[Federal Register Volume 80, Number 95 (Monday, May 18, 2015)]
[Notices]
[Page 28302]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-11885]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Division of Coal Mine Workers' Compensation; Proposed Extension 
of Existing Collection; Comment Request

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 pre-clearance 
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:
    Authorization for Release of Medical Information (CM-936). 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 July 17, 2015.

ADDRESSES: Ms. Yoon Ferguson, U.S. Department of Labor, 200 
Constitution Ave. NW., Room S-3201, Washington, DC 20210, telephone 
(202) 354-9647, fax (202) 343-5974, Email [email protected]. Please 
use only one method of transmission for comments (mail, fax, or Email).

SUPPLEMENTARY INFORMATION: 
    I. Background: The Black Lung Benefits Act, as amended, 30 U.S.C. 
901, and 20 CFR 725.405, requires that all relevant medical evidence be 
considered before a decision can be made regarding a claimant's 
eligibility for benefits. The CM-936 is a form that gives the 
claimant's consent for release of information, required by the Privacy 
Act, and contains information required by medical institutions and 
private physicians to enable them to release pertinent medical 
information. This information collection is currently approved for use 
through October 31, 2015.
    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 currently-approved information collection in 
order to obtain claimant consent for the release of medical information 
for consideration by the Division of Coal Mine Workers' Compensation as 
evidence to support their claim for benefits. Failure to gather this 
information would inhibit the adjudication of black lung claims because 
pertinent medical data would not be available for consideration during 
the processing of the claim.
    Agency: Office of Workers' Compensation Programs.
    Type of Review: Extension.
    Title: Authorization for Release of Medical Information.
    OMB Number: 1240-0034.
    Agency Number: CM-936.
    Affected Public: Individuals or households.
    Total Respondents: 900.
    Total Annual Responses: 900.
    Average Time per Response: 5 minutes.
    Estimated Total Burden Hours: 75.
    Frequency: On occasion.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $3,835.
    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: May 12, 2015.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2015-11885 Filed 5-15-15; 8:45 am]
 BILLING CODE 4510-CK-P