View Information Collection Request (ICR) Package
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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:
3079-0001
ICR Reference No:
202111-3079-001
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
FMSHRC
Agency Tracking No:
Title:
Medical Exception Request to the COVID-19 Vaccination Requirement
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
12/03/2021
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/30/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/22/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2022
6 Months From Approved
Responses
6
0
0
Time Burden (Hours)
24
0
0
Cost Burden (Dollars)
600
0
0
Abstract:
In order to ensure the health and safety of the Federal workforce and the efficiency of the civil service, full Coronavirus Disease 2019 Vaccination is now mandatory for all Federal employees, with exceptions only required by law, under the new Executive Order 14043. Employees may seek a legal exception to the vaccination requirement due to a disability or medical reason. Requests for “medical accommodation” or “medical exceptions” will be treated as requests for disability accommodation and evaluated and decided under applicable Rehabilitation Act standards for reasonable accommodation absent undue hardship to the agency. An employee may also request a delay for complying with the vaccination requirement based on certain medical considerations that may not justify an exception under the Rehabilitation Act. Safer Federal Workforce Task Force guidance on medical considerations that may warrant a delay is available here.
Emergency Justfication:
In accordance with government-wide policy that requires all Federal employees, as defined in 5 U.S.C. § 2105, to be vaccinated against COVID-19, with exceptions only as required by law. Our agency is currently conducting the requisite steps so our employees may seek a legal exception to the vaccination requirement due to a disability. Requests for “medical accommodation” or “medical exceptions” will be treated as requests for disability accommodation and evaluated and decided under applicable Rehabilitation Act standards for reasonable accommodation absent undue hardship to the agency. Before we are able to circulate request forms to requestors, the Safer Federal Workforce Task Force has directed us to seek emergency review from OIRA.
Authorizing Statute(s):
US Code:
29 USC 791
Name of Law: Rehabilitation Act Section 501
EO: EO 14043 Name/Subject of EO: Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
Citations for New Statutory Requirements:
EO: EO 14043 Name/Subject of EO: Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR 66301
11/22/2021
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
FMSHRC Medical Exception Request Form
FMSHRC-09-001
FMSHRC Medical Exception Request Form
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
6
0
0
6
0
0
Annual Time Burden (Hours)
24
0
0
24
0
0
Annual Cost Burden (Dollars)
600
0
0
600
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The increase in burden occurred due to an Executive Order that required all federal employees to be vaccinated against COVID-19. The Commission has 5-6 employees that need to request a medical exception and reasonable accommodation for this vaccination mandate. The burden is minimal for respondents, record-keepers, and medical providers. The request form is very simple to fill out, and requires a digital signature from the medical provider. Record-keeping systems are already in place and can easily accommodate the addition of electronic records.
Annual Cost to Federal Government:
$999
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
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?
Yes
Agency Contact:
Michael Chirico 202 434-9909 mchirico@fmshrc.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:
11/22/2021
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