[Federal Register Volume 86, Number 192 (Thursday, October 7, 2021)]
[Notices]
[Pages 55862-55863]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-21912]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Agency Information Collection Activities; Comment Request; 
Miner's Claim for Benefits Under the Black Lung Benefit's Act (CM-911) 
and Employment History (CM-911A) Division of Coal Mine Workers' 
Compensation

AGENCY: Office of Workers' Compensation Programs.

ACTION: Notice.

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SUMMARY: Currently, the Office of Workers' Compensation Programs is 
soliciting comments concerning the proposed collection: Miner's Claim 
for Benefits under the Black Lung Benefit's Act (CM-911) and Employment 
History (CM-911A). A copy of the proposed information collection 
request can be obtained by contacting the office listed below in the 
addresses section of this Notice. 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.

DATES: Consideration will be given to all written comments received on 
or before December 6, 2021.

ADDRESSES: You may submit comments by mail, delivery service, or by 
hand to Ms. Anjanette Suggs, U.S. Department of Labor, 200 Constitution 
Ave. NW, Room S-3323, Washington, DC 20210; by fax to (202) 354-9660; 
or by Email to [email protected]. Please use only one method of 
transmission for comments (mail/delivery, fax, or Email). Please note 
that comments submitted after the comment period will not be 
considered.

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

SUPPLEMENTARY INFORMATION: The Department of Labor, as part of its 
continuing effort to reduce paperwork and respondent burden, conducts a 
preclearance consultation program to

[[Page 55863]]

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).
    I. Background: The Black Lung Benefits Act (BLBA), (30 U.S.C. 901 
et seq.) provides benefits to coal miners who are totally disabled due 
to pneumoconiosis (black lung disease) and to certain survivors of 
miners. Miners entitled to benefits also receive medical benefits for 
treatment related to their pneumoconiosis and resulting disability. A 
miner who applies for black lung benefits must complete the CM-911 
(application form). The completed form gives basic identifying 
information about the applicant and is the beginning of the development 
of the black lung claim. Title 20 CFR 725.304a authorizes this 
information collection. This form, when completed, provides a complete 
history of the miner's employment and helps to establish whether the 
individual currently or formerly worked in the nation's coal mines and 
how long that employment lasted. Title 20 CFR 725.404(a) authorizes 
this information collection. This information collection is currently 
approved for use through March 31, 2022.
    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 the approval 
for the extension of this currently-approved information collection in 
order to carry out its responsibility to administer the Black Lung 
Benefits Act.
    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.
    Agency: Office of Workers' Compensation Programs.
    Type of Review: Revision.
    Title: Miner's Claim for Benefits under the Black Lung Benefit's 
Act (CM-911) and Employment History (CM-911A).
    OMB Number: 1240-0038.
    Agency Number: CM-911 and CM-911A.
    Affected Public: Individuals or households.

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                                    Time to       Frequency of       Number of       Number of
             Form                  complete         response        respondents      responses     Hours burden
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CM-911........................              45  once............           4,900           4,900           3,675
CM-911A.......................              40  once............           4,900           4,900           3,266
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    Totals....................  ..............  ................           9,800           9,800           6,970
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    Total Respondents: 9,800.
    Total Annual Responses: 9,800.
    Average Time per Response: 42.5 minutes.
    Estimated Total Burden Hours: 6,941.
    Frequency: On occasion.
    Total Burden Cost (capital/startup): $0.

Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2021-21912 Filed 10-6-21; 8:45 am]
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