30-day FRN (1240-0020) published

30-day FRN (1240-0020) published.pdf

Representative Payee Report, Representative Payee Report (Short Form), and Physician's/Medical Officer's Statement

30-day FRN (1240-0020) published

OMB: 1240-0020

Document [pdf]
Download: pdf | pdf
Federal Register / Vol. 86, No. 48 / Monday, March 15, 2021 / Notices
DEPARTMENT OF LABOR
Office of the Secretary
Agency Information Collection
Activities; Submission for OMB
Review; Comment Request;
Representative Payee Report,
Representative Payee Report (Short
Form), and Physician’s/Medical
Officer’s Statement
Notice of availability; request
for comments.

ACTION:

The Department of Labor
(DOL) is submitting this Office of
Workers’ Compensation Programs
(OWCP)-sponsored information
collection request (ICR) to the Office of
Management and Budget (OMB) for
review and approval in accordance with
the Paperwork Reduction Act of 1995
(PRA). Public comments on the ICR are
invited.
DATES: The OMB will consider all
written comments that agency receives
on or before April 14, 2021.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
Comments are invited on: (1) Whether
the collection of information is
necessary for the proper performance of
the functions of the Department,
including whether the information will
have practical utility; (2) if the
information will be processed and used
in a timely manner; (3) the accuracy of
the agency’s estimates of the burden and
cost of the collection of information,
including the validity of the
methodology and assumptions used; (4)
ways to enhance the quality, utility and
clarity of the information collection; and
(5) ways to minimize the burden of the
collection of information on those who
are to respond, including the use of
automated collection techniques or
other forms of information technology.
FOR FURTHER INFORMATION CONTACT:
Anthony May by telephone at 202–693–
4129 (this is not a toll-free number) or
by email at [email protected].
SUPPLEMENTARY INFORMATION: Benefits
due to a DOL Black Lung beneficiary are
paid to a representative payee on behalf
of the beneficiary when he or she is
unable to manage the benefits due to
incapability or incompetence or because
the beneficiary is a minor. The
Representative Payee Report (Form CM–

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623) and Representative Payee Report
Short Form (Form CM–623S) are used to
ensure that benefits paid to a
representative payee are used for the
beneficiary’s well-being. The
Physician’s/Medical Officer’s Statement
(Form CM–787) is used to determine the
beneficiary’s capability to manage
monthly black lung benefits. The Black
Lung Benefits Act, 30 U.S.C. 922,
authorizes this information collection.
For additional substantive
information about this ICR, see the
related notice published in the Federal
Register on December 30, 2020 (85 FR
86582).
This information collection is subject
to the PRA. A Federal agency generally
cannot conduct or sponsor a collection
of information, and the public is
generally not required to respond to an
information collection, unless the OMB
approves it and displays a currently
valid OMB Control Number. In addition,
notwithstanding any other provisions of
law, no person shall generally be subject
to penalty for failing to comply with a
collection of information that does not
display a valid OMB Control Number.
See 5 CFR 1320.5(a) and 1320.6.
DOL seeks PRA authorization for this
information collection for three (3)
years. OMB authorization for an ICR
cannot be for more than three (3) years
without renewal. The DOL notes that
information collection requirements
submitted to the OMB for existing ICRs
receive a month-to-month extension
while they undergo review.
Agency: DOL–OWCP.
Title of Collection: Representative
Payee Report, Representative Payee
Report (Short Form), and Physician’s/
Medical Officer’s Statement.
OMB Control Number: 1240–0020.
Affected Public: Individuals and
households.
Total Estimated Number of
Respondents: 1,325.
Total Estimated Number of
Responses: 1,325.
Total Estimated Annual Time Burden:
679 hours.
Total Estimated Annual Other Costs
Burden: $769.
Authority: 44 U.S.C. 3507(a)(1)(D).
Dated: March 8, 2021.
Anthony May,
Management and Program Analyst.
[FR Doc. 2021–05261 Filed 3–12–21; 8:45 am]
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DEPARTMENT OF LABOR
Office of the Secretary
Agency Information Collection
Activities; Submission for OMB
Review; Comment Request; Certificate
of Medical Necessity
Notice of availability; request
for comments.

ACTION:

The Department of Labor
(DOL) is submitting this Office of
Workers’ Compensation Programs
(OWCP)-sponsored information
collection request (ICR) to the Office of
Management and Budget (OMB) for
review and approval in accordance with
the Paperwork Reduction Act of 1995
(PRA). Public comments on the ICR are
invited.
DATES: The OMB will consider all
written comments that agency receives
on or before April 14, 2021.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
Comments are invited on: (1) Whether
the collection of information is
necessary for the proper performance of
the functions of the Department,
including whether the information will
have practical utility; (2) if the
information will be processed and used
in a timely manner; (3) the accuracy of
the agency’s estimates of the burden and
cost of the collection of information,
including the validity of the
methodology and assumptions used; (4)
ways to enhance the quality, utility and
clarity of the information collection; and
(5) ways to minimize the burden of the
collection of information on those who
are to respond, including the use of
automated collection techniques or
other forms of information technology.
FOR FURTHER INFORMATION CONTACT:
Anthony May by telephone at 202–693–
4129 (this is not a toll-free number) or
by email at [email protected].
SUPPLEMENTARY INFORMATION: The Office
of Workers’ Compensation Programs
administers the Federal Black Lung
Workers’ Compensation Program. The
Black Lung Benefits Act (30 U.S.C.
901(a)(b) and its implementing
regulations necessitate this information
collection. The regulations at 20 CFR
725.701, establish miner eligibility for
medical services and supplies for the
length of time required by the miner’s
SUMMARY:

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