Notice2024-00490
Agency Information Collection Activities; Comment Request; Representative Payee Report, Representative Payee Report (Short Form), and Physician's/Medical Officer's Statement
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
January 12, 2024
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, "Representative Payee Report, Representative Payee Report (Short Form), and Physician's/ Medical Officer's Statement." 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 89 Issue 9 (Friday, January 12, 2024)</title>
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[Federal Register Volume 89, Number 9 (Friday, January 12, 2024)]
[Notices]
[Pages 2254-2255]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-00490]
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DEPARTMENT OF LABOR
Office of the Workers' Compensation Programs
Agency Information Collection Activities; Comment Request;
Representative Payee Report, Representative Payee Report (Short Form),
and Physician's/Medical Officer's Statement
AGENCY: Division of Coal Mine Workers' Compensation.
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, ``Representative Payee
Report, Representative Payee Report (Short Form), and Physician's/
Medical Officer's Statement.'' 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
March 12, 2024.
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#f28187959581dc939c98939c97868697b2969d9edc959d84"><span class="__cf_email__" data-cfemail="3241475555411c535c58535c5746465772565d5e1c555d44">[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#2251574545510c434c48434c4756564762464d4e0c454d54"><span class="__cf_email__" data-cfemail="3f4c4a58584c115e51555e515a4b4b5a7f5b505311585049">[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#fc8f899b9b8fd29d92969d9299888899bc989390d29b938a"><span class="__cf_email__" data-cfemail="1b686e7c7c68357a75717a757e6f6f7e5b7f7477357c746d">[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
[[Page 2255]]
clearly understood, and the impact of collection requirements can be
properly assessed.
Benefits due to a DOL Black Lung beneficiary are paid to a
representative payee on behalf of the beneficiary when he or she is
unable to manage the benefits due to incapability or incompetence or
because the beneficiary is a minor. The Representative Payee Report
(Form CM-623) and Representative Payee Report Short Form (Form CM-623S)
are used to ensure that benefits paid to a representative payee are
used for the beneficiary's well-being. The Physician's/Medical
Officer's Statement (Form CM-787) is used to determine the
beneficiary's capability to manage monthly black lung benefits. The
Black Lung Benefits Act, 30 U.S.C. 922, authorizes this information
collection. authorizes this information collection.
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 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 1240-0020.
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: Representative Payee Report, Representative
Payee Report (Short Form), and Physician's/Medical Officer's Statement.
Form: Representative Payee Report (CM-623), Representative Payee
Report (Short Form) (CM-623S) and Physician's/Medical Officer's
Statement (CM-787).
OMB Control Number: 1240-0020.
Affected Public: Individuals or Households.
Estimated Number of Respondents: 282.
Frequency: Occasionally.
Total Estimated Annual Responses: 282.
Estimated Average Time per Response: 10-90 minutes.
Estimated Total Annual Burden Hours: 153 hours.
Total Estimated Annual Other Cost Burden: $192.00.
Authority: 44 U.S.C. 3506(c)(2)(A).
Dated: January 8, 2024.
Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2024-00490 Filed 1-11-24; 8:45 am]
BILLING CODE 4510-CK-P
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