress of work of other employees;
(h) Radiation overexposure;
(i) Biological
exposure resulting in lost time or of accidental release of biologicals
where the public may be over-exposed. It also covers visiting scientists,
contractor personnel;
(j) Hospitalized patients, out-patients,
employees of other Federal agencies, State or local governments or members of
the public who suffer injury, illness or property damage on or in SSA premises
or as a result of SSA activities.
Categories of Records in the system:
This system
consists of a variety of information and supporting documentation resulting
from the reporting and investigation of accidents which have resulted in
injury, illness, property damage or the interruption or interference with the
orderly progress of work.
The records contain information about
individuals involved in, or experiencing, accidents including, but not limited
to, the severity of the injury, whether consciousness was lost, the type of
injury, culmination of any injury, days lost from work, if any, the nature of
the injury, illness or disease, the body part affected, causal factors, weather
factors, agency of accident, whether unsafe mechanical, physical, or personal
acts or factors were involved, the accident's area of origin and if fire was
involved, the type and form of materials involved.
Property damage (both public and private)
is noted through the property sequence number, who owned the property involved,
property damage and actual or estimated monetary loss, the SSA installation
number, if appropriate, and the year of manufacture or construction if
appropriate.
Identifiers relating to a particular
accident include the organization, case number assigned, date and time of
occurrence, State or territory, site, type and classification of accident,
estimated amount of tort claims, if appropriate, name of individual(s)
involved, the Social Security number (SSN), sex, age, grade series and level,
Computer Sciences Corporation (CSC) series, address, other departments notified
of accident, duty status, activity at time of accident and time on duty before
accident. Management's evaluation and corrective action taken or proposed is
also noted.
Authority for maintenance of the system:
Section
19 of the Occupational Safety and Health Act of 1970 (Pub. L. 91-596, 29 U.S.C. 651, et seq.); 5 U.S.C. 7902; 29 CFR part
1960; Executive Order (E.O.) No. 12196 (45 FR 12769 4/26/80).
Purpose(s):
The purpose of
the system is to comply with the reporting and statistical analyses
requirements of section 19 of the Occupational Safety and Health Act (OSHA) of
1970 (Pub. L. 91-596) as amended (29 U.S.C. 668); 5 U.S.C. 7902; 29 CFR Part
1960; E.O. 12196 and such other purposes as are described below. The Safety
Management Information System is a SSA-wide system utilized by all
organizational components of the Agency. Thus, in addition to the routine uses
subsequently noted in this system notice, there may be other ad hoc disclosures
within the Agency on an official business ``need-to-know'' basis. Some of the
purposes are the following:
Establish a written record of the causes
of accidents;
Provide information to initiate and
support corrective or preventive action;
Provide statistical information relating
to accidents resulting in occupational injuries; illnesses, and/or property
damage;
Provide management with information with
which to evaluate the effectiveness of safety management programs;
Provide the means for complying with the
reporting requirements of section 19 of the Occupational Safety and Health Act
of 1970 and such other reporting requirements as may be required by legislative
or regulative requirements;
Provide such other summary descriptive
statistics and analytical studies as necessary in support of the function for
which the records are collected and maintained including general requests for
statistical information without personal identification of individuals;
Information in these records is used by or
may be disclosed to:
The Office of Facilities Management (OFM),
Office of the Deputy Commissioner for Finance, Assessment and Management
(DCFAM), in the review of accident experience data to determine the adequacy of
corrective actions, the effect of codes, standards and guides, the
consolidation, summarization and dissemination of accident experience data
throughout SSA and other government departments and agencies as needed or
required;
The supervisor, administrative officer or
other official initiating an accident report, including each succeeding
reviewing official in the chain of command through which the report passes, to
insure that corrective action, as needed and appropriate, is taken; and
Appropriately appointed
Safety Directors, Officers, or others with safety responsibilities within the
Agency in the verifying, assembling, analyzing, summarizing and disseminating
data concerning the accident in their areas of responsibility and in the
initiation of appropriate corrective action.
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:
1. To a Federal, State, local agency or
private sources to obtain information relevant to the investigation of an
accident and/or corrective action.
2. To a congressional office in response to
an inquiry from that office made at the request of the subject of the record.
3. To the Department of Justice (DOJ), a
court or other tribunal, or another party before such tribunal, when:
(a) The Social Security Administration
(SSA), or any component thereof; or
(b) Any SSA employee in his/her official
capacity; or
(c) Any SSA employee in his/her individual
capacity where DOJ (or SSA where it is authorized to do so) has agreed to
represent the employee; or
(d) The United States or any agency thereof
where SSA determines that the litigation is likely to affect the operations of
SSA or any of its components, is a party to the litigation or has an interest
in such litigation, and SSA determines that the use of such records by DOJ, a
court or other tribunal, or another party before tribunal, is relevant and
necessary to the litigation, provided, however, that in each case, SSA
determines that such disclosure is compatible with the purpose for which the
records were collected.
4. To Federal, State, or local law
enforcement agencies if a record maintained by this agency to carry out its functions
indicates a violation or potential violation of law, whether civil, criminal or
regulatory in nature.
5. To student volunteers, individuals
working under a personal services contract, and other workers who technically
do not have the status of Federal employees, when they are performing work for
the Social Security Administration (SSA), as authorized by law, and they need
access to personally identifiable information in SSA records in order to
perform their assigned Agency functions.
6. To the General Services Administration
and the National Archives Records Administration (NARA) under 44 U.S.C. 2904
and 2906, as amended by the NARA Act of 1984, information which is not
restricted from disclosure by Federal law for the use of those agencies in
conducting records management studies.
7. We
may disclose information to appropriate Federal, State, and local agencies,
entities, and persons when (1) we suspect or confirm that the security or
confidentiality of information in this system of records has been compromised;
(2) we determine that as a result of the suspected or confirmed compromise
there is a risk of harm to economic or property interests, identity theft or
fraud, or harm to the security or integrity of this system or other systems or
programs of SSA that rely upon the compromised information; and (3) we
determine that disclosing the information to such agencies, entities, and
persons is necessary to assist in our efforts to respond to the suspected or
confirmed compromise and prevent, minimize, or remedy such harm. SSA will use
this routine use to respond only to those incidents involving an unintentional
release of its records.
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Records are
maintained in automated format (e.g., on magnetic tapes, discs, computer
storage,) and in paper form (e.g., punch cards, lists, forms, in file folders,
binders and index cards).
Retrievability:
Records are
retrieved by name, SSN, case number or cross reference.
Safeguards:
Access to, and
use of, those records is limited to those persons whose official duties require
such access. Personnel screening is employed to prevent unauthorized
disclosure. Access http://www.socialsecurity.gov/foia/bluebook/app_g.htm for additional
information relating to SSA data security measures.
Retention and disposal:
All accident
reports, records, logs, and other information relating to an accident are
retained by Headquarters and components for at least five years following the
end of the calendar year in which the accident occurred. Specific occupational
safety and health standards (such as the standards, covering the handling of
carcinogenic chemicals) may be required to be kept for up to twenty years.
Records may be retained indefinitely.
System manager(s) and address(es):
Safety Manager
Office
of Facilities Management
Social Security Administration
Notification procedures:
An individual
can determine if this system contains a record about him/her by writing to the
system manager(s) at the above address and providing his/her name, SSN or other
information that may be in the system of records that will identify him/her. An
individual requesting notification of records in person should provide the same
information, as well as provide an identity document, preferably with a
photograph, such as a driver's license or some other means of identification.
If an individual does not have any identification documents sufficient to
establish his/her identity, the individual must certify in writing that he/she
is the person claimed to be and that he/she understands that the knowing and
willful request for, or acquisition of, a record pertaining to another
individual under false pretenses is a criminal offense.
If notification is requested by telephone,
an individual must verify his/her identity by providing identifying information
that parallels information in the record to which notification is being
requested. If it is determined that the identifying
information provided by telephone is insufficient, the individual will be
required to submit a request in writing or in person. If an individual
is requesting information by telephone on behalf of another individual, the
subject individual must be connected with SSA and the requesting individual in
the same phone call. SSA will establish the subject individual's identity
(his/her name, SSN, address, date of birth and place of birth, along with one
other piece of information, such as mother's maiden name) and ask for his/her
consent in providing information to the requesting individual.
If a request for notification is submitted
by mail, an individual must include a notarized statement to SSA to verify
his/her identity or must certify in the request that he/she is the person
claimed to be and that he/she understands that the knowing and willful request
for, or acquisition of, a record pertaining to another individual under false
pretenses is a criminal offense. These procedures are in accordance with SSA
Regulations (20 CFR 401.40(c)).
Record access procedures:
Same
as Notification procedures. Requester should also reasonably identify
the record, specify the record contents being sought, and state time and brief
description of the accident in which they were involved. These procedures are
in accordance with SSA Regulations (20 CFR 401.40(c)).
Contesting record procedures:
Same
as Notification procedures. Requester should also reasonably identify
the record, specify the information they are contesting and the corrective
action sought, and the reasons for the correction, with supporting
justification showing how the record is incomplete, untimely, inaccurate or
irrelevant. These procedures are in accordance with SSA Regulations (20 CFR
401.65(a)).
Record source categories:
The information
in this system is obtained from the following sources:
(1) The
individual to whom the record pertains;
(2) witnesses to the accident;
(3) investigation officials (Federal, State, local);
(4) medical personnel seeing the individual as a result of the
accident;
(5) supervisory
personnel;
(6) reviewing officials;
(7) personnel offices;
(8) investigative
material furnished by Federal, State, or local agencies; and
(9) on site observations.
Systems exempted from certain provisions of the Privacy Act:
None.