[Federal Register Volume 78, Number 115 (Friday, June 14, 2013)]
[Notices]
[Pages 35981-35982]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-14104]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Proposed Extension of the Approval of Information Collection 
Requirements

ACTION: Notice.

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SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a preclearance 
consultation program to provide the general public and Federal agencies 
with an opportunity to comment on proposed and/or continuing 
collections of information in accordance with the Paperwork Reduction 
Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to 
ensure that requested data can be provided in the desired format, 
reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements on respondents can be properly assessed. 
Currently, the Office of Workers' Compensation Programs is soliciting 
comments concerning the proposed collection: Medical Travel Refund 
Request (OWCP-957). A copy of the proposed information collection 
request can be obtained by contacting the office listed below in the 
addresses section of this Notice.

DATES: Written comments must be submitted to the office listed in the 
addresses section below on or before August 13, 2013.

ADDRESSES: Mr. Vincent Alvarez, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3201, Washington, DC 20210, telephone 
(202) 693-0372, fax (202) 693-2447, Email [email protected]. 
Please use only one method of transmission for comments (mail, fax, or 
Email).

SUPPLEMENTARY INFORMATION: I. Background: The Office of Workers' 
Compensation Programs (OWCP) is the agency responsible for 
administration of the Federal Employees' Compensation Act (FECA), 5 
U.S.C. 8101 et seq., the Black Lung Benefits Act (BLBA), 30 U.S.C. 901 
et seq., and the Energy Employees Occupational Illness Compensation 
Program Act of 2000 (EEOICPA), 42 U.S.C. 7384 et seq. All three of 
these statutes require that OWCP reimburse beneficiaries for travel 
expenses for covered medical treatment. In order to determine whether 
amounts requested as travel expenses are appropriate, OWCP must receive 
certain data elements, including the signature of the physician for 
medical expenses claimed under the BLBA. Form OWCP-957 is the standard 
format for the collection of these data elements. The regulations 
implementing these three statutes allow for the collection of 
information needed to enable OWCP to determine if reimbursement 
requests for travel expenses should be paid. This information 
collection is currently approved for use through October 31, 2013.
    II. Review Focus: The Department of Labor is particularly 
interested in comments which:
    * Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    * evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    * enhance the quality, utility and clarity of the information to be 
collected; and
    * minimize the burden of the collection of information on those who 
are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.
    III. Current Actions: The Department of Labor seeks approval for 
the extension of this information collection in order to carry out its 
responsibility to determine if requests for reimbursement for out-of-
pocket expenses incurred

[[Page 35982]]

when traveling to medical providers for covered medical testing or 
treatment should be paid.
    Type of Review: Extension.
    Agency: Office of Workers' Compensation Programs.
    Title: Medical Travel Refund Request.
    OMB Number: 1240-0037.
    Agency Number: CM-957.
    Affected Public: Individual or households.
    Total Respondents: 302,794.
    Total Responses: 302,794.
    Time per Response: 10 minutes.
    Estimated Total Burden Hours: 50,263.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $148,369.
    Comments submitted in response to this notice will be summarized 
and/or included in the request for Office of Management and Budget 
approval of the information collection request; they will also become a 
matter of public record.

    Dated: June 10, 2013.
Vincent Alvarez,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2013-14104 Filed 6-13-13; 8:45 am]
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