NRC Form 798, “Request for a Medical Exception to the COVID-19 Vaccine Requirement"

Forms and Documents

Document Name	Status
Form NRC Form 798 NRC Form 798, Request for a Medical Exception to the COVID-19 Vaccination Requirement Form and Instruction	New
Letter to OMB Justification for Emergency Clearance for NRC Form 798, Request for a Medical Exception to the to the COVID-19 Vaccination Requirement.pdf Supplementary Document	2021-10-25
Supporting statement NRC Form 798.docx Supporting Statement A	2021-10-25

IC Document Collections

IC ID	Document Title	Status
249896	NRC Form 798, Request for a Medical Exception to the COVID-19 Vaccination Requirement Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202110-3150-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Form 798, “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: 10/28/2021
Date Submitted to OIRA: 10/25/2021

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	50	0
Time Burden (Hours)	25	0
Cost Burden (Dollars)	0	0

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Abstract: Consistent with Executive Order 14043, of September 9, 2021, “Requiring Coronavirus Disease 2019 Vaccination for Federal Employees” and included within the Safer Federal Workforce Task Force Guidance mandating all Federal employees be vaccinated by November 22, 2021, the NRC has established specific safety protocols for individuals fully vaccinated and not fully vaccinated against coronavirus disease 2019 (COVID-19). Individuals who are not fully vaccinated against COVID-19 by November 22, 2021, or who choose not to provide this information will be required to comply with applicable OMB, OPM, and NRC guidance for individuals not fully vaccinated against COVID-19, which may include wearing masks regardless of the transmission rate in a given area, physical distancing, regular screening testing, and adhering to applicable travel requirements. NRC employees may request an exception on the basis of a medical condition or circumstance. Exceptions will be granted in limited circumstances and only where legally required.

Emergency Justfication: Executive Order (EO) 14043, titled, “Requiring Coronavirus Disease 2019 Vaccination for Federal Employees,” requires all Federal employees, as defined in 5 U.S.C. § 2105, to be vaccinated against COVID-19, with exceptions only as required by law. Requests for "medical accommodation" or "medical exceptions" will be treated as requests for a disability accommodation and evaluated and decided under applicable Rehabilitation Act standards for reasonable accommodation absent undue hardship to the agency. An employee may also request a delay for complying with the vaccination requirement based on certain medical considerations that may not justify an exception under the Rehabilitation Act. The agency will be required to keep confidential any medical information provided, subject to the applicable Rehabilitation Act standards. Employees who receive an exception or a delay from the vaccination requirement would instead comply with alternative health and safety protocols. The Nuclear Regulatory Commission (NRC) is requesting emergency review of NRC Form 798, which will be used to collect information from employees seeking a medical exception from the COVID-19 vaccination requirement. The information is needed before the expiration of the normal time limits under the Office of Management and Budget’s regulations at 5 CFR 1320 that implement the provisions of the Paperwork Reduction Act of 1995. Because of the nature of the public health emergency and the urgent need for the agency to meet the required deadline that all Federal employees be vaccinated except those approved for an exception as required by law, the NRC cannot reasonably comply with the normal clearance procedures because of a need for a swift response to allow for the collection of this information by November 1, 2021.

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Authorizing Statute(s): EO: EO 14043 Name/Subject of EO: Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
  

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: 1

IC Title	Form No.	Form Name
NRC Form 798, Request for a Medical Exception to the COVID-19 Vaccination Requirement	NRC Form 798	Request for a Medical Exception to the COVID-19 Vaccine 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	50	0	0	50	0	0
Annual Time Burden (Hours)	25	0	0	25	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 NRC staff anticipates receiving 50 requests for medical exceptions via the NRC Form 798, “Request for a Medical Exception to the COVID-19 Vaccine Requirement” resulting in 25 hours of burden to respondents.

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Annual Cost to Federal Government: $28,800

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.     Yes

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.     Yes

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? Yes

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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: 10/25/2021

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