Rehabilitation Action Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form OWCP-44 Rehabilitation Action Report	Form	Modified	Available
Longshore Privacy Act System of Records.docx	Supplementary Document	Uploaded 2017-09-13	Available
opm salary tables 2017 rus 1240-0008.pdf	Supplementary Document	Uploaded 2017-09-13	Available
Longshore Section 908 (g) and 939 (c) for 1240-0008x.docx	Supplementary Document	Uploaded 2017-09-13	Available
Sections 8104 and 8111 for 1240-0008.docx	Supplementary Document	Uploaded 2017-09-13	Available
Privacy Act System of Records DOL GOVT-1 2017.doc	Supplementary Document	Uploaded 2017-09-13	Available
Supporting Statement 1240-0008 2017.doc	Supporting Statement A	Uploaded 2017-11-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13901	Rehabilitation Action Report	Form	Modified

ICR Details

OMB Control No: 1240-0008	ICR Reference No: 201709-1240-001
Status: Active	Previous ICR Reference No: 201405-1240-002
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Rehabilitation Action Report
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: 02/09/2018
	Date Received in OIRA: 12/31/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved	02/28/2018
Responses	4,066	0	4,775
Time Burden (Hours)	678	0	796
Cost Burden (Dollars)	0	0	0

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Abstract: The OWCP-44 is the form used to report the status of a rehabilitation case, submitted by the contractor vocational rehabilitation counselor during an ongoing vocational rehabilitation effort, and to request prompt adjudicatory claims action based on events arising during that effort.

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Authorizing Statute(s): US Code: 33 USC 908 Name of Law: LHWCA
   US Code: 33 USC 939 Name of Law: LHWCA
   US Code: 5 USC 8104 Name of Law: FECA
   US Code: 5 USC 8111 Name of Law: FECA
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 48533	10/18/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 203	12/31/2017
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Rehabilitation Action Report	OWCP-44	Rehabilitation Action Report

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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	4,066	4,775	0	0	-709	0
Annual Time Burden (Hours)	678	796	0	0	-118	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: As indicated in item 12, since the last clearance three years ago, the responses from the respondents decreased from 4,775 to 4,066, which is an adjustment of 709 responses. Accordingly, the burden hours decreased from 796 to 678, an adjustment of 118 hours. We attribute the reduction due to the decrease in the number of claims filed since the last submission. The agency believes this most recent data accurately reflects the actual average number of responses and has made a corresponding change to the estimates. The OWCP-44 form was updated prior to the last clearance in 2014. As such, there have been no requested or completed changes to the form’s structure since that time.

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Annual Cost to Federal Government: $91,648

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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

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Common Form ICR:  No

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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: 12/31/2017

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