RI20-123_SupportingStatement_2024_04_29_Final

Supporting Statement for Paperwork Reduction Act Submissions

Title: Request for Case Review for Enhanced Disability Annuity Benefit

OMB Control Number: 3206-0254

1. Justification

1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.

Title 5, U. S. Code, Chapter 83, Sections 8337 and 8339, and Chapter 84, Section 8452, provide for disability retirement benefits for individuals who performed service as law enforcement officers, firefighters, nuclear materials carriers, Customs and Border Patrol officers, members of the Capitol and the Supreme Court police, Congressional employees, and air traffic controllers. A series of court decisions affect the computation of benefits. Because these court orders were handed down long after some of the affected individuals retired and/or died and the individuals are not identified in the Office of Personnel Management (OPM) computer systems, it is necessary for the affected individuals to self-identify. Form RI 20-123, Request for Case Review for Enhanced Disability Annuity Benefit, is used by the affected individuals and their survivors to request that their benefit computations be reviewed.

2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.

The proposed version of the RI 20-123 will be available to annuitants and survivor annuitants on the OPM website by the end of 2024. The current version is mailed, faxed or emailed to the requestor upon request for review of a disability annuity.

This form is used by retirees who have retired under disability annuity provisions and who have performed service as law enforcement officers, firefighters, nuclear materials carriers, air traffic controllers, Congressional employees, Members of Congress, Capitol and Supreme Court police, or Custom and Border protection officers (and their survivors or beneficiaries), to request that Retirement Operations review the computations of the retiree’s disability annuities.

Retirements under the above provisions receive higher annuity computations, both in disability and immediate retirement types. Upon receipt of RI 20-123 from an annuitant, survivor, or beneficiary, OPM will review the initial annuity computation to ensure that the special computation for Law Enforcement etc. was applied. If OPM determines the monthly annuity should be increased, the annuitant, survivor, or beneficiary will receive any amounts accrued and unpaid, as appropriate.

3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses, and the basis for the decision for adopting this means of collection. Also describe any consideration of using information technology to reduce burden.

This proposed form will be made available in a PDF fillable format once approval has been granted. The current form is not available on our website.

In OPM’s Congressional Budget Justification and Annual Performance Plan (FY 2025) OPM discusses the imperative to create a more modern retirement experience for Federal employees who earned these benefits over a career serving the American public. Essential to creating an excellent customer experience is digitizing OPM’s currently largely paper-centric process. OPM’s strategy involves creating a more streamlined Federal annuitant experience starting with a digital application that will make it easier for annuitants to apply and speed up the time they get their annuity. OPM projects that this will also reduce the need for annuitants to spend time following up on progress.

4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item 2 above.

Every effort is made to identify and avoid duplication. The information is collected individually and respondents with no earnings are asked not to respond. There is no other way to obtain this information.

5. If the collection of information impacts small businesses or other small entities
   (Item 5 of OMB Form 83-I), describe any methods used to minimize.

This information collection request has no impact on small businesses and organizations.

6. Describe the consequence to Federal/ program or policy activities if the collection of information is not conducted, or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.

If this information is not collected, the pay of eligible annuitants and survivor annuitants

would not receive the computed pay difference provided in law for individuals who

performed the aforementioned service.

7. Explain any special circumstances that would cause an information collection to be conducted in a manner:

• requiring respondents to report information to the agency more often than quarterly;

• requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;

• requiring respondents to submit more than an original and two copies of any document;

• requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records, for more than three years;

• in connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study;

• requiring the use of statistical data classification that has not been reviewed and approved by OMB;

• that includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which is unnecessarily impedes sharing of data with other agencies for compatible confidential use; or

• requiring respondents to submit proprietary trade secrets, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information’s confidentiality to the extent permitted by law.

There are no special circumstances involved in the collection of this information.

8. Federal Register Notice: Provide a copy and identify the date and page number of the publication in the Federal Register of the agency’s notice soliciting comments on the information collection prior to submission to OMB.

On March 10, 2022, a 60-Day Federal Register Notice was published at 87 Fed Reg 13777 requesting comment. OPM received no comments in response to its request for this collection.

A 30-Day Federal Register Notice was published at 87 Fed Reg 52041 on Wednesday, August 24, 2022, requesting comment and no comments were received.

9. Explain any decision to provide any payment or gift to respondents, other than remuneration of contractors or grantees.

No payment or gift is provided to respondents.

10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.

This information collection is protected by the Privacy Act of 1974 and OPM regulations (5 CFR 831.106, 47 FR 12937). The routine uses of disclosure appear in the Federal Register for OPM/Central-1 (87 FR 5874, published February 2, 2022).

11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.

This information collection does not include questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.

12. Provide estimates of the hour burden of the collection of information. The statement
should:

a. Indicate the number of respondents, frequency of response, annual hour burden,
and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desired. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices.

b. If this request for approval covers more than one form, provide separate hour
burden estimates for each form and aggregate the hour burdens in Item 13 of OMB Form 83-I.

c. Provide estimates of annualized cost to respondents for the hour burdens for
collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 14.

Type of Respondent	Collection Name	No. of Respondents	No. of Responses per Respondent	Average Burden per Response (in hours)	Total Annual Burden (in hours)
Federal annuitants	Request for Case Review for Enhanced Disability Annuity Benefit	100	1	.08333	8

Approximately 100 forms RI 20-123 are processed annually. The form takes approximately 5 minutes to complete, the annual burden is 8 hours.

13. Provide an estimate of the total annual cost burden to respondents or record-keepers
resulting from the collection of information. (Do not include the cost of any hour burden
shown in Items 12 and 14.)

The cost estimate should be split into two components: (1) a total capital and start-up cost component (annualized over its expected useful life); and (b) a total operation and maintenance and purchase of services component. The estimates should take into account costs associated with generating, maintaining, and disclosing or providing the information. Include descriptions of methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s), and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities.

If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection as appropriate.

Generally, estimates should not include purchases of equipment or services, or portions thereof, made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information to keep records for the government, or (4) as part of customary and usual business or private practices.

The Total Annual Respondent Cost is $225.00. There is no change in the respondent burden.

Type of Respondent		Form Number	No. of Respondents	Total No. of Responses	Average Burden per Response (in hours)	Hourly Wage Rate	Total Respondent Cost
Federal annuitants	RI 20-123		100	100	.08333	$21.50	$225.00

14. Provide estimates of annualized cost to the Federal Government. Also, provide a
description of the method used to estimate cost, which should include quantification of
hours, operational expenses (such as equipment, overhead, printing and support staff),
and any other expense that would have been incurred without this collection of
information. You may also aggregate cost estimates for Items 12, 13, and 14 in a single table.

We estimate that the annualized cost to the Federal government is $5,550. This cost is derived from employee salaries, staff hours required to process the forms and the cost of printing, storing and shipping forms.

15. Explain the reasons for any program changes or adjustments reported in Items 13 or 14 of
the OMB Form 83-I. Changes in hour burden, i.e., program changes or adjustments made
to annual reporting and recordkeeping hour and cost burden. A program change is the
result of deliberate Federal government action. All new collections and any subsequent
revisions of existing collections (e.g., the addition or deletion of questions) are recorded
as program changes. An adjustment is a change that is not the result of a deliberate
Federal government action. These changes that result from new estimates or actions not
controllable by the Federal government are recorded as adjustments.

There is no change in the hour or cost burden.

16. For collections of information whose results will be published, outline plans for
tabulation and publication. Address any complex analytical techniques that will be used.
Provide the time schedule for the entire project, including beginning and ending dates of
the collection of information, completion of report, publication dates, and other actions.

No information collected from the form will be published.

17. If seeking approval to not display the expiration date for OMB approval of the
information collection, explain reasons that display would be inappropriate.

We seek approval to not display the OMB clearance expiration date on the forms and
to communicate version changes to the public via the revision date. The substance of this

information collection has not changed. However, OPM has modified the Public Burden Statement on this form so that the public can ensure the collection is active and can be used to collect this information via www.reginfo.gov.

18. Explain each exception to the certification statement identified in Item 19 “Certification
for Paperwork Reduction Act Submissions,” of OMB Form 83-I.

There are no exceptions to the certification statement.