[Federal Register Volume 82, Number 37 (Monday, February 27, 2017)]
[Notices]
[Pages 11946-11947]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-03758]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


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 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). 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: Request for Information on Earnings, Dual Benefits, 
Dependents and Third Party Settlement (CA-1032). 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 April 28, 2017.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3201, Washington, DC 20210, telephone/fax 
(202) 354-9647, Email [email protected]. Please use only one method 
of

[[Page 11947]]

transmission for comments (mail, fax, or Email).

SUPPLEMENTARY INFORMATION: 
    I. Background: The collection of this information is necessary 
under provisions of the Federal Employees' Compensation Act (FECA) 
which states: (1) Compensation must be adjusted to reflect a claimant's 
earnings while in receipt of benefits (5 U.S.C. 8106); (2) compensation 
is payable at the augmented rate of 75 percent only if the claimant has 
one or more dependents as defined by the FECA (5 U.S.C. 8110); (3) 
compensation may not be paid concurrently with certain benefits from 
other Federal Agencies, such as the Office of Personnel Management, 
Social Security, and the Veterans Administration (5 U.S.C. 8116); (4) 
compensation must be adjusted to reflect any settlement from a third 
party responsible for the injury for which the claimant is being paid 
compensation (5 U.S.C. 8132); (5) an individual convicted of any 
violation related to fraud in the application for, or receipt of, any 
compensation benefit, forfeits (as of the date of such conviction) any 
entitlement to such benefits, for any injury occurring on or before the 
date of conviction (5 U.S.C. 8148(a)); (6) no Federal compensation 
benefit can be paid to any individual for any period during which such 
individual is incarcerated for any felony offense (5 U.S.C. 
8148(b)(1)). The information collected through Form CA-1032 is used to 
ensure that compensation being paid on the periodic roll is correct. 
This information collection is currently approved for use through May 
31, 2017.
    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 ensure that 
compensation being paid on the periodic roll is correct.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: Request for Information on Earnings, Dual Benefits, 
Dependents and Third Party Settlement.
    OMB Number: 1240-0016.
    Agency Number: CA-1032.
    Affected Public: Individuals or household.
    Total Respondents: 45,161.
    Total Annual Responses: 45,161.
    Average Time per Response: 20 minutes.
    Estimated Total Burden Hours: 15,054.
    Frequency: Annually.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $23,484.
    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: February 14, 2017.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, US 
Department of Labor.
[FR Doc. 2017-03758 Filed 2-24-17; 8:45 am]
 BILLING CODE 4510-CH-P