Proposed Collection; Comment Request [Notices] [08/08/1997]
Proposed Collection; Comment Request [08/08/1997]
Volume 62, Number 153, Page 42825[DOCID:fr08au97-113]
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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 is soliciting
comments concerning a proposed extension information collection: CM-
936, Authorization for Release of Medical Information.
Copies of the proposed information collection request can be
obtained by contacting the office listed below in the addresses section
of this notice.
DATES: Written comments must be submitted to the office listed in the
ADDRESSES section below on or before October 8, 1997. The Department of
Labor is particularly interested in comments which:
<bullet> 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;
<bullet> 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;
<bullet> enhance the quality, utility and clarity of the
information to be collected; and
<bullet> 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.
ADDRESSES: Ms. Margaret Sherrill, U.S. Department of Labor, 200
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone
(202) 219-7601. (This is not a toll-free number.) Fax 202-219-6592.
SUPPLEMENTARY INFORMATION:
I. Background
The Federal Mine Safety and Health Act of 1977, as amended (30
U.S.C. 923) and 20 CFR 725.405 require that all relevant medical
evidence be considered before a decision can be made regarding a
claimant's eligibility for benefits. The CM-936 is a form that gives
the claimant's consent for the release of medical information covered
by the Privacy Act of 1974, and contains information required by
medical institutions and private physicians to enable them to release
pertinent medical information.
II. Current Actions
The Department of Labor (DOL) seeks extension of approval to
collect this information in order to obtain the claimant's consent for
medical institutions and private physicians to release medical
information to the Division of Coal Mine Workers Compensation, as
evidence to support their claim. Failure to gather this information
would inhibit the adjudication of black lung claims because pertinent
medical data would not be considered, during claims processing.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Authorization for Release of Medical Information.
OMB Number: 1215-0057.
Agency Numbers: CM-936.
Affected Public: Individuals or households.
Total Respondents: 3,000.
Frequency: Once.
Total Response: 3,000.
Average Time Per Response for Reporting: 5 minutes.
Estimated Total Burden Hours: 250.
Total Burden Cost (capital/startup): 0.
Total Burden Cost (operating/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 requests; they will also become
a matter of public record.
Dated: August 5, 1997.
Cecily A. Rayburn,
Director, Division of Financial Management, Office of Management,
Administration and Planning, Employment Standards Administration.
[FR Doc. 97-21028 Filed 8-7-97; 8:45 am]
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