Proposed Collection; Comment Request

RAILROAD RETIREMENT BOARD

Proposed Collection; Comment Request

summary: In accordance with the requirement of Section 3506 (c)(2)(A)

of the Paperwork Reduction Act of 1995 which provides opportunity for

public comment on new or revised data collections, the Railroad

Retirement Board (RRB) will publish periodic summaries of proposed data

collections.

Comments are invited on: (a) Whether the proposed information

collection is necessary for the proper performance of the functions of

the agency, including whether the information has practical utility;

(b) the accuracy of the RRB's estimate of the burden of the collection

of the information; (c) ways to enhance the quality, utility, and

clarity of the information to be collected; and (d) ways to minimize

the burden related to the collection of information on respondents,

including the use of automated collection techniques or other forms of

information technology.

Title and purpose of information collection: Application and Claim

for Sickness Insurance Benefits; OMB 3220-0039.

Under Section 2 of the Railroad Unemployment Insurance Act (RUIA),

sickness benefits are payable to qualified railroad employees who are

unable to work because of illness or injury. In addition, sickness

benefits are payable to qualified female employees if they are unable

to work, or if working would be injurious, because of pregnancy,

miscarriage or childbirth. Under Section 1(k) of the RUIA, a statement

of sickness with respect to days of sickness of an employee is to be

filed with the RRB within a 10-day period from the first day claimed as

a day of sickness. The RRB's authority for requesting supplemental

medical information is Section 12(I) and 12(n) of the RUIA. The

procedures for claiming sickness benefits and for the RRB to obtain

supplemental medical information needed to determine a claimant's

eligibility for such benefits is prescribed in 20 CFR part 335.

The forms used by the RRB to obtain information needed to determine

eligibility for and the amount of sickness benefits due a claimant

follows: Form SI-1a, Application for Sickness Benefits; Form SI-1b,

Statement of Sickness; Form SI-3, Claim for Sickness Benefits; Form SI-

7, Supplemental Doctor's Statement; Form SI-8, Verification of Medical

Information; Form ID-7h, Non-Entitlement to Sickness Benefits and

Information on Unemployment Benefits; and Form ID-11a, Requesting

Reason for Late Filing of Sickness Benefit. Completion is required to

obtain or retain benefits. One response is requested of each

respondent.

The RRB proposes to revise Form SI-1a to add new items that obtain

information from a sickness claimant who is filing a delayed claim for

benefits and also to reformat and clarify an existing item that

requests wage information. Form SI-3 is being revised to clarify an

existing item that requests wage information and also to modify the

certification statement. Form SI-8 is being revised primarily to

emphasize that a response is needed only if the information provided is

erroneous. Minor editorial changes which include the addition of

language required by the Paperwork Reduction Act of 1995 are also

proposed to Forms SI-1b, SI-7, SI-8 and ID-11A.

Estimate of Annual Respondent Burden

The estimated annual respondent burden is as follows:

------------------------------------------------------------------------

Annual Time Burden

Form Nos. responses (minutes) (hours)

------------------------------------------------------------------------

SI-1a/1b(ee)..................... 27,700 10 4,617

SI-1a/1b(Dr.).................... 27,000 8 3,693

SI-3............................. 181,000 5 15,083

SI-7............................. 33,600 8 4,480

SI-8............................. 50 5 4

ID-7H............................ 50 5 4

ID-11A........................... 800 3 40

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[[Page 65453]]

Total...................... 270,900 ........... 27,921

------------------------------------------------------------------------

Additional Information or Comments

To request more information or to obtain a copy of the information

collection justification, forms, and/or supporting material, please

call the RRB Clearance Officer at (312) 751-3363. Comments regarding

the information collection should be addressed to Ronald J. Hodapp,

Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois

60611-2092. Written comments should be received within 60 days of this

notice.

Chuck Mierzwa,

Clearance Officer.

[FR Doc. 97-32490 Filed 12-11-97; 8:45 am]

BILLING CODE 7905-01-M