[Federal Register Volume 76, Number 185 (Friday, September 23, 2011)]
[Notices]
[Pages 59162-59163]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-24472]


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DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Federal Employees Compensation Act Medical 
Report Forms, Claim for Compensation

ACTION: Notice.

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SUMMARY: The Department of Labor (DOL) is submitting the Office of 
Workers' Compensation Programs (OWCP) sponsored information collection 
request (ICR) titled, ``Federal Employees Compensation Act Medical 
Report Forms, Claim for Compensation,'' as revised, to the Office of 
Management and Budget (OMB) for review and approval for use in 
accordance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 
3501 et seq.).

DATES: Submit comments on or before October 24, 2011.

ADDRESSES: A copy of this ICR with applicable supporting documentation; 
including a description of the likely respondents, proposed frequency 
of response, and estimated total burden may be obtained from the 
RegInfo.gov Web site, http://www.reginfo.gov/public/do/PRAMain, on the 
day following publication of this notice or by contacting Michel Smyth 
by telephone at 202-693-4129 (this is not a toll-free number) or 
sending an e-mail to [email protected].
    Submit comments about this request to the Office of Information and 
Regulatory Affairs, Attn: OMB Desk Officer for the Department of Labor, 
Office of Worker Compensation Programs, Office of Management and 
Budget, Room 10235, Washington, DC 20503, Telephone: 202-395-6929/Fax: 
202-395-6881 (these are not toll-free numbers), e-mail: [email protected].

FOR FURTHER INFORMATION CONTACT: Michel Smyth by telephone at 202-693-
4129 (this is not a toll-free number) or by e-mail at [email protected].

SUPPLEMENTARY INFORMATION: The 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 FECA outlines the elements of pay which are to be included in an 
individual's pay rate, and sets forth various other criteria for

[[Page 59163]]

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 Office of Personnel Management or 
certain Veterans Administration 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. Forms CA-7, CA-16, CA-17, CA-20, CA-1331, CA-1332, OWCP-5A, 
OWCP-5B, and OWCP-5C are used for filing claims for wage loss or 
permanent impairment due to a Federal employment-related injury and to 
obtain necessary medical documentation to determine whether a claimant 
is entitled to benefits under the FECA.
    This information collection is subject to the PRA. A Federal agency 
generally cannot conduct or sponsor a collection of information, and 
the public is generally not required to respond to an information 
collection, unless it is approved by the OMB under the PRA and displays 
a currently valid OMB Control Number. In addition, notwithstanding any 
other provisions of law, no person shall generally be subject to 
penalty for failing to comply with a collection of information if the 
collection of information does not display a valid OMB Control Number. 
See 5 CFR 1320.5(a) and 1320.6. The DOL obtains OMB approval for this 
information collection under OMB Control Number 1240-0046. The current 
OMB approval is scheduled to expire on September 30, 2011; however, it 
should be noted that existing information collection requirements 
submitted to the OMB receive a month-to-month extension while they 
undergo review. For additional information, see the related notice 
published in the Federal Register on May 18, 2011 (76 FR 28818).
    Interested parties are encouraged to send comments to the OMB, 
Office of Information and Regulatory Affairs at the address shown in 
the ADDRESSES section within 30 days of publication of this notice in 
the Federal Register. In order to help ensure appropriate 
consideration, comments should reference OMB Control Number 1240-0046. 
The OMB is particularly interested in comments that:
     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: Office of Workers' Compensation Programs.
    Title of Collection: Federal Employees Compensation Act Medical 
Report Forms, Claim for Compensation.
    OMB Control Number: 1240-0046.
    Affected Public: Individuals or Households.
    Total Estimated Number of Respondents: 232,853.
    Total Estimated Number of Responses: 232,853.
    Total Estimated Annual Burden Hours: 21,212.
    Total Estimated Annual Other Costs Burden: $109,441.

    Dated: September 19, 2011.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2011-24472 Filed 9-22-11; 8:45 am]
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