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:
202201-3079-001
Status:
Historical Active
Previous ICR Reference No:
202111-3079-001
Agency/Subagency:
FMSHRC
Agency Tracking No:
Title:
Medical Exception Request to the COVID-19 Vaccination Requirement
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
06/06/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/28/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2025
36 Months From Approved
06/30/2022
Responses
6
0
6
Time Burden (Hours)
24
0
24
Cost Burden (Dollars)
600
0
600
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 was made mandatory for all Federal employees, with exceptions only required by law, under Executive Order 14043. Subsequently, a federal court imposed an injunction preventing the federal government from enforcing mandatory vaccination. However, because the Information Collection form for seeking a Reasonable Accommodation to the vaccination had already been approved by OMB for FMSHRC use prior to the court injunction, FMSHRC is seeking to renew the ICR in the event that the injunction is lifted or further COVID-19 vaccinations are required during the period that an approved ICR Renewal would be in effect. In the event that vaccinations may be required, 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 per guidance provided by the Safer Federal Workforce Task Force.
Authorizing Statute(s):
EO: EO 14043 Name/Subject of EO: Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
US Code:
29 USC 791
Name of Law: Rehabilitation Act Section 501
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
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR 17
01/26/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 19513
04/04/2022
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-09-002
FMSHRC Medical Exception Request Form
,
Medical Exception Request to the Vaccination Requirement
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
6
0
0
0
0
Annual Time Burden (Hours)
24
24
0
0
0
0
Annual Cost Burden (Dollars)
600
600
0
0
0
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:
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:
Kimberly Burch 202 494-9913 kburch@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:
04/28/2022
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