Proposed Collection; Comment Request [Notices] [03/21/2002]
Proposed Collection; Comment Request [03/21/2002]
Volume 67, Number 55, Page 13195-13196
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DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Collection; Comment Request
ACTION: Notice.
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SUMMARY: The Department of Labor, as part of its continuing effort to
reduce paperwork and respondent burden, conducts a preclearance
consultation program to provide the general public and Federal agencies
with an opportunity to comment on proposed and/or continuing
collections of information in accordance with the Paperwork Reduction
Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to
ensure that requested data can be provided in the desired format,
reporting burden (time and financial resources) is minimized,
collection instruments are clearly understood, and the impact of
collection requirements on respondents can be properly assessed.
Currently, the Employment Standards Administration, Office of Workers'
Compensation Programs (OWCP) is soliciting comments concerning the
following proposed collections: (1) FECA Medical Report Forms and Claim
for Compensation (CA-16b, CA-17b, CA-20, CA-1090, CA-1303, CA-1305, CA-
1306, CA-1314, CA-1316, CA-1331, CA-1332, CA-1336, OWCP-5a, OWCP-5b,
OWCP-5c, and CA-7); and (2) Rehabilitation Action Report (OWCP-44). A
copy of the proposed information collection requests can be obtained by
contacting the office listed below in the addressee section of this
Notice.
DATES: Written comments must be submitted to the office listed in the
addressee section below on or before May 20, 2002.
ADDRESSES: Ms. Patricia A. Forkel, U.S. Department of Labor, 200
Constitution Ave., N.W., Room S-3201, Washington, D.C. 20210, telephone
(202) 693-0339, fax (202) 693-1451, EMail pforkel@feix2.dol-esa.gov.
Please use only one method of transmission for comments (mail, fax, or
e-mail).
SUPPLEMENTARY INFORMATION:
FECA Medical Report Forms (CA-16b, CA-17b, CA-20, CA-1090, CA-1303,
CA-1305, CA-1331, CA-1332, QCM letters, OWCP-5a, OWCP-5b, OWCP-5c),
and Claim for Compensation (CA-7)
I. Background
The Federal Employees' Compensation Act (FECA) provides for the
payment of benefits for wage loss and/or for permanent impairment to a
scheduled member, arising out of a work related injury or disease.
Before compensation may be paid, the case file must contain medical
evidence showing that the claimant's disability is causally related to
the claimant's federal employment. As a particular claim ages, there is
continuing need for updated information to support continuing benefits.
The FECA Medical Report Forms collect medical information from
physicians which is necessary to determine entitlement to benefits
under the Act. Form CA-7, Claim for Compensation, requests information
from the injured worker regarding pay rate, dependents, earnings, dual
benefits, and third-party information. This information collection is
approved by the Office of Management and Budget for use through August
2002.
II. Review Focus
The Department of Labor 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 submissions of responses.
III. Current Actions
The Department of Labor seeks approval of this information
collection request in order to carry out its statutory responsibility
to compensate injured employees under the provisions of the Act. The
OWCP has carefully reviewed usage of these forms and has determined
that three forms formerly included as part of this OMB clearance
number, (CA-1306, CA-1314, and CA-1316,) have not been used in the past
year and are obsolete. These forms have been eliminated. The CA-1336
formerly approved as part of this information collection request has
been replaced by the QCM Letters. In addition, the CM-1090, the OWCP
5a, 5b, and 5c have been revised.
Type of Review: Revision.
Agency: Employment Standards Administration.
Title(s): Claim for Compensation, FECA Medical Reports.
OMB Number: 1215-0103.
Agency Number(s): CA-16b, CA-17b, CA-20, CA-1090, CA-1303, CA-1305,
CA-1331, CA-1087, QCM letters, OWCP-5a, OWCP-5b, OWCP-5c), and Claim
for Compensation (CA-7).
Affected Public: Individuals or households; businesses or other
for-profit; Federal government.
Frequency: As needed.
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Average
Form No. of minutes per Burden hours
respondents response
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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 34
CA-1303......................................................... 2,000 20 667
CA-1305......................................................... 10 20 3
CA-1331......................................................... 200 5 17
[[Page 13196]]
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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Total Responses: 286,010.
Estimated Total Burden Hours: 28,991.
Total Burden Cost (capital/startup): $0.
Total Burden Cost (operating/maintenance): $105,824.
Rehabilitation Action Report (OWCP 44)
I. Background
The Office of Workers' Compensation Programs (OWCP) administers the
Federal Employees' Compensation Act. Section 8104(a) of the Act
provides that eligible injured workers are furnished vocational
rehabilitation services. The costs of these services are paid from the
Employees' Compensation Fund. The Rehabilitation Action Report (OWCP-
44) is submitted by a rehabilitation counselor to report transition
periods in the vocational rehabilitation process and to request prompt
adjudicatory action. The form gives prompt notification of key events
requiring action in the vocational rehabilitation process. The form is
currently approved by the Office of Management and Budget OMB for use
through August 2002.
II. Review Focus
The Department of Labor 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 submissions of responses.
III. Current Actions
The Department of Labor seeks an extension of approval to collect
this information in order to gather information to enable OWCP to make
timely, informed decisions about rehabilitation services for an injured
worker. There is no change to the form since the last approval.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Rehabilitation Action Report.
OMB Number: 1215-0182.
Agency Number: OWCP-44.
Affected Public: Businesses or other for-profit; individuals or
households.
Frequency: On occasion.
Total Respondents: 7,000.
Time per Response: 30 minutes.
Estimated Total Burden Hours: 3,500.
Total Burden Cost (capital/startup): $0.
Total Burden Cost (operation/maintenance): $0.
Comments submitted in response to this notice will be summarized
and/or included in the request for Office of Management and Budget
approval of the information collection request; they will also become a
matter of public record.
Dated: March 15, 2002.
Gary D. Thayer,
Director, Division of Financial Management, Office of Management,
Administration and Planning, Employment Standards Administration.
[FR Doc. 02-6866 Filed 3-20-02; 8:45 am]
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