[Federal Register Volume 81, Number 205 (Monday, October 24, 2016)]
[Notices]
[Pages 73142-73143]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-25396]


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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 December 23, 2016.

ADDRESSES: Ms Yoon Ferguson, U.S. Department of Labor, 200 Constitution 
Ave. NW., Room S-3223, Washington, DC 20210, telephone/fax (202) 354-
9647, 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 
December 31, 2016.
    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,

[[Page 73143]]

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 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: OWCP-957.
    Affected Public: Individual or households.
    Total Respondents: 342,462.
    Total Responses: 342,462.
    Time per Response: 10 minutes.
    Estimated Total Burden Hours: 56,849.
    Total Burden Cost (Capital/Startup): $0.
    Total Burden Cost (Operating/Maintenance): $171,123.
    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: October 14, 2016.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, 
U.S. Department of Labor.
[FR Doc. 2016-25396 Filed 10-21-16; 8:45 am]
 BILLING CODE 4510-CR-P