1225-0093 Supporting Statement - Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compe

Request for Approval under the “Generic Clearance for Improving Customer Experience: OMB Circular A-11, Section 280 Implementation”

(OMB Control Number: 1225-0093)

TITLE OF INFORMATION COLLECTION: Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (DEEOIC)

PURPOSE OF COLLECTION: Surveys to gather feedback from claimants under the Energy Employees Occupational Illness Compensation Program Act. Soliciting feedback on what the program does well, if there are any areas for improvement, and an overall idea of how well we serve our stakeholders in this area. We will use the information to improve our claimants’ experiences and identify potential areas for improvement and/or training. Additionally, information collected through these surveys will be used to inform a journey mapping project.

TYPE OF ACTIVITY: (Check one)

[ ] Customer Research (Interview, Focus Groups)

[ X ] Customer Feedback Survey

[ ] User Testing

ACTIVITY DETAILS

1. How will you collect the information? (Check all that apply)
   
   

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ X ] In-person

[ ] Mail

[ X ] Other*, Explain

*Surveys will be handed out in person at the outreach event and participants will fill it out and put it in a box.

2. Who will you collect the information from?

Outreach event attendees.

3. How will you ask a respondent to provide this information?

Written, on a survey form.

4. What will the activity look like?

Outreach attendees will have the opportunity to fill out a paper survey form.

5. Please provide your question list.

1. Please describe pain points and bright spots related to: Filing a claim.
   
   

2. Please describe pain points and bright spots related to:
   The process leading to a decision on your claim.(After filing and before receiving a decision. Things like: working with Claims Examiner, providing additional requested evidence, etc.)
   
   

3. Please describe pain points and bright spots related to: Receiving a decision and what follows. (After receiving a Final Decision. Examples: appeals, reopening, receiving compensation).

4. What changes could DEEOIC make to improve the experience of future claimants? 

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Script/prompt language attached.

6. When will the activity happen?

DEEOIC will conduct outreach events from June-September 2022.

7. Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants?

[ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden Hours
Stakeholders	600	5 minutes	50
Totals			50

CERTIFICATION:

I certify the following to be true:

1. The collections are voluntary;

2. The collections are low-burden for respondents (based on considerations of total burden hours or burden-hours per respondent) and are low-cost for both the respondents and the Federal Government;

3. The collections are non-controversial and do not raise issues of concern to other Federal agencies;

4. Any collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the near future;

5. Personally identifiable information (PII) is collected only to the extent necessary and is not retained;

6. Information gathered is intended to be used for general service improvement and program management purposes

7. Upon agreement between OMB and the agency aggregated data may be released as part of A-11, Section 280 requirements only on performance.gov. Summaries of customer research and user testing activities may be included in public-facing customer journey maps.

8. Additional release of data will be coordinated with OMB.

Name: Joshua Novack

All instruments used to collect information must include:

OMB Control No. 1225-0093

Expiration Date: 02/29/2024

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