STANDARDS FOR DETERMINING COAL MINERS' DISABILITY DUE TO PNEUMOCONIOSIS

ICR 198005-1215-004

OMB: 1215-0090

Federal Form Document

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ICR Details
1215-0090 198005-1215-004
Historical Active
DOL/ESA
STANDARDS FOR DETERMINING COAL MINERS' DISABILITY DUE TO PNEUMOCONIOSIS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 05/22/1980
Retrieve Notice of Action (NOA) 05/12/1980
  Inventory as of this Action Requested Previously Approved
03/31/1984 03/31/1984
160,000 0 0
40,000 0 0
0 0 0

20CFR 718 CONTAINS STANDARDS FOR THE MEDICAL DETERMINATION OF COAL WORKER'S PNEUMOCONIOSIS. PURSUANT TO THIS REGULATION, FORM CM-907, CM-933, AND CM-983 ARE UTILIZED TO GATHER INFORMATION FROM PHYSICIANS TO DETERMINE A CLAIMANT'S MEDICAL ELIGIBILITY UNDER THE BLACK LUNG BENEFITS ACT.

None
None


No

1
IC Title Form No. Form Name
STANDARDS FOR DETERMINING COAL MINERS' DISABILITY DUE TO PNEUMOCONIOSIS ESA 20 CFR, PART 718

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 160,000 0 0 0 160,000 0
Annual Time Burden (Hours) 40,000 0 0 0 40,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/12/1980


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