Survey of Occupational Injuries and Illnesses

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BLS 9300 Survey of Occupational Injuries and Illnesses - Private Sector	Form and Instruction	Modified	Available
Form HSOII Questionnair Household Survey of Occupational Injuries and Illnesses Pilot Test (HSOII)	Form and Instruction	Unchanged	Available
Form SOII IDCF Public Sector - Voluntary	Form and Instruction	Modified	Available
Form BLS 9300 N06 Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory	Form and Instruction	Modified	Available
1220-0045 Supporting Statement.docx	Supporting Statement A	Uploaded 2018-04-27	Available
Note to Reviewer - 1220-0045.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2017-09-12	Available
Note to Reviewer - 1220-0045.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2017-06-20	Available
1220-0045 Supporting Statement Part B (1-24-2017).docx	Supporting Statement B	Uploaded 2017-01-24	Available
SOII_IDCF_2008.doc	Supplementary Document	Uploaded 2016-06-30	Available
SOII_Edits_test_2012_finalreport_draft.docx	Supplementary Document	Uploaded 2016-06-30	Available
SOII_Adobe_2009.doc	Supplementary Document	Uploaded 2016-06-30	Available
Sample Allocation to Increase the Expected Number of Publishabel Cells in the SOII.pdf	Supplementary Document	Uploaded 2016-06-27	Available
Nonresponse Bieas in the SOII (August 2013).pdf	Supplementary Document	Uploaded 2016-06-27	Available
Secretary_Order_5-2002.doc	Supplementary Document	Uploaded 2016-06-27	Available
Variance Estimation for SOII Summary Estimates 6-23-05.pdf	Supplementary Document	Uploaded 2016-06-27	Available
Variance Estimation for SOII Case and Demographic Estimates 2-22-02.docx	Supplementary Document	Uploaded 2016-06-27	Available
The growth in cases with Restricted Activity or Job Transfer.docx	Supplementary Document	Uploaded 2016-06-27	Available
sample_overview.pdf	Supplementary Document	Uploaded 2016-06-27	Available
homch9.pdf	Supplementary Document	Uploaded 2016-06-27	Available
Deriving Inputs for the Allocation of State Samples for OMB Supporting Doc.docx	Supplementary Document	Uploaded 2016-06-27	Available
CIPSEA_TitleV.doc	Supplementary Document	Uploaded 2016-06-15	Available
Public Law 91-596.doc	Supplementary Document	Uploaded 2016-06-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
38596	Survey of Occupational Injuries and Illnesses - Private Sector	Form and Instruction	Modified
225295	Household Survey of Occupational Injuries and Illnesses Pilot Test (HSOII)	Form and Instruction	Unchanged
192801	Public Sector - Voluntary	Form and Instruction	Modified
179004	Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory	Form and Instruction	Modified

ICR Details

OMB Control No: 1220-0045	ICR Reference No: 201712-1220-004
Status: Historical Active	Previous ICR Reference No: 201709-1220-002
Agency/Subagency: DOL/BLS	Agency Tracking No:
Title: Survey of Occupational Injuries and Illnesses
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: 06/18/2018
	Date Received in OIRA: 04/27/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	12/31/2019	12/31/2018
Responses	243,520	0	243,520
Time Burden (Hours)	316,644	0	311,644
Cost Burden (Dollars)	0	0	0

---

Abstract: The Survey of Occupational Injuries and Illnesses is the primary indicator of the Nation's progress in providing every working man and woman safe and healthful working conditions. The survey measures the overall rate of work injuries and illnesses by industry. Survey data are also used to evaluate the effectiveness of Federal and State programs and to prioritize scarce resources. Respondents include employers who maintain OSHA records in accordance with the Occupational Safety and Health Act and employers who are normally exempt from OSHA recordkeeping. Each year a sample of exempt employers is required to keep records and participate in the Survey.

---

Authorizing Statute(s): PL: Pub.L. 91 - 596 24(a) Name of Law: Occupational Safety and Health Act of 1970
   PL: Pub.L. 107 - 347 Title 5 Name of Law: Confidential Information Protection and Statistical Efficiency Act (CIPSEA)
  

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:
	81 FR 31666	05/19/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 18596	04/27/2018
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Survey of Occupational Injuries and Illnesses - Private Sector	BLS 9300 N06, BLS9300 FAX, BLS 9300, IDCF	Survey of Occupational Injuries and Illnesses ,   IDCF Screen Shots ,   SoII Data Collection Booklet - Spanish Version ,   SOII 2016
Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory	BLS 9300, 9300 FAX, IDCF, BLS 9300 N06	SOII Form ,   Spanish SOII Form ,   SOII Fax Form ,   SOII IDCF
Public Sector - Voluntary	SOII 9300 N06, BLS 9300 FAX, SOII IDCF	IDCF Screenshots ,   SOII Form ,   SOII Fax Form
Household Survey of Occupational Injuries and Illnesses Pilot Test (HSOII)	HSOII Questionnaire	HSOII Questionnaire

---

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	243,520	243,520	0	0	0	0
Annual Time Burden (Hours)	316,644	311,644	0	0	5,000	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: There is an increase in burden of 5,000 hours for the 1 year extension due to an error in the estimate of the time required to report an injury or illness case.

---

Annual Cost to Federal Government: $22,130,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     No

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.     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: 04/27/2018

---