[Federal Register Volume 60, Number 187 (Wednesday, September 27, 1995)]
[Notices]
[Pages 49922-49923]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-23976]



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DEPARTMENT OF LABOR

Employment Standards Administration


Proposed Information Collection Request

    Submitted for Public Comment and Recommendations; (1) Report of 
Ventilatory Study; Roentgenographic Interpretation; Medical History and 
Examination for Coal Mine Workers' Pneumoconiosis; Report of Arterial 
Blood Gas Study.
    (2) Survivors Claim for Benefits Under the Black Lung Benefits Act.
    (3) Black Lung Provider Enrollment Form.

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 is minimized, reporting forms are clearly understood, 
and the impact of collection requirements on respondents can be 
properly assessed. Currently, the Employment Standards Administration 
is soliciting comments concerning the proposed extension collection of 
several information collections, as listed above, under the Office of 
Workers' Compensation Programs (OWCP), Division of Coal Mine Workers' 
Compensation (DCMWC). A copy of the proposed information collection 
requests can be obtained by contacting the employee listed below in the 
ADDRESSEE section of this notice.

DATES: Written comments must be submitted on or before November 28, 
1995. Written comments should address the accuracy of the burden 
estimates 

[[Page 49923]]
and ways to minimize burden including the use of automated collection 
techniques or the use of other forms of information technology, as well 
as, other relevant aspects of the information collection request.

ADDRESSES: Ms. Patricia Forkel, Office of Management, Administration 
and Planning, U.S. Department of Labor, 200 Constitution Ave., NW., S-
3201, Washington, D.C. 20210, (202) 219-7601) (this is not a toll free 
number).

SUPPLEMENTARY INFORMATION: 

I. Background

    (A) Report of Ventilatory Study; Roentgenographic Interpretation; 
Medical History and Examination for Coal Mine Workers' Pneumoconiosis; 
Report of Arterial Blood Gas Study: The Office of Workers' Compensation 
Programs, which administers the Black Lung Benefits Act, use these 
forms to gather information relative to the medical condition of a 
claimant who is alleging the presence of peneumoconiosis as a routine 
function of the claim adjudication process.
    (B) Survivor's Claim for Benefits Under the Black Lung Benefits 
Act: A survivor of a coal miner must file a claim for benefits under 
the Black Lung Benefits Act, as amended, in order to receive benefits. 
The claim and supporting documentation submitted under this information 
collection are reviewed by DCMWC claims examiners to determine the 
survivor's eligibility for benefits.
    (C) Black Lung Provider Enrollment Form: Specific requirements for 
the Federal Black Lung Program to provide medical services by 
authorized medical providers to black lung beneficiaries are set forth 
in statute. This form is designed to facilitate the collection of 
information about medical providers and the payment of bills for the 
medical services they perform.

II. Continuation of These Information Collections Is Necessary for the 
Agency To Determine the Proper Status of a Claimant and His/Her 
Entitlement to Benefits, and To Ensure That Medical Providers Are Paid 
for the Medical Services They Perform for the Black Lung Program

    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Report of Ventilatory Study; Roentgenographic 
Interpretation; Medical History and Examination for Coal Mine Workers' 
Pneumoconiosis; Report of Arterial Blood Gas Study.
    OMB Number: 1215-0090.
    Affected public: Businesses or other for-profit; non-for-profit 
institutions.
    Frequency: One time.

------------------------------------------------------------------------
                                 No. of       Est. time per     Subtotal
         Agency No.           respondents       response         hours  
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CM-907......................       7,425   20 min............      2,475
CM-933......................      14,850   5 min.............      1,238
CM-933b.....................         675   5 min.............         56
CM-988......................       7,425   30 min............      3,712
CM-1159.....................       7,425   15 min............      1,856
Total Burden Hours: 9,338                                               
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    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Survivor's Claim for Benefits Under the Black Lung Benefits 
Act.
    OMB Number: 1215-0069.
    Agency Number: CM-912.
    Frequency: One time.
    Affected Public: Individuals or households.
    Number of Respondents: 1,200.
    Hours per Response: 25 minutes.
    Total Burden Hours: 500.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Black Lung Provider Enrollment Form.
    OMB Number: 1215-0137.
    Agency Number: CM-1168.
    Frequency: One time.
    Affected Public: Businesses or other for-profit.
    Number of Respondents: 6,500.
    Estimated time per respondent: 3 to 7 minutes.
    Total Burden Hours: 525.
    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: September 22, 1995.
Cecily A. Rayburn,
Director, Division of Financial Management, Office of Management, 
Administration and Planning, Employment Standards Administration.
[FR Doc. 95-23976 Filed 9-26-95; 8:45 am]
BILLING CODE 4510-27-M