[Federal Register Volume 76, Number 96 (Wednesday, May 18, 2011)]
[Notices]
[Pages 28818-28819]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-12215]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Division of Federal Employees' Compensation Proposed Renewal of 
the Existing Collection; Comment Request

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: Claim for Compensation 
(CA-7); Authorization for Examination and/or Treatment (CA-16); Duty 
Status Report (CA-17); Attending Physician's Report (CA-20); Request 
for the Services of an Attendant (CA-1090); Referral to a Medical 
Specialist (CA-1305); OWCP Requirements for Audiological Examination 
(CA-1087); Referral for a Complete Audiologic and Otologic Examination 
(CA-1331); Outline for Audiologic Examination (CA-1332); Work Capacity 
Evaluation, Psychiatric/Psychological Conditions (OWCP-5a); Work 
Capacity Evaluation, Cardiovascular/Pulmonary Conditions (OWCP-5b); and 
Work Capacity Evaluation, Musculoskeletal Conditions (OWCP-5c). 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 July 18, 2011.

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 Office of Workers' Compensation Programs (OWCP) administers the 
Federal Employees' Compensation Act (FECA), 5 U.S.C. 8101 et seq. The 
statute provides for the payment of benefits for wage loss and/or for 
permanent impairment to a scheduled member, arising out of a work 
related injury or disease. The Act outlines the elements of pay which 
are to be included in an individual's pay rate, and sets forth various 
other criteria for determining eligibility to and the amount of 
benefits, including: Augmentation of basic compensation for individuals 
with qualifying dependents; a requirement to report any earnings during 
a period that compensation is claimed; a prohibition against concurrent 
receipt of FECA benefits and benefits from OPM or certain VA benefits; 
a mandate that money collected from a liable third party found 
responsible for the injury for which compensation has been paid is 
applied to benefits paid or payable. This information collection is 
currently approved for use through September 30, 2011.

II. Review Focus

    The Department of Labor 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 submissions of responses.

III. Current Actions

    The Department of Labor seeks extension of approval to collect this 
information collection in order to carry out its statutory 
responsibility to compensate injured employees under the provisions of 
the Act.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: FECA Medical Reports, Claim for Compensation.
    OMB Number: 1240-0046.
    Agency Number: CA-7; CA-16; CA-17; CA-20; CA-1090; CA-1305; CA-
1087; CA-1331; CA-1332; OWCP-5a; OWCP-5b; and OWCP-5c
    Affected Public: Individuals or households; Business or other for-
profit; Federal Government.
    Total Respondents: 232,853.

[[Page 28819]]



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                                                                       Number of
                  Form                        Time to complete         responses            Hours burden
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CA-7...................................  13 min...................             500                           108
CA-16..................................  5 min....................          33,699                         2,808
CA-17..................................  5 min....................         143,965                        11,997
CA-20..................................  5 min....................          43,097                         3,591
CA-1090................................  10 min...................             225                            38
CA-1305................................  20 min...................             130                            43
CA-1331/CA-1087 *......................  5 min....................           1,108                            92
CA-1332................................  30 min...................              10                             5
OWCP-5's...............................  15 min...................          10,119                         2,530
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    Totals.............................  .........................         232,853                        21,212
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* Responses and hours associated with Form CA-1087 are included in the estimates for the Form CA-1331. The Form
  CA-1087 is attached to the Form CA-1331.

    Total Annual Responses: 232,853.
    Average Time per Response: 5 minutes-30 minutes.
    Estimated Total Burden Hours: 21,212.
    Frequency: As Needed.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $109,441.
    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: May 13, 2011.
Vincent Alvarez,
Agency Clearance Officer, Office of Workers' Compensation Programs, US 
Department of Labor.
[FR Doc. 2011-12215 Filed 5-17-11; 8:45 am]
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