Rehabilitation Plan and Award

ICR 201011-1240-005

OMB: 1240-0045

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2011-05-16
Supplementary Document
2010-11-23
Supplementary Document
2010-11-23
Supplementary Document
2010-11-23
Supplementary Document
2010-11-23
IC Document Collections
IC ID
Document
Title
Status
13717 Modified
ICR Details
1240-0045 201011-1240-005
Historical Active 201003-1240-045
DOL/OWCP
Rehabilitation Plan and Award
Extension without change of a currently approved collection   No
Regular
Approved without change 07/25/2011
Retrieve Notice of Action (NOA) 05/20/2011
  Inventory as of this Action Requested Previously Approved
07/31/2014 36 Months From Approved 07/31/2011
5,500 0 7,000
2,750 0 3,500
0 0 0

Form OWCP-16 is used by vocational rehabilitation counselors to submit an agreed upon rehabilitation plan to OWCP for approval, and documents OWCP's award of payment for any approved services.

US Code: 5 USC 8101 et seq. Name of Law: Federal Employees' Compensation Act (FECA)
   US Code: 33 USC 901 et seq Name of Law: Longshore and Harbor Workers' Compensatinon Act (LHWCA)
  
None

Not associated with rulemaking

  76 FR 2421 01/13/2011
76 FR 29272 05/20/2011
No

1
IC Title Form No. Form Name
Rehablitation Plan and Award OWCP-16 Rehabilitation Plan and Award

  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 5,500 7,000 0 0 -1,500 0
Annual Time Burden (Hours) 2,750 3,500 0 0 -750 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
More accurate assessment of usage was completed based on updated numbers for open rehab cases. (FECA)

$265,225
No
No
No
No
No
Uncollected
Vincent Alvarez 202 693-0372 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/20/2011


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