Notice2021-19429
Agency Information Collection Activities; Comment Request; Statement of Recovery Forms
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
September 9, 2021
Issuing agencies
Labor DepartmentWorkers' Compensation Programs Office
Abstract
The Department of Labor (DOL, is soliciting comments concerning a proposed extension for the authority to conduct the information collection request (ICR) titled, "[Statement of Recovery (SOR) Forms (CA-1108 and CA-1122)]." This comment request is part of continuing Departmental efforts to reduce paperwork and respondent burden in accordance with the Paperwork Reduction Act of 1995 (PRA).
Full Text
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<title>Federal Register, Volume 86 Issue 172 (Thursday, September 9, 2021)</title>
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[Federal Register Volume 86, Number 172 (Thursday, September 9, 2021)]
[Notices]
[Pages 50559-50560]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-19429]
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DEPARTMENT OF LABOR
Office of the Workers' Compensation Programs
Agency Information Collection Activities; Comment Request;
Statement of Recovery Forms
AGENCY: Office of Workers' Compensations, DOL.
ACTION: Notice.
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SUMMARY: The Department of Labor (DOL, is soliciting comments
concerning a proposed extension for the authority to conduct the
information collection request (ICR) titled, ``[Statement of Recovery
(SOR) Forms (CA-1108 and CA-1122)].'' This comment request is part of
continuing Departmental efforts to reduce paperwork and respondent
burden in accordance with the Paperwork Reduction Act of 1995 (PRA).
DATES: Consideration will be given to all written comments received by
November 8, 2021.
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 by
contacting Anjanette Suggs by telephone at 202-354-9660 or by email at
<a href="/cdn-cgi/l/email-protection#92e1e7f5f5e1bcf3fcf8f3fcf7e6e6f7d2f6fdfebcf5fde4"><span class="__cf_email__" data-cfemail="5d2e283a3a2e733c33373c33382929381d393231733a322b">[email protected]</span></a>.
Submit written comments about, or requests for a copy of, this ICR
by mail or courier to the U.S. Department of Labor, Office of Workers'
Compensation Programs, Room S3323, 200 Constitution Avenue NW,
Washington, DC 20210; by email: <a href="/cdn-cgi/l/email-protection#2f5c5a48485c014e41454e414a5b5b4a6f4b404301484059"><span class="__cf_email__" data-cfemail="7d0e081a1a0e531c13171c13180909183d191211531a120b">[email protected]</span></a>.
FOR FURTHER INFORMATION CONTACT: Anjanette Suggs by telephone at 202-
354-9660 or by email at <a href="/cdn-cgi/l/email-protection#196a6c7e7e6a3778777378777c6d6d7c597d7675377e766f"><span class="__cf_email__" data-cfemail="e99a9c8e8e9ac788878388878c9d9d8ca98d8685c78e869f">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: The DOL, as part of continuing efforts to
reduce paperwork and respondent burden, conducts a pre-clearance
consultation program to provide the general public and Federal agencies
an opportunity to comment on proposed and/or continuing collections of
information before submitting them to the OMB for final approval. This
program helps to ensure 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 can be properly assessed.
Background: A Federal employee who sustains a work-related injury
is entitled to receive compensation under the Federal Employees'
Compensation Act (FECA). If that injury is caused under circumstances
that create a legal liability in a third party to pay damages, the FECA
authorizes the Secretary of Labor to require the employee to assign his
or her right of action to the United States or to prosecute the action
in his or her own name. See 5 U.S.C. 8131.
When the employee receives a payment for his or her damages,
whether from a final court judgment on or a settlement of the action,
section 8132 of the FECA (5 U.S.C. 8132) provides that the employee
``shall refund to the United States that amount of compensation paid by
the United States. . . .'' To enforce the United States' statutory
right of reimbursement, the Office of Workers' Compensation Programs
(OWCP) has promulgated regulations. The regulations require a FECA
beneficiary to report these types of payments (20 CFR 10.710) and
submit the detailed information necessary to calculate the amount of
the refund and surplus, if any, according to the formula in the statute
(20 CFR 10.707(e)). The information collected by Form CA-1108 and Form
CA-1122 from the FECA beneficiary includes this information and is
necessary to calculate the amount of the refund and surplus owed to the
United States from the FECA beneficiary's settlement or judgment, as
required in the statute and the regulations. This information
collection is currently approved for use through February 28, 2022.
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 the OMB under the PRA approves it and displays a
currently valid OMB Control Number. In addition, notwithstanding any
other provisions of law, no person 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.
Interested parties are encouraged to provide comments to the
contact shown in the ADDRESSES section. Written comments will receive
consideration, and summarized and included in the request for OMB
approval of the final ICR. In order to help ensure appropriate
consideration, comments should mention OMB Number 1240-0001. Submitted
comments will also be a matter of public record for this ICR and posted
on the internet, without redaction. The DOL encourages commenters not
to include personally identifiable information, confidential business
data, or other sensitive statements/information in any comments.
The DOL is particularly interested in comments that:
<bullet> 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.
<bullet> 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.
<bullet> Enhance the quality, utility, and clarity of the
information to be collected; and
<bullet> 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-Office of Workers' Compensation Programs.
Type of Review: Extension.
Agency: Office of Workers' Compensation Programs.
Title of Collection: Statement of Recovery Forms.
Form: CA-1108 and CA-1122.
OMB Number: 1240-0001.
Affected Public: Business or other for profit, Individuals or
households.
Estimated Number of Respondents: 1164.
Frequency: As needed.
Total Estimated Annual Responses: 1164.
Estimated Average Time per Response: 5-30 minutes.
[[Page 50560]]
Estimated Total Annual Burden Hours: 580.
Total Estimated Annual Other Cost Burden: $41,384.
Authority: 44 U.S.C. 3506(c)(2)(A).
Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2021-19429 Filed 9-8-21; 8:45 am]
BILLING CODE 4510-CH-P
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