Survey of Occupational Injuries and Illnesses

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BLS-9300 N06 Survey of Occupational Injuries and Illnesses - Private Sector	Form and Instruction	Modified	Available
Form OSHA 300 Survey of Occupational Injuries and Ilnesses - State and Local	Form and Instruction	Modified	Available
Note to Reviewer - new IDCF form.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2009-10-01	Available
Note to Reviewer - new IDCF form.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2008-06-24	Available
Note to Reviewer - QA survey and Public Sector Data.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2008-01-16	Available
Response to AOL's Comments from the 2nd FR Notice	Supplementary Document	Uploaded 2007-09-06	Available
OMB Questions (with responses) about the Survey of Occupational Injuries and Illnesses.doc	Supplementary Document	Uploaded 2007-09-06	Available
OMB2007 Supporting Statement Part A.doc	Supporting Statement A	Uploaded 2007-06-18	Available
OMB2007 Supporting Statement Part B.doc	Supporting Statement B	Uploaded 2007-06-18	Available
nonresponse two letter 2007.pdf	Supplementary Document	Uploaded 2007-03-13	Available
nonresponse one letter 2007.pdf	Supplementary Document	Uploaded 2007-03-13	Available
Informed Consent.pdf	Supplementary Document	Uploaded 2007-03-13	Available
Comm Order 1-06.doc	Supplementary Document	Uploaded 2007-03-13	Available
Secretary_Order_5-2002.doc	Supplementary Document	Uploaded 2007-03-13	Available
CIPSEA_TitleV.doc	Supplementary Document	Uploaded 2007-03-13	Available
Public Law 91-596.doc	Supplementary Document	Uploaded 2007-03-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
38596	Survey of Occupational Injuries and Illnesses - Private Sector	Form and Instruction	Modified
179004	Survey of Occupational Injuries and Ilnesses - State and Local	Form and Instruction	Modified

ICR Details

OMB Control No: 1220-0045	ICR Reference No: 200910-1220-001
Status: Historical Active	Previous ICR Reference No: 200806-1220-004
Agency/Subagency: DOL/BLS	Agency Tracking No:
Title: Survey of Occupational Injuries and Illnesses
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/06/2009
	Date Received in OIRA: 10/02/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2010	09/30/2010	09/30/2010
Responses	237,000	0	237,000
Time Burden (Hours)	337,510	0	337,510
Cost Burden (Dollars)	0	0	0

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Abstract: The Survey of Occupational Injuries and Illnesses is the primary indicator of the Nation's progress in providing every working man and woman safe and healthful working conditions. Survey data are also used to evaluate the effectiveness of the Federal and State programs and to prioritize scarce resources.

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Authorizing Statute(s): PL: Pub.L. 107 - 347 Title 5 Name of Law: Confidential Information Protection and Statistical Efficiency Act (CIPSEA)
   PL: Pub.L. 91 - 596 24(a) Name of Law: Occupational Safety and Health Act of 1970
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 52	03/19/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 126	07/02/2007
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Survey of Occupational Injuries and Illnesses - Private Sector	OSHA 300, BLS-9300 N06, BLS-9300-IDCF, BLS-9300 FAX, 9300	Survey of Occupational Injuries and Illnesses, 2007 ,   Survey of Cooupational Injuries - Spanish version ,   Survey of Occupational Injuries and Illnesses, 2007 ,   Log of Work-Related Injuries and Illnesses ,   Survey of Occupational Injuries and Illnesses - IDCF
Survey of Occupational Injuries and Ilnesses - State and Local	BLS 9300, BLS 9300, BLS 9300 IDCF, OSHA 300, BLS-9300 N06	Log of Work-Related Injuries and Illnessses ,   Survey of Occupational Injuries and Illnesses, 2007 ,   Survey of Occupational Injuries and Illnesses ,   Survey of Occupational Injuries and Illnesses - Spanish version ,   Survey of Occupational Injuries and Illnesses IDCF

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ICR Summary of Burden

table that charts list of burden

	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	237,000	237,000	0	0	0	0
Annual Time Burden (Hours)	337,510	337,510	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The change in burden is due to the addition of a Quality Assurance Survey (578) and the addition of public sector data collection of (9433).

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Annual Cost to Federal Government: $14,800,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 10/02/2009

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