[Federal Register Volume 79, Number 128 (Thursday, July 3, 2014)]
[Notices]
[Pages 38072-38073]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-15650]


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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

[[Page 38073]]

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 September 2, 2014.

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).

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 October 31, 2014.
    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: 282,353.

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                                                          Time to complete      Number of
                          Form                                 (min)            responses         Hours burden
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CA-7...................................................                 13                500                120
CA-16..................................................                  5             29,519              2,460
CA-17..................................................                  5            182,793             15,233
CA-20..................................................                  5             56,394              4,700
CA-1090................................................                 10                234                 39
CA-1305................................................                 20                136                 45
CA-1331/CA-1087*.......................................                  5              1,062                 89
CA-1332................................................                 30                 30                  6
OWCP-5's...............................................                 15             11,651              2,913
                                                        --------------------------------------------------------
    Totals.............................................  .................            282,353             25,605
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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: 232,353.
    Average Time per Response: 5 minutes-30 minutes.
    Estimated Total Burden Hours: 25,605.
    Frequency: As Needed.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $ 110,118.
    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: June 30, 2014.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2014-15650 Filed 7-2-14; 8:45 am]
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