[Federal Register Volume 64, Number 92 (Thursday, May 13, 1999)]
[Notices]
[Pages 25914-25916]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-12089]


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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 the following proposed extension collections: (1) 
Regulations, 29 CFR Part 801, Application of the Employee Polygraph 
Protection Act of 1988; (2) Certificate of Medical Necessity (CM-893); 
(3) Representative Payee Report (CM-623), Representative Payee Report 
(CM-623S), and Physician's/Medical Officer's Report (CM-787); (4) 
Housing Terms and Conditions (WH-521); and (5) 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, A-1332, CA-1336, 
OWCP-5a, OWCP-5b, OWC-5c, and CA-7). 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 July 14, 1999. 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. Patricia A. Forkel, U. S. Department of Labor, 200 
Constitution Ave., N.W., Room S-3201, Washington, D.C. 20210, telephone 
(202) 693-0339 (this is not a toll-free number), fax (202) 693-1451.

SUPPLEMENTARY INFORMATION:

Regulations, 29 CFR Part 801, Application of the Employee Polygraph 
Protection Act of 1988

    I. Background: The Employee Polygraph Protection Act of 1988 (EPPA) 
prohibits most private employers from using any lie detector tests 
whether for preemployment screening or during the course of employment. 
The law contains several limited exemptions which authorize polygraph 
tests under certain conditions. Section 5 of the Act requires the 
Secretary of Labor to promulgate such rules and regulations as may be 
necessary to carry out the Act and require the keeping of records 
necessary or appropriate for the administration of the Act.
    II. Current Actions: The Department of Labor seeks an extension of 
approval of the recordkeeping and third party disclosure requirements 
of the regulations in order to insure that polygraph examinees receive 
the rights and protections mandated by the Act.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: 29 CFR Part 801, Application of the Employee Polygraph 
Protection Act.
    OMB Number: 1215-0170.
    Agency Number: None.
    Affected Public: Individuals or households; Business or other for-
profit; Not-for-profit institutions.
    Total Respondents: 328,000.
    Frequency: Recordkeeping; Reporting on occasion; Third party 
disclosure.
    Total Responses: 328,000.
    Time per Response: 1 minute to \1/2\ hour.
    Estimated Total Burden Hours: 82,406.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $0.

Certificate of Medical Necessity, CM-893

    I. Background: 30 USC 932 of Public Law 803, as amended, stipulates 
that coal miners eligible for black lung benefits will be furnished 
medical treatment, including services and apparatus, for such period as 
the nature of the illness (pneumoconiosis) or process of recovery will 
require.
    II. Current Actions: The Department of Labor seeks the extension of 
approval to collect this information in order to determine if the miner 
meets the specific impairment standards to qualify for durable medical 
equipment, home nursing care and/or pulmonary rehabilitation.
    Type of Review: Extension.

[[Page 25915]]

    Agency: Employment Standards Administration.
    Title: Certificate of Medical Necessity.
    OMB Number: 1215-0113.
    Agency Number: CM-893.
    Affected Public: Businesses or other for-profit; Individuals or 
households.
    Total Respondents: 9,000.
    Frequency: On occasion.
    Total Responses: 9,000.
    Average Time per Response: 20 to 40 minutes.
    Estimated Total Burden Hours: 3,600.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $0.

Representative Payee Report (CM-623), Representative Payee Report 
(CM-623S), Physician's/Medical Officer's Report (CM-787)

    I. Background: Benefits due to a black lung beneficiary under the 
Federal Mine Safety and Health Act (30 USC 901) may be paid to a 
representative payee on behalf of the beneficiary when the beneficiary 
is unable to manage his/her benefits due to incapability, incompetence 
or minority. The CM-623 is sent to representative payees who are not 
relatives of the beneficiary. The CM-623S, which is a shortened version 
of the CM-623, is sent to representative payees who are relatives of, 
and live with, the beneficiary. In a small number of cases, it is 
necessary to determine the incapability or incompetence of a 
beneficiary to manage his/her monthly benefits. The CM-787 is a form 
used to collect certain medical information from a physician regarding 
a beneficiary's competency.
    II. Current Actions: The Department of Labor seeks extension of 
approval to collect this information in order to determine the 
beneficiary' capability to manage their monthly black lung benefits, 
and to ensure that benefits paid to a representative payee are used for 
the beneficiary's well-being.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title(s): Representative Payee Report, Physician/Medical Officer's 
Report.
    OMB Number: 1215-0173.
    Agency Number(s): CM-623, CM-623S, CM-787.
    Affected Public: Individuals or households; Businesses or other 
for-profit; Not-for-profit institutions.

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                                                                                   Average time
                 Form                      Number of            Frequency          per response    Burden  hours
                                          respondents                                (minutes)
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CM-623................................           2,275  Annually................              90           3,413
CM-623S...............................             600  Annually................              10             100
CM-787................................             223  Once....................              15              56
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    Total Responses: 3,098.
    Estimated Total Burden Hours: 3,569.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $1,035.

Housing Terms and Conditions (WH-521)

    I. Background: Section 201(c) of the Migrant and Seasonal 
Agricultural Worker Protection Act (MSPA) requires that any farm labor 
contractor, agricultural employer, or agricultural association that 
provides housing to any migrant agricultural worker, post in a 
conspicuous place or present to such worker a statement of the terms 
and conditions, if any, of occupancy of such housing. Form WH-521 is an 
optional form which may be used to post or present to a migrant 
agricultural worker a listing of the terms and conditions for occupancy 
of housing.
    II. Current Actions: The Department of Labor seeks extension of 
approval of this information collection in order to carry out it's 
statutory responsibility to ensure that farm labor contractors, 
agricultural employers, and agricultural associations have disclosed to 
migrant workers the terms and conditions of occupancy at each site 
where housing is provided by such employers.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Housing Terms and Conditions.
    OMB Number: 1215-0146.
    Agency Number: WH-521.
    Affected Public: Farms; Individuals or households; Businesses or 
other for-profit.
    Total Respondents: 1,300.
    Frequency: On occasion; Third party disclosure.
    Total Responses: 1,300.
    Time per Response: 30 min.
    Estimated Total Burden Hours: 650.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $0.

FECA Medical Report Forms (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 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. Form CA-7, Claim for Compensation, requests information 
from the injured worker regarding pay rate, dependents, earnings, dual 
benefits, and third-party information. The medical report forms collect 
medical information necessary to determine entitlement to benefits.
    II. Current Actions: The Department of Labor seeks an extension of 
approval for this information collection request in order to carry out 
its statutory responsibility to compensate injured employees under the 
provisions of the Act.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title(s): Claim for Compensation, FECA Medical Reports.
    OMB Number: 1215-0103.
    Agency Number(s): CA-7, 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.
    Affected Public: Individuals or households; Businesses or other 
for-profit; Federal government.
    Frequency: As needed.

[[Page 25916]]



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                                                                                     Average
                              Form                                  Number 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..........................................................          80,000               5          6,667
CA-1090........................................................             325               5             27
CA-1303........................................................           3,000              20          1,000
CA-1305........................................................              10              20              3
CA-1306........................................................               3              10               .5
CA-1314........................................................             125              20             42
CA-1316........................................................              15              10              2.5
CA-1331........................................................             250               5             21
CA-1332........................................................             500              30            250
CA-1336........................................................           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: 302,628.
    Estimated Total Burden Hours: 30,766.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $109.
    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: May 6, 1999.
Margaret J. Sherrill,
Chief, Branch of Management Review and Internal Control, Office of 
Management, Administration and Planning, Employment Standards 
Administration.
[FR Doc. 99-12089 Filed 5-12-99; 8:45 am]
BILLING CODE 4510-27-P