TN 38 (12-21)

DI 39506.231 Preparation Instructions for Form SSA-4514

A. Description of Form SSA-4514

The Form SSA-4514 is used to report the number of hours worked by staffing category and employment status (i.e., full-time, part-time, temporary). This report should reflect all hours worked by personnel engaged in the SSA disability program during the reporting period. See DI 39506.240.B.2. for instructions regarding the reporting of personnel used to process Federal Employee Medicare Only cases.

B. Procedure - Form Heading

Enter the name of the agency, State, and the last day of the quarter for which you are reporting (e.g., March 31, YYYY, June 30, YYYY, etc.).

C. Procedure - Report Columns

1. Column A (on duty hours—excluding overtime)

For each staffing category listed under lines 1-3 (full-time, part-time, and temporary), enter the hours worked during the reporting period by all personnel engaged in the SSA disability program--excluding overtime. The entries in this column should not include hours for holidays observed by the State agency, sick, annual, or other paid or unpaid leave.

2. Column B (holiday and leave hours)

For each staffing category listed under lines 1-3 (full-time, part-time, and temporary), enter the hours for holidays observed by the State agency and for sick, annual, or other paid leave (e.g., lump sum leave, military leave, etc.). The entries in this column should include the proportionate share of holidays and leave time of the regular staff of the agency who worked part-time on the SSA disability program.

3. Column C (total hours--exluding overtime)

This column should reflect the sum of column A (On Duty Hours—excluding overtime) and column B (Holiday and Leave Hours).

4. Column D (overtime hours)

For each staffing category listed under lines 1-3 (full-time, part-time, and temporary), enter the overtime hours worked during the report period by all personnel engaged in the SSA disability program.

5. Column E (total hours)

This column should reflect the total hours to include overtime (sum of columns C and D).     

6. Column F (equivalent full-time positions)

The FTE calculation is based on the workyear (WY)--a standardized unit for measurement of government personnel effort and costs. A workyear is the equivalent of 2,080 work hours. The overtime workyear is equivalent to 1,755 hours because these hours do not include holidays, sick, annual, or other paid leave.

This column should represent the quarterly FTE calculation for each staffing category listed under lines 1-3 (full-time, part-time, and temporary). The quarterly FTE calculation is the sum of column C (divided by 520 hours) plus column D (divided by 438.75 hours).
For example, the calculation for each line would be as follows:

  •  

    (column C/520 hrs) + (column D/438.75 hrs) = FTE

Computations should be carried to two decimal places.

D. Procedure - Line Item Reporting

1. Total full-time personnel

The total full-time personnel should reflect the sum of the entries on lines 1 a through l. The entries should represent only personnel who worked full-time on SSA disability program work. (Temporary personnel--regardless of the number of hours worked--should not be reported here.)

  • Line 1 a and b (Administrative Personnel and Supervisors)

    The entries should represent: (1) the number of work hours chargeable to professional disability program staff who spend full time on non-adjudicative functions such as supervision, administration, organization and methods work, etc., and/or (2) the number of such supervisory hours chargeable to those professional disability program staff members who regularly divide their time between supervisory and adjudicative duties. In the latter instance where actual time records of the time devoted to supervisory duties are maintained, the entries should be made on the basis of such time records. Otherwise, the best possible estimate of the actual division of time should be made, with time-record confirmation of this division at regular intervals. These instructions also apply to the holiday and leave time entries under column B.

  • Lines 1 c through l (Examiners, Hearing Officers, Clericals, Consultants, QA Personnel, Vocational Specialists, Systems Specialists, etc.)

    The entries should represent the number of hours chargeable to staff/consultants who work full-time on SSA disability program work

2. Total part-time personnel

The total part-time personnel should reflect the sum of the entries on lines 2 a through l.

Line 2 a through l (Administrative Personnel, Supervisors, Examiners, Hearing Officers, Clericals, Consultants, QA Personnel, Vocational Specialists, Systems Specialists, etc.)

The entries should represent the number of hours charged to persons working part-time on the SSA disability program.

Where a medical consultant is being paid solely on the basis of the number of hours actually worked, the entry will be on that basis. Where a medical consultant works a predetermined number of hours a week, e.g., 10 hours per week, the entry for hours worked should be an extension of these hours for the quarter. Where a medical consultant is paid on a monthly stipend or case-cost basis, the entry for hours should be estimated if other records are not available

3. Total temporary personnel

This line should reflect DDS personnel hired into temporary positions (full-time and part-time). Do not include acquisition of contract services (e.g., Kelly Services, etc.).

  • Line 3a (Full Time)
    Enter the total hours charged to temporary personnel working full-time on the disability program.

  • Line 3b (Part Time)

    Enter the total hours charged to temporary personnel working part-time on the disability program.

4. Total direct personnel services

This line should reflect the sum of the entries on lines 1 through 3 above (full-time, part-time, and temporary).

5. Total FTE (calculation)

The line reflects the FTE calculation for regular time (line 4--for columns A and C--divided by 520 hours) and overtime (line 4--for column D--divided by 438.57 hours).

E. Procedure - Remarks Section

Explain in this space any unusual situations (e.g., leave without pay, lump sum leave payments, extended sick leave, military leave, staff hours spent attending conferences, etc.) or any other comments necessary to clarify the report.

F. Procedure - Signature/Title/Date

Form SSA-4514 may be signed by any appropriate State agency official., however, no signature is required.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0439506231
DI 39506.231 - Preparation Instructions for Form SSA-4514 - 12/15/2021
Batch run: 12/15/2021
Rev:12/15/2021