In accordance
with 5 CFR 1320, the information collection is not approved at this
time. Prior to publication of the final rule, the agency should
provide to OMB a summary of all comments received on the proposed
information collection and identify any changes made in response to
these comments.
Inventory as of this Action
Requested
Previously Approved
09/30/2019
09/30/2019
09/30/2019
38,480
0
38,480
6,388
0
6,388
68,879
0
68,879
Form OWCP-915 is used to claim
reimbursement for out-of-pocket covered medical expenses paid by a
beneficiary, and must be accompanied by required billing data
elements (prepared by the medical provider) and by proof of payment
by the beneficiary.
US Code:
30
USC 901 Name of Law: Black Lung Benefits Act
US Code: 5 USC
8101 Name of Law: Employees Compensation Act
US Code: 42
USC 7384 Name of Law: Energy Employees Occupational Illness
Compensation Program Act of 2000 (EEOICPA)
The agency received 31,824
responses in FY 2015, fewer than anticipated. This results in a
decrease of 1,105 burden hours (6,388 previously approved hours –
5,283 hours = 1,105 hours). Costs also decreased by $14,142 because
of the decreased number of responses ($68,879 previously approved –
$54,737 = $14,142). In addition, the proposed BLBA rule continues
the current information collection requirements but would change
where the regulatory authorities are codified. This ICR updates the
regulatory citation for the BLBA program’s authority to collect the
information.
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.