[Federal Register Volume 82, Number 65 (Thursday, April 6, 2017)]
[Notices]
[Pages 16858-16859]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-06872]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Division of Federal Employees' Compensation; Proposed Revision to 
Existing Approved 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. 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 is soliciting comments concerning the proposed collection: 
Claim for Compensation (CA-7); Authorization for 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 June 5, 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 
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 January 31, 2018. This ICR has been 
classified as a revision, because of a change to the CA-1332, which 
will include additional questions for the physician to respond to as 
whether a condition of tinnitus has been diagnosed, has impacted a 
claimant's daily living and whether such diagnosis is or isn't due to 
federal employment.

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 a revision in order to carry out its 
statutory responsibility to compensate injured employees under the 
provisions of the Act.
    Type of Review: Revision.
    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 previously approved.
    Total Respondents: 282,353.

[[Page 16859]]



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                                                                      Time to        Number of
                              Form                                complete (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: March 29, 2017.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2017-06872 Filed 4-5-17; 8:45 am]
 BILLING CODE 4510-CH-P