Supporting Statement

SUPPORTING STATEMENT

Injured Worker Satisfaction Survey

1. Explain the circumstances that make the collection of information necessary.

Identify any legal or administrative requirements that necessitate the collection.

Attach a copy of the appropriate section of each statute and of each

regulation mandating or authorizing the collection of information.

The Federal Employees' Compensation Act provides workers' compensation coverage to three million Federal and postal workers around the world for employment-related injuries and occupational diseases.

The Division of Federal Employees' Compensation (DFEC) adjudicates new claims for benefits and manages ongoing cases; pays medical expenses and compensation benefits to injured workers and survivors; and helps injured employees return to work when they are medically able to do so, to include, if applicable, vocational rehabilitation assistance in returning to work. The program has 12 district offices nationwide to assist in the management of the program. The offices are located in the following cities: Boston, New York, Philadelphia, Jacksonville, Cleveland, Chicago, Kansas City, Denver, San Francisco, Seattle, Dallas, and Washington, D.C.

On September 11, 1993, President Clinton issued Executive Order 12862, “Setting Customer Service Standards,” which clearly defined his vision that the Federal agencies will put the people first. To do that, the President called for a “revolution within the Federal government to change the way it does business.” He expected this process to require continual reform of government practices and operations with the result that, when dealing with the Federal agencies, all people would receive services that match or exceed the best service available in the private sector.

Section 1(b) of that Order required agencies to “survey customers to determine the kind and quality of services they want and their level of satisfaction with existing services” and Section 1(e) requires agencies to “survey front-line employees on barriers to, and ideas for, matching the best in business.” These Presidential requirements established a need for the DFEC at the Department of Labor (DOL) to be engaged in an interactive process of collecting information and using it to improve program services and processes. Agencies are therefore authorized to measure customer satisfaction and report results. In addition, the March 22, 1995 Presidential Memo, “Improving Customer Service,” states that customer views should be obtained to determine whether standards have been met on those matters which most concern the customer.

2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

This evaluation, which is a new survey collection, will enable the DFEC to assess satisfaction among Federal employees who have filed a claim and lost time due to a work related injury. This evaluation will assess the injured worker’s satisfaction with various aspects of the claims process, including the following:

• Promptness of response to inquiries

• Courtesy of staff

• Thoroughness of assistance

• Obtaining medical treatment

• Experience with the disability management nurses

• Interaction with vocational rehabilitation counselors

• Communication with the employer

The overall purpose of this survey is to systematically obtain information from claimants which can be then be used to identify problems or complaints that need attention and to improve the quality of services delivered to each claimant.

DFEC is defining its pool of eligible survey participants as Federal employees with a date of injury and lost time from work during the period January 1, 2006, and December 31, 2009. The Injured Worker Satisfaction Survey will consist of a 17-page questionnaire which has 48 questions. It is anticipated this survey will be used periodically.

3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

DFEC will deliver the survey universe to Systems Research and Applications (SRA) International, Inc., which has been contracted to conduct this survey as part of an impact evaluation. SRA will send out an explanatory letter to the selected claimants, who will have the option to complete a survey via a website. Alternatively, the claimant may request a paper survey for completion.

The web-based access system is established to meet the goals of the Government Paperwork Elimination Act (GPEA), and it is anticipated that the implementation of this system will eventually save the government money, in that fewer mailings and returns will be required to accurately measure and report customer perceptions of DFEC and the services provided by the district offices.

4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

The information to be supplied on these surveys will not be duplicated on any other information collection.

5. If the collection of information impacts small businesses or other small entities (Item 5 of OMB Form 83-1), describe any methods used to minimize burden.

Not applicable. The questions are being asked only of individual customers of DFEC.

6. Describe the consequence to Federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

DFEC’s ongoing program improvement plans involve obtaining an outside assessment of the program’s performance. This study is an essential component of evaluating whether the program is effective and achieving its results. Failure to conduct this survey would deprive DFEC of an important tool in making such an evaluation and of identifying areas for improvement.

7. Explain any special circumstance.

There are no special circumstances for the collection of this information.

8. If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency’s notice, required by 5 CFR 1320.8 (d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments.

Not applicable. Request is being made in accordance with ICR 1225-0059, with

OMB concurrence by email within 15 working days.

9. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.

No payment or gift will be provided to respondents in this study.

10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulations, or agency policy.

Participation in this effort is strictly voluntary, and all responses will be kept confidential and used only for the purposes of this study. Respondents will not be required to provide any identifying information such as name, claim number or social security number. The responses will be anonymous. Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with an individual. We will not provide information that identifies a survey participant to anyone outside the study team, except as required by law.

All returned survey documents will be destroyed once the dataset created from those documents has been validated. Since the responses are not individually identifiable, there is no need to store or process these forms in accordance with the Privacy Act. Nonetheless, the applicable Privacy Act system of records is called DOL/GOVT-1. See Web site: http://www.dol.gov/sol/privacy/dol-govt-1.htm.

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary; the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

This data collection will not involve sensitive questions.

12. Provide estimates of the hour burden of the collection of information. The statement should:

Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample of potential respondents is desirable. If the burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated burden and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices. Provide estimates of the hour burden of the collection of information.

The Injured Worker Satisfaction Survey (Attachment 1) covers a broad array of questions; however, we estimate that the survey will take no more than 15 minutes to complete. The 15 minute estimate was determined by testing the survey questions and evaluating time to completion.

During FY 2006 through 2009, there were approximately 50,000 lost time cases per year or a total target population of approximately 150,000 claims. In order to get a 99% confidence level with a plus or minus 3 percent confidence level, 5,400 claimants would need to be surveyed. The estimated response rate is 30 percent for a Customer Service Survey; therefore, the total number of respondents is estimated to be 1,620. With a projected survey response estimated at 1,620, the total burden is 405 hours (1,620 hours * 15/60). The statistical analysis used for this survey is noted in Supporting Statement B.

The following chart shows the projected burden hours for this collection.

Form	Time to Complete	Frequency of Response	Number of Respondents	Number of Responses	Hours Burden
Customer Satisfaction Survey	15 min.	1	1,620	1,620	405

13. Annual Costs to Respondents (capital/start-up & operation and maintenance).

The cost to respondents should be negligible. Participation is voluntary and will not require start‑up, capital, or labor expenditures by respondents. Postage for returning the surveys will be pre-paid.

14. Provide estimates of annualized cost to the Federal government.

The cost to the Government is $30,673.55, which includes printing and mailing the survey notification and any paper surveys requested, as well as the costs paid to SRA International for the survey development and administration.

15. Explain the reasons for any program changes or adjustments reported in Items 13 or 14 of the OMB Form 83-I.

This is a new data collection.

16. For collections of information whose results will be published, outline plans for tabulation and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection information, completion of report, publication dates, and other actions.

Results will primarily be for internal use and process evaluation. Results will be shared with the Office of the Secretary of Labor and may be published if deemed appropriate.

17. If seeking approval to not display the expiration date for OMB approval of the

information collection, explain the reasons that display would be inappropriate.

No exception to the display of the expiration date is sought.

18. Explain each exception to the certification statement identified in Item 19,

"Certification for Paperwork Reduction Act Submissions," of OMB Form 83-I.

No exception.

B. Collections of Information Employing Statistical Methods

1. Provide a numerical estimate of the potential respondent universe and describe any sampling or other respondent selection method to be used. Data on the number of entities (e.g., households or persons) in the universe and the corresponding sample are to be provided in tabular format for the universe as a whole and for each stratum. Indicate expected response rates. If this has been conducted previously, include actual response rates achieved.

• Claims filed CY06-CY09 150,000

• Potential respondent universe: 5,400

(Expected response rate =30%. In order get a 99% confidence level with a + or minus 3% confidence interval, we need to survey about 5,400.)

• Expected response rate: Average of 30% (total responses = 1,620)

• Sampling methodology: See below.

2. Describe the procedures for the collection of information, including:

a. Statistical methodology for stratification and sample selection

b. Estimation procedure

c. Degree of accuracy needed

d. Unusual problems requiring specialized sampling procedures

e. Any use of less frequent than monthly data collection to reduce burden

The selection of the universe is based on the following criteria: (a) Federal employees with accepted claims and lost time from work with a date of injury during the period January 1, 2006, and December 31, 2009. Note: As indicated in Supporting Statement A, this survey will be used periodically, and therefore, the calendar years may change, which will impact on the universe and sample sizes.

Upon identification of these claims by our data processing unit, the claims will then be broken down proportionately by the twelve district offices. Claimants to be selected from this listing as survey participants will be identified in "nth" item order.

This method of selection is random enough to ensure that the cases are selected from the entire range of cases between CY06-CY09. DFEC will then provide the survey participant list to SRA International, Inc.

SRA will transmit the survey to each participant via direct mailings, with a cover letter provided by the DFEC Director. The claimants will be asked to complete the survey on-line or alternatively they can request a paper survey.

The sample size has been determined to be of a sufficient size to give statistically reliable data for each DFEC district office. The data collection provides for sufficiently timely identification of problem areas and undertaking of steps toward improvement. This will allow DFEC to improve on its quality service to the injured worker. We anticipate final results of this survey to be completed and available by October 2010.

3. Describe methods to maximize response rate and to deal with issues of non-response. The accuracy and reliability of information collected must be shown to be adequate for intended uses. For collections based on sampling, a special justification must be provided for any collection that will not yield “reliable” data that can be generalized to the universe studied.

Responses will primarily be completed on-line, but survey questionnaires will be mailed to participants via first class mail upon request. If the claimant requests a paper survey, a postage-paid return envelope will be included for returning the survey.

4. Describe any tests of procedures or methods to be undertaken. Testing is encouraged as an effective means of refining collections to minimize burden and improve utility. Tests must be approved if they call for answers to identical questions of 10 or more individuals.

Not applicable.

5. Provide the name and telephone number of individuals consulted on statistical aspects of the design and the name of the agency unit, contractor(s), grantee(s), or other person(s) who will actually collect and/or analyze the information for the agency.

David Shellard, SRA International, Inc., 703-284-7372

Maddy Bowling, Maddy Bowling and Associates Consulting, Inc. (subcontractor to SRA International, Inc.), (630) 682-3169

David Huth, Maddy Bowling and Associates Consulting, Inc. (subcontractor to SRA International, Inc.), (978) 969-1649

Ann Clayton, Ann Clayton and Associates (subcontractor to SRA International, Inc), (781) 402-0012

Nancy Ricker, Nancy Ricker, Inc. (subcontractor to SRA International, Inc), (904) 269-4240

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