2014-07073. Agency Information Collection Activities; Submission for OMB Review; Comment Request; Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements

ACTION:

Notice.

SUMMARY:

The Department of Labor (DOL) is submitting the Office of Workers' Compensation Programs (OWCP) sponsored information collection request (ICR) revision titled, “Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements,” to the Office of Management and Budget (OMB) for review and approval for use in accordance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501 et seq.). The OMB and DOL invite public comments on the ICR.

DATES:

The OMB will consider all written comments that agency receives on or before April 30, 2014.

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 of charge from the RegInfo.gov Web site at http://www.reginfo.gov/​public/​do/​PRAViewICR?​ref_​nbr=​201310-1240-001 (this link will only become active on the day following publication of this notice) or by contacting Michel Smyth by telephone at 202-693-4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to [e-mail].

Submit comments about this request by mail or courier to the Office of Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL-OWCP, Office of Management and Budget, Room 10235, 725 17th Street NW., Washington, DC 20503; by Fax: [phone] (this is not a toll-free number); or by email: [e-mail]. Commenters are encouraged, but not required, to send a courtesy copy of any comments by mail or courier to the U.S. Department of Labor—OASAM, Office of the Chief Information Officer, Attn: Departmental Information Compliance Management Program, Room N1301, 200 Constitution Avenue NW., Washington, DC 20210; or by email: [e-mail].

FOR FURTHER INFORMATION CONTACT:

Contact Michel Smyth by telephone at 202-693-4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to [e-mail].

Authority: 44 U.S.C. 3507(a)(1)(D).

SUPPLEMENTARY INFORMATION:

This ICR seeks PRA approval to revise the “Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements” (Form Letter CA-1032) information collection. The form letter obtains information from a claimant receiving workers' compensation benefits over an extended period of time. The OWCP uses this information to determine whether the claimant is entitled to continue receiving benefits and whether the benefit amount should be adjusted. This ICR has been classified as a revision, because the OWCP has made a few changes and minor clarifications to the form letter. These changes and clarifications would help to reduce the chance of respondents providing incorrect information and would augment disclosures the OWCP makes to respondents. More specifically, the changes would align the form with the rights of same sex couples, as specified under United States v. Windsor, and add information about assistance available to respondents with disabilities.

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 it is approved by the OMB under the PRA 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. The DOL obtains OMB approval for this information collection under Control Number 1240-0016. The current approval is scheduled to expire on April 30, 2014; however, the DOL notes that existing information collection requirements submitted to the OMB receive a month-to-month extension while they undergo review. New requirements would only take effect upon OMB approval. For additional substantive information about this ICR, see the related notice published in the Federal Register on December 20, 2013 (78 FR 77170).

Interested parties are encouraged to send comments to the OMB, Office of Information and Regulatory Affairs at the address shown in the ADDRESSES section within 30 days of publication of this notice in the Federal Register. In order to help ensure appropriate consideration, comments should mention OMB Control Number 1240-0016. The OMB 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, 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-OWCP.

Title of Collection: Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements.

OMB Control Number: 1240-0016.

Affected Public: Individuals or households.

Total Estimated Number of Respondents: 44,800.

Total Estimated Number of Responses: 44,800.

Total Estimated Annual Time Burden: 14,933 hours.

Total Estimated Annual Other Costs Burden: $23,296.

Dated: March 25, 2014.

Michel Smyth,

Departmental Clearance Officer.