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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Request for Examination and/or Treatment (Employee Burden)
Modified
45000
41250
0
Form
LS-1
Request for Examination and/or Treatment
Request for Examination and/or Treatment (Employer Burden)
Modified
45000
7500
1484816
Form
LS-1
Request for Examination and/or Treatment
Total burden requested under this ICR:
90000
48750
1484816
To view an IC, click on IC Title