Information Collection

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

IC 257874 under ICR 202312-1225-004 · OMB 1225-0093.

⚠️ Notice: This information collection may be referencing outdated material.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

2025-07-10 - No material or nonsubstantive change to a currently approved collection
2025-04-11 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
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

View Information Collection (IC)

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:

table that charts list of 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

Federal Enterprise Architecture Business Reference Module

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 %

table that charts list of burden
	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

table that charts IC Documents
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.