[Federal Register Volume 62, Number 153 (Friday, August 8, 1997)]
[Notices]
[Page 42825]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-21028]


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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:
     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.

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]
BILLING CODE 4510-27-M