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 202507-1225-002 · OMB 1225-0093.

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 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				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		01/20/2023

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

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