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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1240-0016
ICR Reference No:
201310-1240-001
Status:
Historical Active
Previous ICR Reference No:
201008-1240-002
Agency/Subagency:
DOL/OWCP
Agency Tracking No:
Title:
Request for Information on Earnings, Dual Benefits, Dependents and Third Party Settlements
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
05/02/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/31/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2017
36 Months From Approved
05/31/2014
Responses
44,800
0
50,000
Time Burden (Hours)
14,933
0
16,667
Cost Burden (Dollars)
23,296
0
23,500
Abstract:
Form CA-1032 is used to obtain information from claimants receiving compensation for an extended period of time. This information is necessary to ensure that compensation being paid is correct.
Authorizing Statute(s):
US Code:
5 USC 8101-8193
Name of Law: Federal Employees' Compensation Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 77170
12/20/2013
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 18068
03/31/2014
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Request for Information on Earnings, Dual Benefits, Dependents and Third Part Settlements
CA-1032
Request for Information on Earnings, Dual Benefits, Dependents, and Third Party Settlement
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
44,800
50,000
0
0
-5,200
0
Annual Time Burden (Hours)
14,933
16,667
0
0
-1,734
0
Annual Cost Burden (Dollars)
23,296
23,500
0
0
-204
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The previous approved number of annual respondents, 50,000 is now 44, 800 which represents a decrease of 5, 200. The previously approved number for burden hours was 16, 667, and the requested number now is 14, 933, a decrease of 1, 734 hours. The annual cost burden likewise has reduced, from $23, 500 as previously approved, to $21, 504, an adjustment of $1, 996. OWCP has made a few changes and minor clarifications to the Form CA-1032 for this approval request. These changes and clarifications would not materially alter the estimated per response burden, but do help to reduce the chance of respondents providing incorrect information and augment the disclosures OWCP must make to respondents. In Part C, Dependency, revisions were made to applicable paragraphs when augmented compensation is based on claimant's same sex spouse. On June 26, 2013, in United States v. Windsor, the U.S. Supreme Court ruled that Section 3 of the Defense of Marriage Act (DOMA) is unconstitutional. Section 3 of DOMA limited the definition of spouse to a person of the opposite sex who is a husband or wife, and as a result, augmented FECA compensation was not available based on a claimant's same sex spouse. The FECA program has long followed the policy that the validity of a marriage is determined by the law of the jurisdiction where the marriage took place. Thus, consistent with our existing procedures and the Supreme Court's decision in Windsor, claimants who can establish a same-sex marriage valid in the jurisdiction where it took place will be eligible for augmented FECA benefits based on that marriage regardless of their place of residence or domicile. Additionally, the CA-1032 is revised to include an accommodation statement to inform claimants who have mental or physical limitations to contact DFEC if further assistance is needed with the claims process including accessible formats.
Annual Cost to Federal Government:
$508,144
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Marcus Sharpless 202 693-0998 sharpless.marcus@dol.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/31/2014
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