[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]
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