[Federal Register Volume 70, Number 29 (Monday, February 14, 2005)]
[Notices]
[Pages 7519-7520]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-2789]


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DEPARTMENT OF LABOR


Office of the Secretary; Submission for OMB Review: Comment 
Request

February 3, 2005.
    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 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: Certification of Funeral Expenses.
    OMB Number: 1215-0027.
    Form Number: LS-265.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Business and other for-profit.
    Number of Respondents: 195.
    Annual Reponses: 195.
    Average Response Time: 15 minutes.
    Total Annual Burden Hours: 49.
    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $78.00.
    Description: The Office of Workers' Compensation Programs 
administers the Longshore and Harbor Workers' Compensation Act. The Act 
provides benefits to workers injured in maritime employment on the 
navigable waters of the United States or in an adjoining area 
customarily used by an employer in loading, unloading, repairing, or 
building a vessel. The Act provides that reasonable funeral expenses 
not to exceed $3,000 shall be paid in all compensable death cases. The 
LS-265 has been provided for use in submitting the funeral expenses for 
payment.

    Agency: Employment Standards Administration.
    Type of Review: Extension of currently approved collection.
    Title: (1) Comparability of Current Work to Coal Mine Employment; 
(2) Coal Mine Employment Affidavit; (3) Affidavit of Deceased Miner's 
Condition.
    OMB Number: 1215-0056.
    Form Numbers: CM-913; CM-918; and CM-1093.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Individuals or households.
    Number of Respondents: 1,500.

------------------------------------------------------------------------
                                                    Average
                                        Annual     response     Annual
                Form                   responses     time       burden
                                                    (hours)      hours
------------------------------------------------------------------------
CM-913..............................       1,350        0.50         675
CM-918..............................          75        0.17          13
CM-1093.............................          75        0.33          25
                                     -------------
  Total.............................       1,500  ..........         713
------------------------------------------------------------------------

    Total Annualized Capital/Startup Costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $600.00.
    Description: The Black Lung Benefits Act of 1977, as amended, 30 
U.S.C. 901 et seq., provides for the payment of benefits to coal miners 
who have contracted black lung disease as a result of coal mine 
employment, and their dependents and survivors. Once a miner has been 
identified as having performed non-coal mine work subsequent to coal 
mine employment, the miner or the miner's survivor is asked to complete 
a CM-913 to compare coal mine work to non-coal mine work. This 
employment information along with medical information is used to 
establish whether the miner is totally disabled due to black lung 
disease caused by coal mine employment. The CM-918 is an affidavit used 
to gather coal mine employment evidence only when primary evidence, 
such as pay stubs, W-2 forms, employer and union records, and Social 
Security records are unavailable or incomplete. The CM-1093 is an 
affidavit form for recording lay medical evidence, used in survivors' 
claims in which there is no medical evidence that addresses the miner's 
pulmonary or respiratory condition.
    Agency: Employment Standards Administration.
    Type of Review: Revision of currently approved collection.
    Title: Roentgenographic Interpretation (CM-933); Roentgenographic 
Quality Rereading (CM-933b); Medical History and Examination for Coal 
Mine Workers' Pneumoconiosis (CM-988); Report of Arterial Blood Gas 
Study (CM-1159); and Report of Ventilatory Study (CM-2907).
    OMB Number: 1215-0090.

[[Page 7520]]

    Form Numbers: CM-933; CM-933b; CM-988; CM-1159; and CM-2907.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Business and other for-profit and Not-for-profit 
institutions.
    Number of Respondents: 17,500.

----------------------------------------------------------------------------------------------------------------
                                                                     Number of        Average
                              Form                                    annual      response  time  Annual  burden
                                                                     responses        (hours)          hours
----------------------------------------------------------------------------------------------------------------
CM-933..........................................................           3,500            0.08             292
CM-933b.........................................................           3,500            0.05             175
CM-988..........................................................           3,500            0.50           1,750
CM-1159.........................................................           3,500            0.25             875
CM-2907.........................................................           3,500            0.33           1,167
                                                                 -----------------
    Total:......................................................          17,500  ..............           4,259
----------------------------------------------------------------------------------------------------------------

    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $0.
    Description: The Black Lung Act Benefits Act of 1977 as amended, 30 
U.S.C. 901 et seq. and 20 CFR 718.102 set forth criteria for the 
administration and interpretation of x-rays. When a miner applies for 
benefits, the Division of Coal Mine Workers' Compensation is required 
to schedule a series of four diagnostic tests to help establish 
eligibility for black lung benefits. Each of the diagnostic tests has 
its own form that sets forth the medical results. The forms are: CM-
933, Roentgenographic Interpretation; CM-933b, Roentgenographic Quality 
Rereading; CM-988, Medical History and Examination for Coal Mine 
Workers' Pneumoconiosis; CM-1159, Report of Arterial Blood Gas Study; 
and CM-2907, Report of Ventilatory Study.
    The Department of Labor seeks the approval of this information in 
order to carry out its responsibility to determine eligibility for 
black lung benefits.

Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 05-2789 Filed 2-11-05; 8:45 am]
BILLING CODE 4510-23-P