[Federal Register Volume 67, Number 132 (Wednesday, July 10, 2002)]
[Notices]
[Page 45766]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-17320]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review; Comment Request

July 1, 2002.
    The Department of Labor (DOL) has submitted the following public 
information collection requests (ICRs) to the Office of Management and 
Budget (OMB) for review and approval in accordance with the Paperwork 
Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35). A copy of 
each individual ICR, with applicable supporting documentation, may be 
obtained by calling the Department of Labor. To obtain documentation 
contact Marlene Howze at ((202) 693-4158 or Email [email protected].
    Comments should be sent to Office of Information and Regulatory 
Affairs, Attn: OMB Desk Officer for ESA, Office of Management and 
Budget, Room 10235, Washington, DC 20503 ((202) 395-7316), within 30 
days from the date of this publication in the Federal Register.
    The OMB 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 submission of responses.
    Type of Review: Revision of a currently approved collection.
    Agency: Employment Standards Administration (ESA).
    Title: FECA Medical Report Forms, Claim for Compensation.
    OMB Number: 1215-0103.
    Affected Public: Business or other for-profit; Individuals or 
households; and Federal Government.
    Frequency: As Needed.
    Number of Respondents: 286,010.
    Number of Annual Responses: 286,010.
    Estimated Response Times and Total Burden Hours:

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                                                                                      Average
                            Form No.                                 Number of      minutes per    Total burden
                                                                    respondents      response          hours
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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              33
CA-1303.........................................................           2,000              20            6667
CA-1305.........................................................              10              20               3
CA-1331.........................................................             200               5              17
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
                                                                 -----------------------------------------------
    Burden Totals...............................................         286,010             163          28,990
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    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $105,824.00.
    Description: The Office of Workers' Compensation Programs 
administers the Federal Employees' Compensation Act (5 U.S.C. 8101, et 
seq). The statute provides for continuation of benefits for wage loss 
and/or for permanent impairment to a scheduled member, arising out of a 
work related injury or disease. The Act outlines the elements of pay 
which are to be included in an individual's pay rate, and sets forth 
various other criteria for determining eligibility to and the amount of 
benefits, including augmentation of basic compensation for individuals 
with qualifying dependents; a requirement to report any earnings during 
a period that compensation is claimed; a prohibition against concurrent 
receipt of FECA benefits and benefits from OPM or certain VA benefits; 
and a mandate that money collected from a liable third party found 
responsible for the injury for which compensation has been paid be 
applied to benefits paid or payable. The CA 7 is used to claim 
compensation and the other forms in this clearance collect medical 
information necessary to determine entitlement to benefits under the 
FECA. Without the requested information, an eligible beneficiary could 
be denied benefits, or benefits could be authorized at an incorrect 
rate, resulting in an underpayment or overpayment of compensation.

Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 02-17320 Filed 7-9-02; 8:45 am]
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