[Federal Register Volume 70, Number 19 (Monday, January 31, 2005)]
[Notices]
[Pages 4891-4892]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-1670]


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RAILROAD RETIREMENT BOARD


Proposed Collection; Comment Request

SUMMARY: In accordance with the requirement of section 3506 (c)(2)(A) 
of the Paperwork Reduction Act of 1995 which provides opportunity for 
public comment on new or revised data collections, the Railroad 
Retirement Board (RRB) will publish periodic summaries of proposed data 
collections.
    Comments are invited on: (a) Whether the proposed information 
collection is necessary for the proper performance of the functions of 
the agency, including whether the information has practical utility; 
(b) the accuracy of the RRB's estimate of the burden of the collection 
of the information; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden related to the collection of information on respondents, 
including the use of automated collection techniques or other forms of 
information technology.
    Title and Purpose of Information Collection: Medical Reports; OMB 
3220-0038.
    Under Sections 2(a)(1)(iv), 2(a)(2) and 2(a)(3) of the Railroad 
Retirement Act (RRA), annuities are payable to qualified railroad 
employees whose physical or mental condition is such that they are 
unable to (1) work in their regular occupation (occupational 
disability); or (2) work at all (permanent total disability). The 
requirements for establishment of disability and proof of continuance 
of disability are prescribed in 20 CFR part 220.
    Under sections 2(c)(1)(ii)(c) and 2(d)(1)(ii) of the RRA, annuities 
are also payable to qualified spouses and widow(ers), respectively, who 
have a qualified child who is under a disability which began before age 
22. Annuities are also payable to surviving children on the basis of 
disability under section 2(d)(1)(iii)(C) if the child's disability 
began before age 22 and to widow(ers) on the basis of disability under 
section 2(d)(1) (i)(B). To meet the disability standard, the RRA 
provides that individuals must have a permanent physical or mental 
condition such that they are unable to engage in any regular 
employment.
    Under section 2(d)(1)(v) of the RRA, annuities are also payable to 
remarried and surviving divorced spouses on the basis of, inter alia, 
disability or having a qualified disabled child in care. However, the 
disability standard in these cases is that found in the Social Security 
Act. That is, individuals must be able to engage in any substantial 
gainful activity by reason of any medically determinable physical or 
mental impairment. The RRB also determines entitlement to a period of 
early disability and early Medicare entitlement for qualified claimants 
in accordance with Section 216 of the Social Security Act.
    When making disability determinations, the RRB needs evidence from 
acceptable medical sources. The RRB currently utilizes Forms G-3EMP, 
Report of Medical Condition by Employer; G-250, Medical Assessment; G-
250a, Medical Assessment of Residual Functional Capacity; G-260, Report 
of Seizure Disorder; RL-11b, Disclosure of Hospital Medical Records; 
and RL-11d, Disclosure of Medical Records from a State Agency; to 
obtain the necessary medical evidence.
    The RRB proposes significant changes to the information collection. 
The primary change is to add proposed Form G-197, Authorization to 
Release Medical Information, to the information collection. Proposed 
Form G-197 will be the standard Health Insurance Portability and 
Accountability Act (HIPAA) compliant release form used by the RRB to 
obtain consent for the release of medical evidence under the RRA. The 
RRB also proposes to revise, renumber, and rename current Form G-250 to 
proposed Form RL-250, Request for Medical Assessment. Currently, Form 
G-250, requests a narrative report, copies of office records of the 
claimant's treatment, requests completion of Form G-250a, and includes 
a consent statement that the claimant must sign. Proposed Form RL-250 
will not request the narrative report nor contain a consent statement. 
A new Form G-250, titled Medical Assessment is proposed. It is intended 
to provide more complete information while being more user-friendly by 
formatting responses into a question and answer format by body system 
being evaluated. Forms G-3EMP, and RL-11b are being revised to delete 
the consent portions from the versions currently in use. Minor 
editorial changes are proposed to Form G-250a which will continue to be 
used by agency hearings officers as a means to clarify, when necessary, 
information previously received or to obtain precise information needed 
to make a residual functional capacity determination. No changes are 
proposed to Form G-260. Completion is voluntary. One response is 
requested of each respondent.

                                          Estimate of Respondent Burden
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                        Form No.                          Annual response       Time (min)       Burden (hours)
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G-3EMP.................................................                600                 10                100
G-197..................................................              6,000                 10              1,000
G-250..................................................             11,950                 30              5,975
G-250a.................................................                 50                 20                 17
G-260..................................................                100                 25                 42
RL-11b.................................................              5,000                 10                833
RL-250.................................................             11,950                 10              1,992
                                                        --------------------
    Total..............................................             35,900  .................              9,501
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[[Page 4892]]


FOR FURTHER INFORMATION CONTACT: To request more information or to 
obtain a copy of the information collection justification, forms, and/
or supporting material, please call the RRB Clearance Officer at (312) 
751-3363 or send an e-mail request to [email protected]. Comments 
regarding the information collection should be addressed to Ronald J. 
Hodapp, Railroad Retirement Board, 844 North Rush Street, Chicago, 
Illinois 60611-2092 or send an e-mail to [email protected]. Written 
comments should be received within 60 days of this notice.

Charles Mierzwa,
Clearance Officer.
[FR Doc. 05-1670 Filed 1-28-05; 8:45 am]
BILLING CODE 7905-01-P