Employer's Report Of Injury Or Occupational Illness, Physicians' Report On Impairment Of Vision, And Employer's Supplementary Report Of Accident Or Occupational Illness

EMPLOYER'S REPORT OF INJURY OR OCCUPATIONAL ILLNESS, PHYSICIANS' REPORT ON IMPAIRMENT OF VISION, AND EMPLOYER'S SUPPLEMENTARY REPORT OF ACCIDENT OR OCCUPATIONAL ILLNESS

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0031 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	EMPLOYER'S REPORT OF INJURY OR OCCUPATIONAL ILLNESS, PHYSICIANS' REPORT ON IMPAIRMENT OF VISION, AND EMPLOYER'S SUPPLEMENTARY REPORT OF ACCIDENT OR OCCUPATIONAL ILLNESS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	LS-202	No	No
Form	LS-205	No	No
Form	LS-210	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 45,410	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	45,410	45,410
Annual IC Time Burden (Hours)	11,408	11,408
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.