Request for a Medical Exception to the COVID-19 Vaccine Requirement

Forms and Documents

Document Name	Status
Physicians Form	New
Job Applicants Form	New
Medical Exception to Vaccin - Letter to OMB - 10-29-21.pdf Supplementary Document	2021-10-29
vaccination exception PRA Supporting Statement 10.25.2021.docx Supporting Statement A	2021-10-29

IC Document Collections

IC ID	Document Title	Status
249960	Physicians Form	New
249959	Job Applicants Form	New

ICR Details

OMB Control No:	ICR Reference No: 202110-1557-003
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: TREAS/OCC	Agency Tracking No:
Title: Request for a Medical Exception to the COVID-19 Vaccine Requirement
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 10/29/2021
Date Submitted to OIRA: 10/29/2021

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	68	0
Time Burden (Hours)	34	0
Cost Burden (Dollars)	0	0

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Abstract: The President, by Executive order 13991 (January 20, 2021) established the Safer Federal Workforce Task Force. The Taskforce was established to give the heads of federal agencies ongoing guidance to keep their employees safe and their agencies operating during the COVID-19 pandemic. The Taskforce issued guidance, in accordance with the President’s Executive Order 14043 (September 9, 2021), requiring federal employees to be vaccinated against COVID-19 by November 22, 2021 absent a legally required exception. To determine whether employees who request a medical exception qualify for the exception and a reasonable accommodation, or, alternatively, must comply with the November 22 deadline, the OCC has developed the Request for Medical Exception to the COVID-19 Vaccination Requirement form (Request form). The Request form was developed, consistent with guidance issued by the Taskforce and the U.S. Department of Treasury’s Office of Civil Rights and Diversity, to gather information from employees who have requested medical exceptions and medical professionals treating those employees, to determine whether such employees qualify for legal exceptions to the vaccine requirement. The Request form will also be used to collect information from job applicants who may request a legal exception and reasonable accommodation after receiving an offer of employment from the OCC. Because employees are required to be vaccinated, absent a legal exception by November 22, 2021, (or by their entry-on-duty date for employees hired after November 22), the information to be collected on the Request form is needed prior to the time periods established [under this part] in order to comply with the mandated November 22 vaccination deadline. Compliance with the vaccination mandate is essential to protecting the health and safety of the OCC’s workforce, which is essential to the OCC’s accomplishment of its mission. The OCC cannot reasonably comply with the normal clearance procedures because the use of normal clearance procedures will prevent the OCC from obtaining information on the Request form necessary to make exception decisions within the timeframes established by the Taskforce pursuant to Executive Order.

Emergency Justfication: The President, by Executive order 13991 (January 20, 2021) established the Safer Federal Workforce Task Force. The Taskforce was established to give the heads of federal agencies ongoing guidance to keep their employees safe and their agencies operating during the COVID-19 pandemic. The Taskforce issued guidance, in accordance with the President’s Executive Order 14043 (September 9, 2021), requiring federal employees to be vaccinated against COVID-19 by November 22, 2021 absent a legally required exception. To determine whether employees who request a medical exception qualify for the exception and a reasonable accommodation, or, alternatively, must comply with the November 22 deadline, the OCC has developed the Request for Medical Exception to the COVID-19 Vaccination Requirement form (Request form). The Request form was developed, consistent with guidance issued by the Taskforce and the U.S. Department of Treasury’s Office of Civil Rights and Diversity, to gather information from employees who have requested medical exceptions and medical professionals treating those employees, to determine whether such employees qualify for legal exceptions to the vaccine requirement. The Request form will also be used to collect information from job applicants who may request a legal exception and reasonable accommodation after receiving an offer of employment from the OCC. Because employees are required to be vaccinated, absent a legal exception by November 22, 2021, (or by their entry-on-duty date for employees hired after November 22), the information to be collected on the Request form is needed prior to the time periods established [under this part] in order to comply with the mandated November 22 vaccination deadline. Compliance with the vaccination mandate is essential to protecting the health and safety of the OCC’s workforce, which is essential to the OCC’s accomplishment of its mission. The OCC cannot reasonably comply with the normal clearance procedures because the use of normal clearance procedures will prevent the OCC from obtaining information on the Request form necessary to make exception decisions within the timeframes established by the Taskforce pursuant to Executive Order.

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Authorizing Statute(s): US Code: 12 USC 1 et seq. Name of Law: The National Bank Act
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Job Applicants	N/A	Medical Exception to COVID Vaccination Requirement
Physicians	N/A	Medical Exception to COVID Vaccination Requirement

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ICR Summary of Burden

	Total Request	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	68	0	0	68	0	0
Annual Time Burden (Hours)	34	0	0	34	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in burden is due to the fact that this is a new collection.

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Annual Cost to Federal Government:

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.     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? No

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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: 10/29/2021

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