OWCP Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Final Decision on a Part E Wage Loss/Impairment Claim

Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0093 can be found here:

Documents and Forms

Document Name Document Type
OWCP Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Final Decision on a Part E Wage Loss/Impairment Claim Form and Instruction
DEEOIC Part E Final Decision Survey and Letter Part E Final Decision Survey and Letter.pdf Form and Instruction
DEEOIC Part E Final Decision Survey and Letter Part E Final Decision Survey and Letter.pdf Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Part E January 2023 FINAL.docx ICR A11 Section 280 Clearance - DEEOIC Paper Survey Part E January 2023 IC Document
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Part E January 2023 FINAL.docx ICR A11 Section 280 Clearance - DEEOIC Paper Survey Part E January 2023 IC Document

Information Collection (IC) Details

IC Title:	OWCP Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Final Decision on a Part E Wage Loss/Impairment Claim	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	DEEOIC Part E Final Decision Survey and Letter	Part E Final Decision Survey and Letter.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Part E January 2023	ICR A11 Section 280 Clearance - DEEOIC Paper Survey Part E January 2023 FINAL.docx	01/20/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.