[Federal Register Volume 81, Number 71 (Wednesday, April 13, 2016)]
[Notices]
[Pages 21905-21906]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-08505]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Proposed Extension of Existing Collection; Comment Request

AGENCY: Division of Federal Employees' Compensation, Office of Workers' 
Compensation Programs, Department of Labor.

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: Death Gratuity Forms (CA-
40, CA-41, and CA-42). 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 June 13, 2016.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-32331, Washington, DC 20210, telephone/
fax (202) 354-9647, Email [email protected]. Please use only one 
method of transmission for comments (mail, fax, or Email).

SUPPLEMENTARY INFORMATION:

I. Background

    The National Defense Authorization Act for Fiscal Year 2008, Public 
Law 110-181, was enacted on January 28, 2008. Section 1105 of P.L. 110-
181 amended the Federal Employees' Compensation Act (FECA) creating a 
new 5 U.S.C. 8102a effective upon enactment. This section established a 
new FECA death gratuity benefit for eligible beneficiaries of federal 
employees and Non-Appropriated Fund Instrumentality (NAFI) employees 
who die from injuries incurred in connection

[[Page 21906]]

with service with an Armed Force in a contingency operation. 5 U.S.C. 
8102a permits agencies to authorize retroactive payment of the death 
gratuity for employees who died on or after October 7, 2001, in service 
with an Armed Force in the theater of operations of Operation Enduring 
Freedom and Operation Iraqi Freedom. 5 U.S.C. 8102a also allows federal 
employees to vary the order of precedence of beneficiaries or to name 
alternate beneficiaries. Form CA-40 requests the information necessary 
from the employee to accomplish this variance. Form CA-41 provides the 
means for those named beneficiaries and possible recipients to file 
claims for those benefits and requests information from such claimants 
so that OWCP may determine their eligibility for payment. Furthermore, 
the statute and regulations require agencies to notify OWCP immediately 
upon the death of a covered employee. CA-42 provides the means to 
accomplish this notification and requests information necessary to 
administer any claim for benefits resulting from such a death. This 
information collection is currently approved for use through August 31, 
2016.

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 in order to carry out its responsibility to meet the 
statutory requirements of the Federal Employees' Compensation Act. The 
information contained in these forms is used by the Division of Federal 
Employees' Compensation to determine entitlement to benefits under the 
Act, to verify dependent status, and to initiate, continue, adjust, or 
terminate benefits based on eligibility criteria.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: Death Gratuity Forms.
    OMB Number: 1240-0017.
    Agency Number: CA-40, CA-41, and CA-42.
    Affected Public: Individuals or household; Federal Government.
    Total Respondents: 262.
    Total Responses: 262.

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                                      Time to      Frequency  of     Number of       Number of
              Form                complete (min)     response       respondents      responses     Hours burden
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CA-40 Individual Respondent.....              15               1             250             250              63
CA-41 Individual Respondent.....              15               1               6               6               2
CA-42 Agency Respondent.........              20               1               6               6               2
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    Totals......................  ..............  ..............             262             262              67
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    Estimated Total Burden Hours: 67.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $3.
    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: April 7, 2016.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2016-08505 Filed 4-12-16; 8:45 am]
 BILLING CODE 4510-CH-P