[Federal Register Volume 68, Number 246 (Tuesday, December 23, 2003)]
[Notices]
[Pages 74255-74256]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-31538]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review; Comment Request

December 11, 2003.
    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 contacting the Department of Labor. To obtain 
documentation, contact Darrin King on 202-693-4129 (this is not a toll-
free number) or E-Mail: [email protected].
    Comments should be sent to Office of Information and Regulatory 
Affairs, Attn: OMB Desk Officer for the Employment Standards 
Administration (ESA), Office of Management and Budget, Room 10235, 
Washington, DC 20503 (202-395-7316/this is not a toll-free number), 
within 30 days from the date of this publication in the Federal 
Register.
    The OMB 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 submission of responses.
    Agency: Employment Standards Administration.
    Type of Review: Extension of a currently approved collection.
    Title: Notice of issuance of insurance policy.
    OMB Number: 1215-0059.
    Affected Public: Business or other for-profit and State, Local, or 
Tribal Government.
    Type of Response: Reporting.
    Frequency: Annually.
    Number of Respondents: 60.
    Annual Responses: 4,000.
    Estimated Time Per Response: 10 minutes.
    Total Burden Hours: 667.
    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $1,800.
    Description: The CM-921 provides insurance carriers with the means 
to supply the Department of Labor with information showing that a 
responsible coal mine operator is insured against its Federal Black 
Lung compensation liability pursuant to the requirements established in 
the Federal Black Lung Benefits Act. The CM-921 is authorized by 20 CFR 
part V, subpart C, 726.208-213.
    Agency: Employment Standards Administration.
    Type of Review: Extension of a currently approved collection.
    Title: Representative Fee Request.
    OMB Number: 1215-0078.
    Affected Public: Business or other for-profit and individuals or 
households.
    Type of Response: Reporting.
    Frequency: On occasion.
    Number of Respondents: 12,700.
    Number of Annual Responses: 12,700.
    Estimated Time Per Response: 30 minutes for Longshore filings and 1 
hour for FECA filings.
    Total Burden Hours: 7,850.
    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $17,215.
    Description: Individuals filing for compensation benefits with the 
Office of Workers' Compensation Programs (OWCP) may be represented by 
an attorney or other representative. The representative is entitled to 
request a fee for services under the Federal Employees' Compensation 
Act (FECA), 20 CFR 10.700-703, and under the Longshore and Harbor 
Workers' Compensation Act (LHWCA), 20 CFR 702.132. The fee must be 
approved by the OWCP before any demand for payment can be made by the 
representative. This information collection request sets forth the 
criteria for the information, which must be presented by the respondent 
in order to have the fee approved by the OWCP. The information 
collection does not have a particular form or format; the respondent 
must present the information in any format which is convenient and 
which meets all the required information criteria. The Department of 
Labor seeks the extension of approval to collect this information in 
order to carry out its responsibility to approve representative fees 
under the two Acts.
    Agency: Employment Standards Administration.
    Type of Review: Extension of a currently approved collection.
    Title: Request for Employment Information.
    OMB Number: 1215-0105.
    Affected Public: Business or other for-profit.
    Type of Response: Reporting.
    Frequency: On occasion.
    Number of Respondents: 500.
    Number of Annual Responses: 500.
    Estimated Time Per Response: 15 minutes.
    Total Burden Hours: 125.
    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $200.
    Description: The Form CA-1027 is used to collect information about 
a claimant's employment. The information is necessary to determine 
continued eligibility for compensation

[[Page 74256]]

payments under the Federal Employee's Compensation Act (5 U.S.C. 8106).
    Agency: Employment Standards Administration.
    Type of Review: Extension of a currently approved collection.
    Title: Provider Enrollment Form.
    OMB Number: 1215-0137.
    Affected Public: Business or other for-profit.
    Type of Response: Reporting.
    Frequency: On occasion.
    Number of Respondents: 12,600.
    Number of Annual Responses: 12,600.
    Estimated Time Per Response: 8 minutes.
    Total Burden Hours: 1,676.
    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $5,040.
    Description: 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., and the 
Longshore and Harbor Workers' Compensation Act (LHWCA), 33 U.S.C. 901 
et seq. These statutes require OWCP to pay for medical and vocational 
rehabilitation services provided to beneficiaries. In order for OWCP's 
billing contractor to pay providers of these services with its 
automated bill processing system, providers must ``enroll'' with one or 
more of the OWCP programs that administer the statues by submitting 
certain profile information, including identifying information, tax 
I.D. information, and whether they possess specialty or sub-specialty 
training. Form OWCP-1168 is used to obtain this information from each 
provider. If this information is not obtained before the provider 
submits his or her first bill, the bill payment process is prolonged 
and increases the burden on providers. The Department of Labor seeks 
approval for the extension of this information collection in order to 
carry out a wide range of automated medical bill ``edits'', such as, 
the identification of duplicate billings, the application of pertinent 
fee schedules that apply to the programs, utilization review, and fraud 
and abuse detection. This information is also used to furnish timely 
and detailed reports to providers on the status of previously submitted 
bills.

Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 03-31538 Filed 12-22-03; 8:45 am]
BILLING CODE 4510-CK-M