[Federal Register Volume 60, Number 187 (Wednesday, September 27, 1995)]
[Notices]
[Pages 49922-49923]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-23976]
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DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Information Collection Request
Submitted for Public Comment and Recommendations; (1) Report of
Ventilatory Study; Roentgenographic Interpretation; Medical History and
Examination for Coal Mine Workers' Pneumoconiosis; Report of Arterial
Blood Gas Study.
(2) Survivors Claim for Benefits Under the Black Lung Benefits Act.
(3) Black Lung Provider Enrollment Form.
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 is minimized, reporting forms 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
several information collections, as listed above, under the Office of
Workers' Compensation Programs (OWCP), Division of Coal Mine Workers'
Compensation (DCMWC). A copy of the proposed information collection
requests can be obtained by contacting the employee listed below in the
ADDRESSEE section of this notice.
DATES: Written comments must be submitted on or before November 28,
1995. Written comments should address the accuracy of the burden
estimates
[[Page 49923]]
and ways to minimize burden including the use of automated collection
techniques or the use of other forms of information technology, as well
as, other relevant aspects of the information collection request.
ADDRESSES: Ms. Patricia Forkel, Office of Management, Administration
and Planning, U.S. Department of Labor, 200 Constitution Ave., NW., S-
3201, Washington, D.C. 20210, (202) 219-7601) (this is not a toll free
number).
SUPPLEMENTARY INFORMATION:
I. Background
(A) Report of Ventilatory Study; Roentgenographic Interpretation;
Medical History and Examination for Coal Mine Workers' Pneumoconiosis;
Report of Arterial Blood Gas Study: The Office of Workers' Compensation
Programs, which administers the Black Lung Benefits Act, use these
forms to gather information relative to the medical condition of a
claimant who is alleging the presence of peneumoconiosis as a routine
function of the claim adjudication process.
(B) Survivor's Claim for Benefits Under the Black Lung Benefits
Act: A survivor of a coal miner must file a claim for benefits under
the Black Lung Benefits Act, as amended, in order to receive benefits.
The claim and supporting documentation submitted under this information
collection are reviewed by DCMWC claims examiners to determine the
survivor's eligibility for benefits.
(C) Black Lung Provider Enrollment Form: Specific requirements for
the Federal Black Lung Program to provide medical services by
authorized medical providers to black lung beneficiaries are set forth
in statute. This form is designed to facilitate the collection of
information about medical providers and the payment of bills for the
medical services they perform.
II. Continuation of These Information Collections Is Necessary for the
Agency To Determine the Proper Status of a Claimant and His/Her
Entitlement to Benefits, and To Ensure That Medical Providers Are Paid
for the Medical Services They Perform for the Black Lung Program
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Report of Ventilatory Study; Roentgenographic
Interpretation; Medical History and Examination for Coal Mine Workers'
Pneumoconiosis; Report of Arterial Blood Gas Study.
OMB Number: 1215-0090.
Affected public: Businesses or other for-profit; non-for-profit
institutions.
Frequency: One time.
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No. of Est. time per Subtotal
Agency No. respondents response hours
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CM-907...................... 7,425 20 min............ 2,475
CM-933...................... 14,850 5 min............. 1,238
CM-933b..................... 675 5 min............. 56
CM-988...................... 7,425 30 min............ 3,712
CM-1159..................... 7,425 15 min............ 1,856
Total Burden Hours: 9,338
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Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Survivor's Claim for Benefits Under the Black Lung Benefits
Act.
OMB Number: 1215-0069.
Agency Number: CM-912.
Frequency: One time.
Affected Public: Individuals or households.
Number of Respondents: 1,200.
Hours per Response: 25 minutes.
Total Burden Hours: 500.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Black Lung Provider Enrollment Form.
OMB Number: 1215-0137.
Agency Number: CM-1168.
Frequency: One time.
Affected Public: Businesses or other for-profit.
Number of Respondents: 6,500.
Estimated time per respondent: 3 to 7 minutes.
Total Burden Hours: 525.
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: September 22, 1995.
Cecily A. Rayburn,
Director, Division of Financial Management, Office of Management,
Administration and Planning, Employment Standards Administration.
[FR Doc. 95-23976 Filed 9-26-95; 8:45 am]
BILLING CODE 4510-27-M
