Benefits Timeliness and Quality Review System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form ETA 9057 Lower Authority Appeals Quality Review	Form and Instruction	Modified	Source copy available
Form ETA 9056 Nonmonetary Determination Quality Review	Form and Instruction	Modified	Available
Form ETA 9055 Appeals Case Aging	Form and Instruction	Modified	Available
Form ETA 9054 Appeals Time Lapse	Form and Instruction	Modified	Available
Form ETA 9052 Nonmonetary Determination TIme Lapse Detection	Form and Instruction	Modified	Available
Form ETA-9051 Continued Weeks Compensated Time Lapse	Form and Instruction	Modified	Available
Form ETA 9050 First Payment Time Lapse	Form and Instruction	Modified	Available
1205-0359 PART B Supporting Statement 11 23 2010 BLS approved.doc	Supporting Statement B	Uploaded 2010-11-24	Available
1205-0359 Part A Supporting Statement 11 23 2010.DOC	Supporting Statement A	Uploaded 2010-11-24	Available
1205-0359 signed, approved BLS cover sheet 11 23 2010.pdf	Supplementary Document	Uploaded 2010-11-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	Lower Authority Appeals Quality Review
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	Nonmonetary Determination Quality Review
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	Appeals Case Aging
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	Appeals Time Lapse
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	Nonmonetary Determination TIme Lapse Detection
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	Continued Weeks Compensated Time Lapse
13147	Benefits Timeliness and Quality Review System	Form and Instruction	Modified	First Payment Time Lapse

ICR Details

OMB Control No: 1205-0359	ICR Reference No: 201010-1205-005
Status: Historical Active	Previous ICR Reference No: 200710-1205-002
Agency/Subagency: DOL/ETA	Agency Tracking No: 012-05-01-05-09-2035-00
Title: Benefits Timeliness and Quality Review System
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/27/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/30/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2014	36 Months From Approved	02/28/2011
Responses	29,976	0	28,912
Time Burden (Hours)	39,892	0	37,532
Cost Burden (Dollars)	0	0	0

---

Abstract: These reports provide data necessary to monitor state performance in administration of Unemployment Insurance as mandated by the Secretary of Labor.

---

Authorizing Statute(s): PL: Pub.L. 109 - 91 303(a)(1) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 55357	09/10/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 74086	11/30/2010
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Benefits Timeliness and Quality Review System	ETA 9052, ETA 9055, ETA 9056, ETA-9051, ETA 9054, ETA 9057, ETA 9050	First Payment Time Lapse ,   Continued Weeks Compensated Time Lapse ,   Nonmonetary Determination TIme Lapse Detection ,   Appeals Time Lapse ,   Appeals Case Aging ,   Nonmonetary Determination Quality Review ,   Lower Authority Appeals Quality Review

---

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	29,976	28,912	0	0	1,064	0
Annual Time Burden (Hours)	39,892	37,532	0	0	2,360	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: No program changes were made; however, the slightly increased burden results from sample sizes for the nonmonetary and appeals quarterly reviews being slightly increased during the past three years, and they are determined by workload. Because of the relatively small added workload, some states were reclassified this time from small to large, resulting in an increase in burden. For nonmonetary determination quality, sample sizes are set annually and depend on the volume of nonmonetary determinations reported to the Department of Labor on the ETA 9052 reports for the prior calendar year. States are classified as large or small based on this caseload. Large states are those that issued 100,000 or more nonmonetary determinations in the prior calendar year. Small states are those that issued fewer than 100,000 nonmonetary determinations in the prior calendar year. Large states will draw a minimum sample of 100 determinations (50 separation issues and 50 nonseparation issues) per quarter for review. Small states will draw a minimum sample of 60 determinations (30 separation issues and 30 nonseparation issues) per quarter for review. For lower authority appeals quality, all States (except those with a workload of more that 40,000 decisions in the prior fiscal year) will review a minimum of 20 randomly selected cases from each of the four quarters of the fiscal year. This is the minimum sample size needed for statistical validity of the results. The States, with annual workloads exceeding 40,000 cases will be required to select a 40 case sample per quarter to assure accurate results. The determination of sample size (20 or 40 cases per quarter) for each State for the calendar year will be made prior to end of the first quarter of each calendar year, based on the workload during the prior calendar year. Additionally, a non-substantive change was made to the 9056 form where three cells were eliminated as a result of the elimination of the 9053 form in the prior report.

---

Annual Cost to Federal Government: $369,153

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(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: 11/30/2010

---