Notice2023-02143
Agency Information Collection Activities; Comment Request; Claim for Compensation by Dependents Information Reports
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
February 2, 2023
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, "Claim for Compensation by Dependents Information Reports." This 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 88 Issue 22 (Thursday, February 2, 2023)</title>
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[Federal Register Volume 88, Number 22 (Thursday, February 2, 2023)]
[Notices]
[Pages 7109-7110]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-02143]
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DEPARTMENT OF LABOR
Office of the Workers' Compensation Programs
Agency Information Collection Activities; Comment Request; Claim
for Compensation by Dependents Information Reports
AGENCY: Office of Workers' Compensation Programs, Division of Federal
Employees', Longshore and Harbor Workers' Compensation--DFELHWC-FECA
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, ``Claim for Compensation
by Dependents Information Reports.'' This 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
April 3, 2023.
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#d3a0a6b4b4a0fdb2bdb9b2bdb6a7a7b693b7bcbffdb4bca5"><span class="__cf_email__" data-cfemail="4033352727336e212e2a212e2534342500242f2c6e272f36">[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#3a494f5d5d49145b54505b545f4e4e5f7a5e5556145d554c"><span class="__cf_email__" data-cfemail="97e4e2f0f0e4b9f6f9fdf6f9f2e3e3f2d7f3f8fbb9f0f8e1">[email protected]</span></a>.
FOR FURTHER INFORMATION CONTACT: Contact Anjanette Suggs by telephone
at 202-354-9660 or by email at <a href="/cdn-cgi/l/email-protection#0d7e786a6a7e236c63676c63687979684d696261236a627b"><span class="__cf_email__" data-cfemail="6e1d1b09091d400f00040f000b1a1a0b2e0a010240090118">[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: The forms included in this package are forms used by
Federal employees and their dependents to claim benefits, to prove
continued eligibility for benefits, to show entitlement to remaining
compensation payments of a deceased employee and to show dependency
under the Federal Employees' Compensation Act. There are six items in
this information collection request. The information collected by Forms
CA-5 is used by dependents for claiming compensation for the work-
related death of a Federal employee and Form CA-5b is used by other
survivors. Form Letter CA-1031 is used in disability cases and provides
information to determine whether a claimant is supporting a dependent
and is entitled to additional compensation. Form Letter CA-1074 is a
follow up to
[[Page 7110]]
CA-5b to request clarification of any information that is unclear and
incomplete in the CA-5b. The Form Letter ``Compensation Due at Death''
is used to request information necessary to distribute compensation due
when an employee dies who was receiving or who was entitled to
compensation at the time of death for either disability benefits or a
scheduled award. The Form Letter ``Student Dependency'' is used to
obtain information regarding the student status of a dependent. When a
child reaches 18 years of age, they are no longer considered an
eligible dependent unless they are a full time student or incapable of
self-support. This information collection is currently approved for use
through July 31, 2023.
This information collection is authorized by 5 CFR 1320.3(c)(3) and
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
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.
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 1240-0013.
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.
Title of Collection: Claim for Compensation by Dependents
Information Reports.
Forms: CA-5, CA-5b; Form Letters (CA-1031, CA-1074, Compensation
Due at Death, and Student Dependency).
OMB Control Number: 1240-0013.
Affected Public: Individuals or Households.
Number of Respondents: 1,241.
Frequency: On occasion.
Number of Responses: 1,241.
Annual Burden Hours: 1,063.
Annual Respondent or Recordkeeper Cost: $556.00.
Authority: 44 U.S.C. 3506(c)(2)(A).
Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2023-02143 Filed 2-1-23; 8:45 am]
BILLING CODE 4510-CH-P
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