[Federal Register Volume 78, Number 72 (Monday, April 15, 2013)]
[Notices]
[Pages 22294-22295]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-08689]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF JUSTICE

[OMB Number 1105-NEW]


Agency Information Collection Activities; Proposed Collection; 
Comments Requested: USMS Medical Forms

ACTION: 60-Day Notice.

-----------------------------------------------------------------------

    The Department of Justice (DOJ), U.S. Marshals Service, will be 
submitting the following information collection request to the Office 
of Management and Budget (OMB) for review and approval in accordance 
with the Paperwork Reduction Act of 1995. The proposed information 
collection is published to obtain comments from the public and affected 
agencies. Comments are encouraged and will be accepted for ``sixty 
days'' until June 14, 2013. This process is conducted in accordance 
with 5 CFR 1320.10.
    If you have comments especially on the estimated public burden or 
associated response time, suggestions, or need a copy of the proposed 
information collection instrument with instructions or additional 
information, please contact Nicole Feuerstein, U.S. Marshals Service, 
CS-3/10th Fl., 2604 Jefferson Davis Hwy, Alexandria, VA 22301.
    Written comments and suggestions from the public and affected 
agencies concerning the proposed collection of information are 
encouraged. Your comments should address one or more of the following 
four points:

--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 agencies 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.

Overview of this Information Collection

    (1) Type of Information Collection: New collection.
    (2) Title of the Form/Collection: USMS Medical Forms.
    (3) Agency form number, if any, and the applicable component of the 
Department of Justice sponsoring the collection:
    Form Numbers:

--USM-522 Physical Examination Report for USMS Operational Employees.
--USM-522A Physician Evaluation Report for USMS Operational Employees.
--USM-522E Medical Update.
--USM-522K Applicant Review of Immunizations.
--USM-522P Physician Evaluation Report for USMS Operational Employees 
Pregnancy Only.
--USM-600 Physical Requirements of USMS District Security Officers.
--CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification.
--CSO-229 Certificate of Medical Examination for Court Security 
Officers Component for all above-listed forms: U.S. Marshals Service.
    (4) Affected public who will be asked or required to respond, as 
well as a brief abstract:

--USM-522 Physical Examination Report for USMS Operational Employees

    [cir] Affected public: Individuals or households (Applicants to 
USMS)
    [cir] Brief abstract: It is the policy of the USMS to ensure a law 
enforcement work force that is medically able to safely perform the 
required job functions. Operational employees are required to meet 
medical standards and physical requirements and are classified as 
either qualified or unqualified based on review of periodic medical 
examination results. All applicants for law enforcement positions must 
have pre-employment physical examinations. The USMS provides and pays 
for applicant medical examinations at the district contract medical 
facility.

--USM-522A Physician Evaluation Report for USMS Operational Employees

    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: This form is completed by an USMS operational 
employee's treating physician to report any illness/injury (other than 
pregnancy) that requires restriction from full performance of duties 
for longer than 80 consecutive hours.
USM-522E USMS Medical Update
    [cir] Affected public: Individuals or households (Applicants to 
USMS)
    [cir] Brief abstract: USMS applicants must complete this form to 
update their medical status in order to remain active in the hiring 
process. Current USMS employees may use this form to update their 
medical status in the off-cycle years of the Periodic Medical Exam 
(PME) schedule.

--USM-522K Applicant Review of Immunizations

    [cir] Affected public: Individuals or households (Applicants to 
USMS)
    [cir] Brief abstract: USMS applicants must complete this record of 
immunizations if an Immunization Record Card cannot be provided with 
the medical examination package.

--USM-522P Physician Evaluation Report for USMS Operational Employees 
(Pregnancy Only)

    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: Form USM-522P must be completed by the OB/GYN 
physician of pregnant USMS operational employees to specify any 
restrictions from full performance of duties.

--USM-600 Physical Requirements of USMS District Security Officers
    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: It is the policy of the USMS to ensure a law 
enforcement work force that is medically able to safely perform the 
required job functions. All applicants for law enforcement positions 
must have pre-employment physical examinations. District Security 
Officers (DSO) are individual contractors, not employees of USMS; Form 
USM-522 does not apply to DSOs.

--CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification

    [cir] Affected public: Private sector (Physicians)

[[Page 22295]]

    [cir] Brief abstract: This form is completed by the Court Security 
Officer (CSO)'s attending physician to determine whether a CSO is 
physically able to return to work after an injury, serious illness, or 
surgery. The physician returns the evaluation to the contracting 
company, and if the determination is that the CSO may return to work, 
the CSO-012 is then signed off on by the contracting company and 
forwarded to the USMS for final review by USMS' designated medical 
reviewing official. Court Security Officers are contractors, not 
employees of USMS; Form USM-522A does not apply to CSOs.

--CSO-229 Certificate of Medical Examination for Court Security 
Officers

    [cir] Affected public: Private sector (Physicians), Individuals or 
households (Applicants to and current employees of the CSO contracting 
companies)
    [cir] Brief abstract: It is the policy of the USMS to ensure a law 
enforcement work force that is medically able to safely perform the 
required job functions. All applicants for law enforcement positions 
must have pre-employment physical examinations. Court Security Officers 
(CSO) are contractors, not employees of USMS; Form USM-522 does not 
apply to CSOs.
    (5) An estimate of the total number of respondents and the amount 
of time estimated for an average respondent to respond:

--USM-522 USMS Physical Examination Report for Operational Employees
    It is estimated that 800 respondents will complete a 45 minute 
form.
--USM-522A Physician Evaluation Report for USMS Operational Employees
    It is estimated that 100 respondents will complete a 20 minute 
form.
--USM-522E USMS Medical Update
    It is estimated that 100 respondents will complete a 20 minute 
form.
--USM-522K Applicant Review of Immunizations
    It is estimated that 350 respondents will completed a 10 minute 
form.
--USM-522P Physician Evaluation Report for USMS Operational Employees 
(Pregnancy Only)
    It is estimated that 12 respondents will complete a 15 minute form.
--USM-600 Physical Requirements of USMS District Security Officers
    It is estimated that 800 respondents will complete a 20 minute 
form.
--CSO-012 Request to Reevaluate Court Security Officer's Medical
    Qualification
    It is estimated that 300 respondents will complete a 30 minute 
form.
--CSO-229 Certificate of Medical Examination for Court Security 
Officers
    It is estimated that 4300 respondents will complete a 30 minute 
form.
    (6) An estimate of the total public burden (in hours) associated 
with the collection:

--USM-522 USMS Physical Examination Report for Operational Employees
    There are an estimated 600 annual total burden hours associated 
with this collection.
--USM-522A Physician Evaluation Report for USMS Operational Employees
    There are an estimated 33 annual total burden hours associated with 
this collection.
--USM-522E USMS Medical Update
    There are an estimated 33 annual total burden hours associated with 
this collection.
--USM-522 K Applicant Review of Immunizations
    There are an estimated 58 annual total burden hours associated with 
this collection.
--USM-522P Physician Evaluation Report for USMS Operational Employees 
(Pregnancy Only)
    There are an estimated 3 annual total burden hours associated with 
this collection.
--USM-600 Physical Requirements of USMS District Security Officers
    There are an estimated 267 annual total burden hours associated 
with this collection.
--CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification
    There are an estimated 150 annual total burden hours associated 
with this collection.
--CSO-229 Certificate of Medical Examination for Court Security 
Officers
    There are an estimated 2,150 annual total burden hours associated 
with this collection.
    Total Annual Time Burden (Hours): 3,269.
    If additional information is required contact: Jerri Murray, 
Department Clearance Officer, Policy and Planning Staff, Justice 
Management Division, Department of Justice, Two Constitution Square, 
145 N Street NE., Room 1407B, Washington, DC 20530.

    Dated: April 9, 2013.
Jerri Murray,
Department Clearance Officer for PRA, U.S. Department of Justice.
[FR Doc. 2013-08689 Filed 4-12-13; 8:45 am]
BILLING CODE 4410-04-P