[Federal Register Volume 68, Number 241 (Tuesday, December 16, 2003)]
[Notices]
[Pages 70037-70038]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-30968]


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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 proposed collection: Medical Travel Refund 
Request (OWCP-957). A copy 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 February 17, 2004.

ADDRESSES: Ms. Hazel M. Bell, U.S. Department of Labor, 200 
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0418, fax (202) 693-1451, Email [email protected]. Please 
use only one method of transmission for comments (mail, fax, or Email).

SUPPLEMENTARY INFORMATION 

I. Background

    The Office of Workers' Compensation Programs (OWCP) administers the 
Federal Employees' Compensation Act (FECA), 5 U.S.C. 8101 et seq., the 
Black Lung Benefits Act (BLBA), 30 U.S.C. 901 et seq., and the Energy 
Employees Occupational Illness Compensation Program Act of 2000 
(EEOICPA), 42 U.S.C. 7384 et seq. All three of these statutes require 
that OWCP reimburse beneficiaries for travel expenses incurred for 
covered medical treatment. In order to determine whether amounts 
requested as travel expenses are appropriate, OWCP must receive certain 
data elements, including the signature of the physician for expenses 
claimed under the BLBA. Form OWCP-957 is the standard format for the 
collection of these data elements. The OWCP-957 is used by OWCP and its 
contractor bill processing staff to process reimbursement requests for 
travel expenses. This information collection is currently approved for 
use through June 30, 2004.

[[Page 70038]]

II. Review Focus

    The Department of Labor is particularly interested in comments 
which:
    [sbull] 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;
    [sbull] 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;
    [sbull] Enhance the quality, utility and clarity of the information 
to be collected; and
    [sbull] 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.

III. Current Actions

    The Department of Labor seeks approval for the extension of this 
information collection in order to carry out its responsibility to 
determine if requests for reimbursement for out-of-pocket expenses 
incurred when traveling to medical providers for covered medical 
testing or treatment should be paid.
    Type of Review: Extension.
    Agency: Employment Standards Administration.
    Title: Medical Travel Refund Request.
    OMB Number: 1215-0054.
    Agency Number: OWCP-957.
    Affected Public: Individual or households.
    Total Respondents: 52,221.
    Total Responses: 52,221.
    Time Per Response: 10 minutes.
    Frequency: On occasion.
    Estimated Total Burden Hours: 8,669.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $19,000.
    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: December 10, 2003.
Bruce Bohanon,
Chief, Branch of Management Review and Internal Control, Division of 
Financial Management, Office of Management, Administration and 
Planning, Employment Standards Administration.
[FR Doc. 03-30968 Filed 12-15-03; 8:45 am]
BILLING CODE 4510-27-P