[Federal Register: May 4, 2005 (Volume 70, Number 85)]
[Notices]
[Page 23230-23231]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr04my05-94]
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DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Collection; Comment Request
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 (time and financial resources) is minimized,
collection instruments 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 collection: Representative Payee
Report (CM-623), Representative Payee Report, Short Form (CM-623S), and
Physician's/Medical Officer's Statement (CM-787). A copy of the
proposed information collection request can be obtained by contacting
the office listed below in the addresses section of this Notice.
[[Page 23231]]
DATES: Written comments must be submitted to the office listed in the
addresses section below on or before [insert date 60 days from the date
of publication].
ADDRESSES: Ms. Hazel M. Bell, U.S. Department of Labor, 200
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone
(202) 693-0418, fax (202) 693-1451, e-mail bell.hazel@dol.gov. Please
use only one method of transmission for comments (mail, fax, or e-
mail).
SUPPLEMENTARY INFORMATION
I. Background
The Office of Workers' Compensation Programs administers the
Federal Black Lung Workers' Compensation Program. Under the Federal
Mine Safety and Health Act (30 U.S.C. 901) benefits due a DOL black
lung beneficiary may be paid to a representative payee on behalf of the
beneficiary when the beneficiary is unable to manage his/her benefits
due to incapability, incompetence, or minority. The CM-623,
Representative Payee Report is used to collect expenditure data
regarding the disbursement of the beneficiary's benefits by the
representative payee to assure that the beneficiary's needs are being
met. The CM-623S, Representative Payee Report, Short Form is a
shortened version of the CM-623 that is used when the representative
payee is a family member. The CM-787, Physician's/Medical Officer's
Statement is a form used by OWCP to gather information from the
beneficiary's physician about the capability of the beneficiary to
manage monthly benefits. It is used by OWCP to determine if it is in
the beneficiary's best interest to have his/her benefits managed by
another party. The regulatory authority for collecting this information
is at 20 CFR 725.506, 510, 511, and 513. This information collection is
currently approved for use through October 31, 2005.
II. Review Focus
The Department of Labor is particularly interested in comments
which:
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 submissions of responses.
III. Current Actions
The Department of Labor seeks the extension of approval to collect
this information in order to carry out its responsibility to determine
if a beneficiary is capable and/or competent to manage his/her black
lung benefits, and to ensure that the representative payee is using the
benefits to meet the beneficiary's needs.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Representative Payee Report (CM-623), Representative Payee
Report, Short Form (CM-623S), and Physician's/Medical Officer's
Statement (CM-787).
OMB Number: 1215-0173.
Agency Number: CM-623, CM-623S, and CM-787.
Affected Public: Individuals or households; Business or other for
profit, Not-for-profit institutions.
Total Respondents: 5,339.
Total Annual responses: 5,399.
Estimated Total Burden Hours: 5,430.
Frequency: On occasion.
Total Burden Cost (capital/startup): $0.
Total Burden Cost (operating/maintenance): $0.
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Respondents/
Forms responses Time per response Burden hours
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CM-623........................................ 3,344 90 minutes...................... 5,016
CM-623S....................................... 1,015 10 minutes...................... 169
CM-787........................................ 980 15 minutes...................... 245
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Total..................................... 5,339 ................................ 5,430
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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: April 27, 2005.
Bruce Bohanon,
Chief, Branch of Management Review and Internal Control, Division of
Financial Management, Office of Management, Administration and
Planning, Employment Standards Administration.
[FR Doc. 05-8844 Filed 5-3-05; 8:45 am]