Proposed Collection; Comment Request

DEPARTMENT OF LABOR

Employment Standards Administration

Proposed 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) [44 U.S.C. 3506(c)(2)(A)]. 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 Employment Standards Administration is soliciting

comments concerning the proposed revision collection of FECA Medical

Report Forms: CA-7, CA-8, CA-16b, CA-20, CA-20a, CA-1090, CA-1303, CA-

1305, CA-1306, CA-1314, CA-1316, CA-1331, CA-1332, A-1336, OWCP-5a,

OWCP-5b, and OWCP-5c.

A copy of the proposed information collection request can be

obtained by contacting the office listed below in the addressee section

of this notice.

DATES: Written comments must be submitted to the office listed in the

addressee section below on or before July 24, 1996. 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.

ADDRESSEE: Mr. Rich Elman, U.S. Department of Labor, 200 Constitution

Ave., NW., Room S-3201, Washington, DC 20210, telephone (202) 219-6375

(this is not a toll-free number), fax 202-219-6592.

SUPPLEMENTARY INFORMATION:

I. Background

Statute 5 USC 8101 et seq. of the Federal Employees' Compensation

Act provides for the payment of benefits for wage-loss and/or for

permanent payment to a scheduled member, arising out of a work-related

injury or disease. The CA-7 and CA-8 request information, allowing the

Office of Workers' Compensation Programs to fulfill its statutory

requirements for the period of compensation claimed (e.g., the pay

rate, dependents, earnings, dual benefits and third party information).

The other forms in this proposed revision collection collect medical

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information necessary to determine entitlement to benefits under FECA.

II. Current Actions

The Department of Labor seeks the revision approval to collect this

information in order to carry out its responsibility to determine

eligibility for and the compensation of benefits. The OWCP-5a, OWCP-5b

and OWCP-5c are being revised. The CA-1302, formerly included in 1215-

0103, is being eliminated.

Type of Review: Revision.

Agency: Employment Standards Administration.

Title: FECA Medical Report Forms.

OMB Number: 1215-0103.

Agency Numbers: CA-7, CA-8, CA-16b, CA-20, CA-20a, CA-1090, CA-

1303, CA-1305, CA-1306, CA-1314, CA-1316, CA-1331, CA-1332, A-1336,

OWCP-5a, OWCP-5b, and OWCP-5c.

Affected Public: Individuals or households; Businesses or other

for-profit; Federal Government.

Total Respondents: 441,855.

Frequency: As needed.

Total Responses: 441,855.

Estimated Total Burden Hours: 43,412.

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Form Burden

Total respondents Responses Total response time hours

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CA-7.................................... 200 200 20 min......................... 67

CA-8.................................... 200 200 5 min.......................... 17

CA-16B.................................. 157,000 157,000 5 min.......................... 13,083

CA-17B.................................. 134,000 134,000 5 min.......................... 11,167

CA-20................................... 92,000 92,000 5 min.......................... 7,667

CA-20a.................................. 20,000 20,000 5 min.......................... 1,667

CA-1090................................. 800 800 5 min.......................... 67

CA-1303................................. 4,000 4,000 20 min......................... 1,333

CA-1305................................. 80 80 20 min......................... 27

CA-1306................................. 25 25 10 min......................... 4

CA-1314................................. 1,200 1,200 20 min......................... 400

CA-1316................................. 1,100 1,100 10 min......................... 183

CA-1331................................. 750 750 5 min.......................... 63

CA-1332................................. 1,500 1,500 30 min......................... 750

CA-1336................................. 2,000 2,000 5 min.......................... 167

OWCP-5a................................. 7,000 7,000 15 min......................... 1,750

OWCP-5b................................. 5,000 5,000 15 min......................... 1,250

OWCP-5c................................. 15,000 15,000 15 min......................... 3,750

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Totals............................ 441,855 441,855 ............................... 43,412

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Total Burden Cost (capital/startup): $0.

Total Burden Cost (operating/maintenance): $141,394.

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: May 17, 1996.

Cecily A. Rayburn,

Director, Division of Financial Management, Office of Management,

Administration and Planning, Employment Standards Administration.

[FR Doc. 96-12846 Filed 5-21-96; 8:45 am]

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