[Federal Register Volume 69, Number 160 (Thursday, August 19, 2004)]
[Notices]
[Pages 51483-51484]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-19001]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review: Comment Request

August 12, 2004.
    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 ICR, with applicable supporting documentation, may be obtained by 
contacting the Department of Labor (DOL). 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:
     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.
    Agency: Employment Standards Administration.
    Type of Review: Extension of currently approved collection.
    Title: Employer's First Report of Injury or Occupational Disease; 
Physician's Report on Impairment of Vision; and Employer's 
Supplementary Report of Accident or Occupational Illness.
    OMB Number: 1215-0031.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Business and other for-profit and not-for-profit 
institutions.
    Number of Respondents: 21,060.

------------------------------------------------------------------------
                                                  Average       Annual
               Form                   Annual      response      burden
                                    responses    time hours     hours
------------------------------------------------------------------------
LS-202...........................       21,000         0.25        5,250
LS-205...........................           60         0.75           45
LS-210...........................        2,160         0.25          540
                                  --------------
    Total........................       23,220  ...........        5,835
------------------------------------------------------------------------

    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $10,333.
    Description: The Longshore and Harbor Workers' Compensation Act 
provides benefits to workers injured in maritime employment on the 
navigable waters of the United States and adjoining area customarily 
used by an employee in loading, unloading, repairing, or building a 
vessel. The Form LS-202 is used by employers initially to report 
injuries that have occurred which are covered under the Longshore Act 
and its related statutes. The Form LS-210 is used to report additional 
periods of lost time from work. The Form LS-205 is a medical report 
based on a comprehensive examination of visual impairment. Regulatory 
authority is found in 20 CFR 702.201, 702.202, and 702.407.

    Agency: Employment Standards Administration.
    Type of Review: Extension of currently approved collection.
    Title: Operator Controversion; Operator Response; Operator Response 
to Schedule for Submission of Additional Evidence; and Operator 
Response to Notice of Claim.
    OMB Number: 1215-0058.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Business or other for-profit and State, local, or 
tribal government.
    Number of Respondents: 8,200.

------------------------------------------------------------------------
                                                  Average       Annual
               Form                   Annual      response      burden
                                    responses    time hours     hours
------------------------------------------------------------------------
CM-970...........................          100         0.25           25
CM-970a..........................          100         0.17           17

[[Page 51484]]

 
CM-2970..........................        4,000         0.17          667
CM-2970a.........................        4,000         0.25        1,000
                                  --------------
    Total........................        8,200  ...........        1,709
------------------------------------------------------------------------

    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $3,280.
    Description: The Black Lung Benefits Act (30 U.S.C. 901 et seq.) 
provides benefits to coal miners totally disabled due to pneumoniosis, 
and their surviving dependents. When the Division of Coal Mine Workers' 
Compensation makes an initial finding that an applicant is eligible for 
benefits, and, if a coal mine operator has been identified as 
potentially liable for payment of those benefits, the responsible 
operator is notified of the initial finding. The CM-970 gives the 
operator an opportunity to controvert the liability. The CM-970A is 
sent to the operator with the Notice of Claim notifying the operator of 
potential liability of payment for benefits. The CM-970A gives the 
operator an opportunity to agree or disagree with the identification. 
The CM-970A is used for all claims filed before January 19, 2001. The 
CM-2970 and CM-2970A serve the same purposes as the CM-970 and CM-970A; 
however, these forms are be used for all claims filed after January 19, 
2001. Regulatory authority is found in 20 CFR 725.408, 725.410, 
725.412, and 725.413.

Ira Mills,
Departmental Clearance Officer.
[FR Doc. 04-19001 Filed 8-18-04; 8:45 am]
BILLING CODE 4510-CF-P