[Federal Register: July 10, 2002 (Volume 67, Number 132)]
[Notices]
[Page 45766]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr10jy02-139]
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DEPARTMENT OF LABOR
Office of the Secretary
Submission for OMB Review; Comment Request
July 1, 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) 693-4158 or Email Howze-
Marlene@dol.gov.
Comments should be sent to Office of Information and Regulatory
Affairs, Attn: OMB Desk Officer for ESA, Office of Management and
Budget, Room 10235, Washington, DC 20503 ((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: Revision of a currently approved collection.
Agency: Employment Standards Administration (ESA).
Title: FECA Medical Report Forms, Claim for Compensation.
OMB Number: 1215-0103.
Affected Public: Business or other for-profit; Individuals or
households; and Federal Government.
Frequency: As Needed.
Number of Respondents: 286,010.
Number of Annual Responses: 286,010.
Estimated Response Times and Total Burden Hours:
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Average
Form No. Number of minutes per Total burden
respondents response hours
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CA-7............................................................ 400 13 87
CA-16B.......................................................... 130,000 5 10,833
CA-17B.......................................................... 60,000 5 5,000
CA-20........................................................... 65,000 5 5,417
CA-1090......................................................... 200 10 33
CA-1303......................................................... 2,000 20 6667
CA-1305......................................................... 10 20 3
CA-1331......................................................... 200 5 17
CA-1332......................................................... 200 30 100
QCM Letters..................................................... 1,000 5 83
OWCP-5A......................................................... 7,000 15 1,750
OWCP-5B......................................................... 5,000 15 1,250
OWCP-5C......................................................... 15,000 15 3,750
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Burden Totals............................................... 286,010 163 28,990
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Total Annualized Capital/Startup Costs: $0.
Total Annual Costs (operating/maintaining systems or purchasing
services): $105,824.00.
Description: The Office of Workers' Compensation Programs
administers the Federal Employees' Compensation Act (5 U.S.C. 8101, et
seq). The statute provides for continuation of benefits for wage loss
and/or for permanent impairment to a scheduled member, arising out of a
work related injury or disease. The Act outlines the elements of pay
which are to be included in an individual's pay rate, and sets forth
various other criteria for determining eligibility to and the amount of
benefits, including augmentation of basic compensation for individuals
with qualifying dependents; a requirement to report any earnings during
a period that compensation is claimed; a prohibition against concurrent
receipt of FECA benefits and benefits from OPM or certain VA benefits;
and a mandate that money collected from a liable third party found
responsible for the injury for which compensation has been paid be
applied to benefits paid or payable. The CA 7 is used to claim
compensation and the other forms in this clearance collect medical
information necessary to determine entitlement to benefits under the
FECA. Without the requested information, an eligible beneficiary could
be denied benefits, or benefits could be authorized at an incorrect
rate, resulting in an underpayment or overpayment of compensation.
Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 02-17320 Filed 7-9-02; 8:45 am]
BILLING CODE 4510-CH-M