OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Petition for the Addition of a Health Condition

IC 233098 under ICR 202502-0920-001 · OMB 0920-0891.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Petition for the Addition of a Health Condition
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Petition for the addition of health conditions App NN Petition for Addition of a New WTC Condition.docx No   Paper Only
Form and Instruction 0920-0891 WTCHP Petition for Designation of New Condition Form_10FEB2025 App M-Petition for Addition New WTC-Related Health Condition Form.pdf N/A Yes Yes Fillable Fileable

Health Health Care Services

09-20-0147 Occupational Health Epidemiologic Studies and EEOICPA Program Records and WTC Health Program Records HHS/CDC/NIOSH  76 FR 34706

35 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 35 0 0 0 35 0
Annual IC Time Burden (Hours) 35 0 0 0 35 0
Annual IC Cost Burden (Dollars) 1,260 0 0 0 1,260 0

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