Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlements
No material or nonsubstantive change to a currently approved collection
No
Regular
Approved with change
05/11/2023
05/04/2023
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
11/30/2023
11/30/2023
11/30/2023
37,056
0
37,056
12,228
0
12,228
15,030
0
15,030
Form CA-1032 is used to obtain information from claimants receiving compensation for an extended period of time. This information is necessary to ensure that compensation being paid is correct.
US Code:
5 USC 8116
Name of Law: Federal Employees' Compensation Act
US Code:
5 USC 8132
Name of Law: Federal Employees' Compensation Act
US Code:
5 USC 8148
Name of Law: Federal Employees' Compensation Act
US Code:
5 USC 8110
Name of Law: Federal Employees' Compensation Act
There are no changes with the previous submission related to number of respondents and IC cost burden dollars, which remains 37,056, and $15,030, respectively. However, the previously approved burden hours, 12,352, is reduced to 12,228 (a decrease of 124) due to rounding of the average burden hour to â.33 versus .33333333333â. In addition, the revision to this ICR only affects a change to a question in PART D--OTHER FEDERAL BENEFITS OR PAYMENTS of Form CA-1032. This change was necessary to help clarify the question regarding the respondent's receipt of Social Security benefits in conjunction with Federal Employees' Retirement System (FERS) benefits due to Federal service. Such receipt receipt requires an offset from compensation benefits for disability and the question was rephrased to better clarify the information needed. Specific changes are noted as follows and are outlined in Question15 of the Supporting Statement.
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:
(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;
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.
Form CA-1032 Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlement
revised justification for ca-1032 electronic version 5 10 23.docx
opm salary table 2020.pdf
Request for Information on Earnings, Dual Benefits, Dependents, and Third Part Settlements