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,

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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 extension collection of

Form LS-1, Request For Examination and/or Treatment.

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 September 4, 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.

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

Ave., N.W., Room S-3201, Washington, D.C. 20210, telephone (202) 219-

6375 (this is not a toll-free number), fax 202-219-6592.

SUPPLEMENTARY INFORMATION:

I. Background

The Longshore and Harbor Workers' Compensation Act provides

benefits to workers injured in maritime employment area customarily

used by an employee in loading, unloading, repairing or building a

vessel. Under Section 702.419 of the Act the employer/insurance carrier

is responsible for furnishing medical care for the injured employee for

such period of time as the injury or recovery period may require. Form

LS-1 serves two purposes: it authorizes the medical care and provides a

vehicle for the treating physician to report the findings, treatment

given, and anticipated physical condition of the employee.

II. Current Actions

The Department of Labor seeks extension approval to collect this

information to carry out its responsibility to verify that proper

medical treatment has been authorized and to determine the severity of

a claimant's injuries and entitlement to compensation benefits which an

employer is responsible by law to provide if a claimant is medically

unable to work as a result of a work-related injury. If the information

were not collected, verification of authorized medical care and

entitlement to compensation benefits would not be possible.

Type of Review: Extension.

Agency: Employment Standards Administration.

Title: Request For Examination and/or Treatment, LS-1.

OMB Number: 1215-0066.

Affected Public: Individuals or households.

Total Respondents: 16,500.

Frequency: On occasion.

Total Responses: 132,000 (average of 8 per respondent).

Average Time Per Response for Reporting: 1 hour.

Estimated Total Burden Hours: 142,560.

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

Total Burden Cost (operating/maintenance): $46,000.

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: June 21, 1996.

Cecily A. Rayburn,

Director, Division of Financial Management, Office of Management,

Administration and Planning, Employment Standards Administration.

[FR Doc. 96-16458 Filed 6-26-96; 8:45 am]

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