Justification for Change of World Trade Center Health Program 062813 (3)

Justification for Non-substantive Change of World Trade Center Health Program Enrollment,

Appeals & Reimbursement Information Collection Request (0920-0891)

The World Trade Center Health Program is requesting a nonmaterial/non-substantive change request for the approved information collection for the World Trade Center Health Program Enrollment, Appeals & Reimbursement (0920-0891). The current expiration date is 12/31/2014.

The Program supports health monitoring and treatment for emergency responders; recovery and cleanup workers; and residents, building occupants, and area workers in New York City who were directly impacted and adversely affected by the terrorist attacks of September 11, 2001. The current ICR accounts for the data collection from the eligibility and enrollment forms. It also outlines the areas where an applicant or member of the Program has an opportunity to appeal adverse decisions made by the Program. This includes the right to appeal denial of eligibility and denial of health condition certification. The change to the approved ICR is to add clarification about what a member can request during the appeal process for denial of health condition certification. Specifically, the change clarifies that a member can request the opportunity to provide an oral statement to a Federal official during the appeal review. The member also has the option of making a request (in writing) to add a designated representative to act on their behalf during the entire appeals process. There are no forms for members to complete but they can request the designated representative and/or oral statement in writing by fax or mail (Appendix H).

It is not expected that the time or cost burden will increase with the clarification added to the currently approved ICR because the original request accounts for the member’s appeal time, including submitting a request for a review which is when they can request a designated representative and/or oral statement.