Notice to Reviewer 2017

OMB No. 1240-0041

Notice of Payments (LS-208)

Notice to OMB Reviewer:

The Office of Workers’ Compensation Programs (OWCP) Division of Longshore and Harbor Workers’ Compensation (DLHWC) is requesting a non-material change to stop the duplication of information collected on two of our forms used in accordance with the Longshore and Harbor Workers’ Compensation Act.

Section 914(b) of the Act requires the employer/carrier to issue payment of the first installment of compensation on or before the fourteenth day after notification of injury and requires the notification of such payment. Section 14(c) of the Act requires the employer/carrier to immediately issue notification that payment has begun or has been suspended. Section 30(b) and (e) of the Act requires the employer/carrier to file notice of payment and anytime an interim change in benefit payment is made. Section 914(g) of the Act requires the employer/carrier issue notification of final payment of compensation. These notifications are currently submitted on the LS-206 (Payment of Compensation Without Award) 20 C.F.R. 702.234 and the LS-208 (Notice of Final Payment or Suspension of Compensation Payments) 20 C.F.R. 702.235. A thorough review of the two forms reveals a duplication of information collected on both forms. The OWCP is planning to collect the information under one form, the LS-208 (Notice of Payments), thereby reducing the burden on the public and the government. The LS-208 is currently approved under 1240-0041 and form LS-206 is currently approved under 1240-0043. The new streamline version will collect all necessary information from both forms into one form under OMB No, 1240-0041. Form LS-206 (1240-0043) will be discontinued once the streamlined LS-208 is approved. The Industry Notice uploaded into ROCIS explains the changes in detail. The Industry Notice will also notify the public of the changes.

OWCP is combining two forms in order to streamline the collection. The following table shows how the burden is affected by creating one form for the respondents to utilize:

• Although the burden for this non material request shows an increase in the burden hours of 2,100 hours, once OWCP form LS-206 is discontinued the end result will be a reduction of the total burden that was utilized by both forms. OWCP is estimating a total reduction of 3,150 burden hours. The creation of one form decreased the average burden by 5 minutes (from 15 minutes to 10 minutes) and therefore decreased the overall burden hours.

• The costs for this non-material request shows an increase in the costs of $8,512 under this ICR. Once 1240-0043 is discontinued the postage cost to the respondent under A13 will be reduced overall from the current total of $17,100 to $16,112. The increased use of electronic submissions resulted in lower mailing costs for the new form.

Forms	OMB Control Number	No. of Respondents		No. of Responses per Respondent	Total Number of Responses	Avg. Burden per Response (In hrs.)	Total Burden Hours
Old Forms:
LS – 206 Payment of Compensation Without Award	1240-0043		600	28	16,800	15/60	4,200
LS - 208 Notice of Final Payment or Suspension of Compensation Benefits	1240-0041		600	35	21,000	15/60	5,250
Totals			600	63	37,800	15/60	9,450
Streamlined Form:
LS-208 Notice of Payments	1240-0041		600	63	37,800	10/60	6,300
Total:			600	63	37,800	10/60	6,300
Difference:	--		0	0	0	-5/60	-3,150