Justification Statement for Non-substantive Change

Justification Statement – Non-substantive Change

Retaining Employment and Talent after Injury/Illness Network (RETAIN)

Demonstration Projects and Evaluation

ODEP is requesting approval for a non-substantive change relating to the Baseline Participant forms that are part of the currently approved information collection under OMB Control No. 1230-0014, in which RETAIN grantees administer the Baseline Participant form part 1 to prospective enrollees and then have the Baseline Participant form part 2 filled out by a combination of medical practitioners and Return-to-Work Coordinators. One grantee has requested a Spanish-language translation of these documents, for the purpose of administering this translation to prospective enrollees who can more easily understand the translation than the original documents. Since only one version of each Baseline Participant form will be completed per prospective enrollee, there will be no change to the burden in terms of hours or cost.