[Federal Register Volume 85, Number 220 (Friday, November 13, 2020)]
[Notices]
[Pages 72701-72702]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-25149]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Agency Information Collection Activities; Comment Request; 
Federal Employees' Compensation Act Medical Reports and Compensation 
Claims

AGENCY: Office of Workers' Compensation, DOL.

ACTION: Notice.

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SUMMARY: The Department of Labor (DOL), is soliciting comments 
concerning a proposed extension for the authority to conduct the 
information collection request (ICR) titled, ``Medical Forms and Claim 
for Compensation.'' This comment request is part of continuing 
Departmental efforts to reduce paperwork and respondent burden in 
accordance with the Paperwork Reduction Act of 1995 (PRA).

DATES: Consideration will be given to all written comments received by 
January 12, 2021.

ADDRESSES: A copy of this ICR with applicable supporting documentation; 
including a description of the likely respondents, proposed frequency 
of response, and estimated total burden may be obtained free by 
contacting Anjanette Suggs by telephone at 202-354-9660 or by email at 
[email protected].
    Submit written comments about, or requests for a copy of, this ICR 
by mail or courier to the U.S. Department of Labor, Office of Workers' 
Compensation Programs, Room S3323, 200 Constitution Avenue NW, 
Washington, DC 20210; by email: [email protected].

FOR FURTHER INFORMATION CONTACT: Anjanette Suggs by telephone at 202-
354-9660 or by email at [email protected].

SUPPLEMENTARY INFORMATION: The DOL, as part of continuing efforts to 
reduce paperwork and respondent burden, conducts a pre-clearance 
consultation program to provide the general public and Federal agencies 
an opportunity to comment on proposed and/or continuing collections of 
information before submitting them to the OMB for final approval. This 
program helps to ensure 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 can be properly assessed.
    Background: The Office of Worker's Compensation Programs (OWCP) 
administers the Federal Employees' Compensation Act (FECA). 5 U.S.C. 
8149, Congress gives the Secretary of Labor authority to prescribe the 
rules and regulations necessary for the administration and enforcement 
of the FECA. 5 U.S.C. 8102, the FECA requires the United States to 
provide compensation to individuals who sustain an injury while in the 
course of federal employment. 5 U.S.C. 8103, authorizes FECA to provide 
medical and initial medical and other benefits.

5 U.S.C. 8102, Compensation for Disability or Death of Employee

    (a) The United States shall pay compensation as specified by this 
subchapter for the disability or death of an employee resulting from 
personal injury sustained while in the performance of his duty, unless 
the injury or death is--
    (1) caused by willful misconduct of the employee;
    (2) caused by the employee's intention to bring about the injury or 
death of himself or of another; or
    (3) proximately caused by the intoxication of the injured employee.
    (b) Disability or death from a war-risk hazard or during or as a 
result of capture, detention, or other restraint by a hostile force or 
individual, suffered by an employee who is employed outside the 
continental United States or in Alaska or in the areas and 
installations in the Republic of Panama made available to the United 
States pursuant to the Panama Canal Treaty of 1977 and related 
agreements (as described in section 3(a) of the Panama Canal Act of 
1979), is deemed to have resulted from personal injury sustained while 
in the performance of his duty, whether or not the employee was engaged 
in the course of employment when the disability or disability resulting 
in death occurred or when he was taken by the hostile force or 
individual. This subsection does not apply to an individual--
    (1) whose residence is at or in the vicinity of the place of his 
employment and who was not living there solely because of the 
exigencies of his employment, unless he was injured or taken while 
engaged in the course of his employment; or
    (2) who is a prisoner of war or a protected individual under the 
Geneva Conventions of 1949 and is detained or utilized by the United 
States.

5 U.S.C. 8103, Medical Services and Initial Medical and Other Benefits

    (a) The United States shall furnish to an employee who is injured 
while in the performance of duty, the services, appliances, and 
supplies prescribed or recommended by a qualified physician, which the 
Secretary of Labor considers likely to cure, give relief, reduce the 
degree or the period of disability, or aid in lessening the amount of 
the monthly compensation. These services, appliances, and supplies 
shall be furnished--
    (1) whether or not disability has arisen;
    (2) notwithstanding that the employee has accepted or is entitled 
to receive benefits under subchapter III of chapter 83 of this title or 
another retirement system for employees of the Government; and
    (3) by or on the order of United States medical officers and 
hospitals, or, at the employee's option, by or on the order of 
physicians and hospitals designated or approved by the Secretary. The 
employee may initially select a physician to provide medical services, 
appliances, and supplies, in accordance with such regulations and 
instructions as the Secretary considers necessary, and may be furnished 
necessary and reasonable transportation and expenses incident to the 
securing of such services, appliances, and supplies. These expenses, 
when authorized or approved by the Secretary, shall be paid from the 
Employees' Compensation Fund.
    The following forms and letters are the standard forms and letters 
for the collection of this information: Claim for Compensation (CA-7); 
Authorization for Examination and/or Treatment (CA-16); Duty Status 
Report (CA-17); Attending

[[Page 72702]]

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). This 
information collection is currently approved for use through March 31, 
2021. This information collection is subject to the PRA. A Federal 
agency generally cannot conduct or sponsor a collection of information, 
and the public is generally not required to respond to an information 
collection, unless the OMB under the PRA approves it and displays a 
currently valid OMB Control Number. In addition, notwithstanding any 
other provisions of law, no person generally be subject to penalty for 
failing to comply with a collection of information that does not 
display a valid Control Number. See 5 CFR 1320.5(a) and 1320.6.
    Interested parties are encouraged to provide comments to the 
contact shown in the ADDRESSES section. Written comments will receive 
consideration, and summarized and included in the request for OMB 
approval of the final ICR. In order to help ensure appropriate 
consideration, comments should mention OMB Number 1240-0046.
    Submitted comments will also be a matter of public record for this 
ICR and posted on the internet, without redaction. The DOL encourages 
commenters not to include personally identifiable information, 
confidential business data, or other sensitive statements/information 
in any comments.
    The DOL is particularly interested in comments that:
     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 submission of responses.
    Agency: DOL-Office of Workers' Compensation Programs.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title of Collection: FECA medical Reports, Claim for Compensation.
    Form: 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.
    OMB Number: 1240-0046.
    Affected Public: Individuals or households.
    Estimated Number of Respondents: 282, 353.
    Frequency: As needed.
    Total Estimated Annual Responses: 282, 353.
    Estimated Average Time per Response: 5-30 minutes.
    Estimated Total Annual Burden Hours: Hours 25,605.
    Total Estimated Annual Other Cost Burden: $110,118.

    Authority: 44 U.S.C. 3506(c)(2)(A).

Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2020-25149 Filed 11-12-20; 8:45 am]
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