[Federal Register Volume 75, Number 18 (Thursday, January 28, 2010)]
[Notices]
[Pages 4586-4587]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-1642]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Division of Federal Employees' Compensation; Proposed Extension 
of the Approval of Information Collection Requirements

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 Office of Workers' Compensation Programs is soliciting 
comments concerning the proposed collection: Death Gratuity Forms (CA-
40, CA-41, and CA-42). 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 March 29, 2010.

ADDRESSES: Mr. Vincent Alvarez, U.S. Department of Labor, 200 
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0372, fax (202) 693-1378, e-mail [email protected]. 
Please use only one method of transmission for comments (mail, fax, or 
e-mail).

SUPPLEMENTARY INFORMATION 

I. Background

    The National Defense Authorization Act for Fiscal Year 2008, Public 
Law 110-181, was enacted on January 28, 2008. Section 1105 of Public 
Law 110-181 amended the Federal Employees' Compensation Act (FECA) 
creating a new section 8102a effective upon enactment. This section 
established a new FECA death gratuity benefit for eligible 
beneficiaries of Federal employees and Non-Appropriated Fund 
Instrumentality (NAFI) employees who die from injuries incurred in 
connection with service with an Armed Force in a contingency operation. 
Section 8102a also permits agencies to authorize retroactive payment of 
the death gratuity for employees who died on or after October 7, 2001, 
in service with an Armed Force in the theater of operations of 
Operation Enduring Freedom and Operation Iraqi Freedom. Form CA-40 
requests the information necessary from the employee to accomplish this 
variance. Form CA-41 provides the means for those named beneficiaries 
and possible recipients to file claims for those benefits and requests 
information from such claimants so that OWCP may determine their 
eligibility for payment. Furthermore, the statute and regulations 
require agencies to notify OWCP immediately upon the death of a covered 
employee. CA-42 provides the means to accomplish this notification and 
requests information necessary to administer any claim for benefits 
resulting from such a death. This information collection is currently 
approved for use through May 31, 2010.

II. Review Focus

    The Department of Labor is particularly interested in comments 
which:

[[Page 4587]]

    * 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 
submissions of responses.

III. Current Actions

    The Department of Labor seeks extension of approval to collect this 
information in order to carry out its responsibility to meet the 
statutory requirements of the Federal Employees' Compensation Act. The 
information contained in these forms is used by the Division of Federal 
Employees' Compensation to determine entitlement to benefits under the 
Act, to verify dependent status, and to initiate, continue, adjust, or 
terminate benefits based on eligibility criteria.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: Death Gratuity Forms.
    OMB Number: 1215-0206.
    Agency Number: CA-40, CA-41, and CA-42.
    Affected Public: Individuals or household; Federal Government.
    Total Respondents: 2,635.
    Total Responses: 2,635.

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                                      Time to
               Form                  complete      Frequency of      Number of       Number of     Hours burden
                                       (min)         response       respondents      responses
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CA-40 (Individual Respondent)...              15               1           2,600           2,600             650
CA-41 (Individual Respondent)...              15               1              25              25            6.25
CA-42 (Agency Respondent).......              20               1              10              10            3.33
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    Totals......................  ..............  ..............           2,635           2,635          659.58
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    Estimated Total Burden Hours: 659
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $12.
    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: January 22, 2010.
Vincent Alvarez,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
Department of Labor.
[FR Doc. 2010-1642 Filed 1-27-10; 8:45 am]
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