[Federal Register: April 5, 2002 (Volume 67, Number 66)]
[Notices]
[Page 16439-16441]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05ap02-106]
-----------------------------------------------------------------------
DEPARTMENT OF LABOR
Office of the Secretary
Submission for OMB Review; Comment Request
March 25, 2002.
The Department of Labor (DOL) has submitted the following public
information collection requests (ICRs) to the Office of Management and
Budget (OMB) for review and approval in accordance with the Paperwork
Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. Chapter 35). A copy of
each individual ICR, with applicable supporting documentation, may be
obtained by calling the Department of Labor. To obtain documentation
contact Marlene Howze at (202) 219-8904 or Email Howze-Marlene@dol.gov.
Comments should be sent to the Office of Information and Regulatory
Affairs, Attn: OMB Desk Officer for ESA, Office of Management and
Budget, Room 10235, Washington, DC 20503
[[Page 16440]]
((202) 395-7316), within 30 days from the date of this publication in
the Federal Register.
The OMB is particularly interested in comments which:
Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
Evaluate the accuracy of the agency's estimate of the
burden of the proposed collection of information, including the
validity of the methodology and assumptions used;
Enhance the quality, utility, and clarity of the
information to be collected; and minimize the burden of the collection
of information on those who are to respond, including through the use
of appropriate automated, electronic, mechanical, or other
technological collection techniques or other forms of information
technology, e.g., permitting electronic submission of responses.
Type of Review: Extension of a currently approved collection.
Agency: Employment Standards Administration (ESA).
Title: Miner's Claim for Benefits Under the Black Lung Benefits
Act; (2) Employment History; (3) Miner Reimbursement Form.
OMB Number: 1215-0052.
Affected Public: Individuals or households; Business or other for-
profit.
Frequency: On Occasion.
Total Respondents/Responses: 20,200.
Total Burden Hours: 9,116.
------------------------------------------------------------------------
Estimated
Respondents/ time per Burden
Form responses response hours
(min)
------------------------------------------------------------------------
CM-911.......................... 4,800 45 3,600
CM-911a......................... 5,900 40 3,933
CM-915.......................... 9,500 10 1,583
------------------------------------------------------------------------
Total Annualized Capital/Startup Costs: $0.
Total Annual Costs (operating/maintaining systems or purchasing
services): $4,060.75.
Description: The Black Lung Benefits Act of 1977, as amended, 30
U.S.C. 901 et. seq., provides for the payment of benefits to coal
miners who are totally disabled by black lung disease, and to certain
survivors. The CM-911 is the application for benefits. The CM-911a,
which is completed along with the CM-911, renders a complete history of
employment and is used to establish employment criteria for benefit
eligibility. CM-915 is the standard data collection form used by miner
payees when requesting reimbursement for black lung related medical
services. If the information were not collected, the requirement of the
Act would not be met and the potential for making improper
reimbursements to the miner payees would increase and, in some cases,
delay program reimbursements on medical treatment claims.
Type of Review: Extension of a currently approved collection.
Agency: Employment Standards Administration (ESA).
Title: Pre-Hearing Statement.
OMB Number: 1215-0085.
Affected Public: Individuals or households; Business or other for-
profit.
Frequency: On Occasion.
Number of Respondents: 6,800.
Number of Annual Responses: 6,800.
Estimated Time Per Response: 10 minutes.
Total Burden Hours: 1,088.
Total Annualized Capital/Startup Costs: $0.
Total Annual Costs (operating/maintaining systems or purchasing
services): $2,595.50.
Description: Title 20, CFR 702.317 provides for the referral of
claims under the Longshore and Harbor Workers' Compensation Act. This
Act provides benefits to workers' injured in maritime employment on the
navigable waters of the United States or in an adjoining area
customarily used by an employer in loading, unloading, repairing, or
building a vessel. The LS-18 is used to refer cases to the Office of
Administrative Law Judges for formal hearings under the Act. The
information obtained is used to establish and clarify the issues
involved and to prepare cases for formal hearings. If the information
were not collected, there would not be a uniform method of referring
cases for formal hearings or a means to determine the issues involved
for resolution.
Type of Review: Extension of a currently approved collection.
Agency: Employment Standards Administration (ESA).
Title: Overpayment Recovery Questionnaire.
OMB Number: 1215-0144.
Affected Public: Individuals or households.
Frequency: On occasion.
Number of Respondents: 4,500.
Number of Annual Responses: 4,500.
Estimated Time Per Response: 1 hour.
Total Burden Hours: 4,500.
Total Annualized Capital/Startup Costs: $0.
Total Annual Costs (operating/maintaining systems or purchasing
services): $1,665.00.
Description: The Federal Coal Mine Health and Safety Act of 1969,
as amended, 30 U.S.C. 923(b) and 20 CFR 725.544(c) authorize the Black
Lung program to collect information to determine whether or not the
recovery of any Black Lung or Federal Employees' Compensation (FECA)
overpayment may be waived compromised, terminated, or collected in
full. The OWCP-20 collects information to ascertain the financial
profile of beneficiaries who have been overpaid benefits, and their
ability to repay. If the information were not collected, Black Lung and
FECA would have little basis to decide on collection proceedings.
Type of Review: Extension of a currently approved collection.
Agency: Employment Standards Administration (ESA).
Title: Claim for Continuance of Compensation.
OMB Number: 1215-0154.
Affected Public: Individuals or households.
Frequency: Annually.
Number of Respondents: 5,900.
Number of Annual Responses: 5,900.
Estimated Time Per Response: 5 minutes.
Total Burden Hours: 492.
Total Annualized Capital/Startup Costs: $0.
Total Annual Costs (operating/maintaining systems or purchasing
services): $2,006.00.
Description: The Office of Workers' Compensation Programs (OWCP)
administers the Federal Employees' Compensation Act, 5 U.S.C. 8133.
Under the Act, eligible dependents of deceased employees receive
compensation benefits on account of the employee's death. The CA-12 is
used to
[[Page 16441]]
obtain information on marital status of beneficiaries in death cases,
in order to determine continued entitlement to benefits under the
provisions of the Federal `Employees' Compensation Act. If the
information were not collected the OWCP could not ensure that death
benefits being paid are correct and that payments are not made to
ineligible survivors.
Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 02-8264 Filed 4-4-02; 8:45 am]
BILLING CODE 4510-CK-M