[Federal Register Volume 77, Number 105 (Thursday, May 31, 2012)]
[Notices]
[Pages 32140-32141]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-13119]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Division of Coal Mine Workers' Compensation Proposed Extension of 
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 pre-clearance 
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: Authorization for Release 
of Medical Information (CM-936). 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 30, 2012.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0701, fax (202) 693-1447, Email [email protected]. Please 
use only one method of transmission for comments (mail, fax, or Email).

[[Page 32141]]


SUPPLEMENTARY INFORMATION: 

I. Background

    The Black Lung Benefits Act, as amended, 30 U.S.C. 901, and 20 CFR 
725.405, requires that all relevant medical evidence be considered 
before a decision can be made regarding a claimant's eligibility for 
benefits. The CM-936 is a form that gives the claimant's consent for 
release of information, required by the Privacy Act, and contains 
information required by medical institutions and private physicians to 
enable them to release pertinent medical information. This information 
collection is currently approved for use through November 30, 2012.

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 approval for the extension of this 
currently-approved information collection in order to obtain claimant 
consent for the release of medical information for consideration by the 
Division of Coal Mine Workers' Compensation as evidence to support 
their claim for benefits. Failure to gather this information would 
inhibit the adjudication of black lung claims because pertinent medical 
data would not be available for consideration during the processing of 
the claim.
    Agency: Office of Workers' Compensation Programs.
    Type of Review: Extension.
    Title: Authorization for Release of Medical Information.
    OMB Number: 1240-0034.
    Agency Number: CM-936.
    Affected Public: Individuals or households.
    Total Respondents: 900.
    Total Annual Responses: 900.
    Average Time per Response: 5 minutes.
    Estimated Total Burden Hours: 75.
    Frequency: On occasion.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $3,671.
    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 24, 2012.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs U.S. 
Department of Labor.
[FR Doc. 2012-13119 Filed 5-30-12; 8:45 am]
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