Ri 30-9 Ss

OMB SUPPORTING STATEMENT

RI 30-9 – Reinstatement of Disability Annuity Previously Terminated Because

of Restoration to Earning Capacity

A. Justification

1. Title 5, U. S. Code, Chapter 83, Section 8337 and Chapter 84, Section 8455 provide for the restoration of a disability annuity which has been terminated because the annuitant’s earnings were 80 percent of the current rate of pay for the position occupied immediately before retirement. The annuity will not be restored if the person (1) has been reemployed in a position subject to a Federal retirement system, (2) has recovered from the disability, or (3) has reached age 62.

2. RI 30-9 informs former annuitants of their right to request restoration. It also specifies the conditions to be met and the documentation that must be submitted with a request for reinstatement. If this collection of information were not conducted, OPM would be unable to determine whether a disability annuity should be reinstated as required by law. The Public Burden Statement meets the requirements of 5 CFR 1320.8(b)(3).

3. Use of improved information technology to reduce the burden is not possible because disabled annuitants apply for reinstatement as the need arises. This form is available on the OPM web site at http://www.opm.gov/retire/pubs/pamphlets/list.asp.

4. Requests for reinstatement are filed individually. There is no duplication because the respondents initiate the collection.

5. Information is not collected from small businesses.

6. This information collection is initiated by disabled annuitants who wish to be restored to our rolls. Less frequent collection would delay the restoration of benefits authorized by law.

7. The collection is consistent with the guidelines in 5 CFR 1320.6.

8. A notice of proposed information collection was published in the Federal Register on June 2, 2009, giving persons outside the agency an opportunity to comment on the form. No comments were received.

9. No payment or gift is provided to these respondents.

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10. This information collection is protected by the Privacy Act of 1974 and OPM regulations (5 CFR 831.106). The routine uses for disclosure appear in the Federal Register for OPM/Central-1 (73 FR 15013, et seq., March 20, 2008).

11. This collection includes medical and financial information from the respondents. This information is commonly considered private and is protected by OPM as described in item 10 above. The information must be collected in order for OPM to determine whether the respondent is disabled and is not earning as much as 80 percent of the current rate of pay for the position from which he or she retired. The respondent is not required to submit this information; however, without such information OPM is not able to reinstate the disability annuity.

12. The number of respondents is approximately 200. The frequency of response is on occasion. It is estimated to take 60 minutes to respond, including a medical examination. The annual estimated burden is 200 hours. Burden may vary depending on the time required for a medical examination.

13. Although recent physicians’ reports are required so that we can make a disability determination, there is no way to estimate the cost to the annuitants because they are paying for their continuing medical care anyway. They do not necessarily have to get a special medical evaluation to fulfill the OPM requirements.

14. The annualized cost to the Federal government is $10,500. This cost was determined by employee salary hours devoted to the program, forms cost, and overhead.

15. There are no changes to the respondent burden.

16. The results of this information collection are not published.

17. It is not cost effective to reprint the whole supply of forms to change the OMB clearance expiration date. Therefore, we seek approval not to display the date on the form.

18. There are no exceptions to the certification statement.