[Federal Register Volume 88, Number 19 (Monday, January 30, 2023)]
[Notices]
[Pages 5925-5926]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-01779]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Agency Information Collection Activities; Comment Request; Death 
Gratuity

AGENCY: Office of Workers' Compensation Programs, Division of Federal 
Employees', Longshore and Harbor Workers' Compensation--DFELHWC-FECA

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, ``Death Gratuity.'' This 
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 
March 31, 2023.

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 information collected through Forms CA-40, CA-41 
and CA-42 is used by claims examiners in OWCP to determine a person's 
entitlement to any or all of the death gratuity payment provided by 5 
U.S.C. 8102a. The National Defense Authorization Act for Fiscal Year 
2008, Public Law (Pub. L.) 110-181, was enacted on January 28, 2008. 
Section 1105 of Public Law 110-181 amended the Federal Employees' 
Compensation Act (FECA) creating a new section, 5 U.S.C. 8102a 
effective upon enactment. This section establishes a FECA death 
gratuity benefit of up to $100,000 for eligible beneficiaries of 
federal employees and Non-Appropriated Fund Instrumentality (NAFI) 
employees who die from injuries incurred in connection with service 
with an Armed Force in a contingency operation. 5 U.S.C. 8102a also 
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. 20 CFR 10.909 and 10.911 provides that the 
Forms CA-40, CA-41, and CA-42 as the forms to be used to designate 
beneficiaries and initiate the payment process for death gratuity 
benefits. See 5 U.S.C. 8145 and 8149.
    Form CA-40 is an optional form that requests the information 
necessary from the employee to accomplish this variance and to name 
alternate beneficiaries only if the employee wishes to do so. 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. Further, the statute and regulations require agencies to 
notify OWCP immediately upon the death of a covered employee. Form 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 July 31, 2023. 5 CFR 1320.3(c)(3) authorizes this 
information collection. 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 shall 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 1240-0017.
    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,

[[Page 5926]]

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.
    Title of Collection: Death Gratuity.
    Forms: CA-40, Designation of a Recipient of the Federal Employees' 
Compensation Act Death Gratuity Payment under 5 U.S.C. 8102a; CA-41, 
Claim for Survivor Benefits Under the Federal Employees' Compensation 
Act Section 8102a Death Gratuity; and CA-42, Official Notice of 
Employees' Death for Purposes of FECA Section 8102a Death Gratuity.
    OMB Control Number: 1240-0017.
    Affected Public: Individuals or Households.
    Estimated Number of Respondents: 1.
    Frequency: On occasion.
    Total Estimated Annual Responses: 1.
    Estimated Average Time per Response: 15 minutes.
    Estimated Total Annual Burden Hours: .25.
    Total Estimated Annual Other Cost Burden: $0.00.
    Authority: 44 U.S.C. 3506(c)(2)(A).

Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2023-01779 Filed 1-27-23; 8:45 am]
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