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OMB Control No: 1240-0033	ICR Reference No: 202304-1240-007
Status: Historical Active	Previous ICR Reference No: 202002-1240-005
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Coal Mine Operator Response to Schedule for Submission of Additional Evidence and Operator Response to Notice of Claim
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: 10/16/2023
	Date Received in OIRA: 09/11/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2026	36 Months From Approved	10/31/2023
Responses	5,294	0	9,800
Time Burden (Hours)	1,173	0	2,042
Cost Burden (Dollars)	1,096	0	2,842

Abstract: The OWCP, Division of Coal Mine Workers' Compensation (DCMWC) administers the Black Lung Benefits Act (30 U.S.C. 901 et seq.), which provides benefits to coal miners totally disabled due to pneumoconiosis and their surviving dependents. When the DCMWC makes a preliminary analysis of a claimant's eligibility for benefits, and if a coal mine operator has been identified as potentially liable for payment of those benefits, the responsible operator is notified of the preliminary analysis. Regulations codified at 20 CFR part 725 require that a coal mine operator be identified and notified of potential liability as early in the adjudication process as possible. Coal Mine Operator Response to Schedule for Submission of Additional Evidence (Form CM-2970) and Operator Response to Notice of Claim (Form CM-2970a) are used for claims filed after January 19, 2001, and indicate that the coal mine operator will submit additional evidence or respond to the notice of claim.

Authorizing Statute(s): US Code: 30 USC 901 Name of Law: Black Lung Benefits 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:
	88 FR 29697	05/08/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 62400	09/11/2023
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
Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim	CM-2970a, CM-2970	,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	5,294	9,800	-4,506
Annual Time Burden (Hours)	1,173	2,042	-869
Annual Cost Burden (Dollars)	1,096	2,842	-1,746

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Respondents: The number of respondents increased from 4,900 to 5,294. Responses: Responses have decreased from 9,800 to 8,082 because, in the last iteration of this collection, the number of responses was incorrectly calculated as twice the number of Notice of Claim forms that OWCP issued in FY-19 (4,900). The previous iteration assumed OWCP issued a Notice of Claim to a single operator in a case then subsequently issued a Schedule for the Submission of Additional Evidence to the same operator in each case. However, OWCP issues more Notices of Claims than Schedules for the Submission of Additional Evidence. (Reasons for notifying multiple employers of a single claim include, but are not limited to: the miner’s reporting of who his last coal mine employer was differs from who his Social Security Earnings Records indicate was the last to employ him; the miner withdraws or abandons his claim before a Schedule for the Submission of Additional Evidence is issued; and the most recent employer is not financially capable of assuming liability for the claim and OWCP must notify the next most-recent coal mine employer .) Thus, the previous calculation both overstated the number of responses to Form CM-2970 and understated the number of responses to Form CM-2970a. For the current iteration of this collection, OWCP has used the actual FY-22 response rates to each form to more precisely estimate the burden associated with this collection. The following also decreased due to the change in method of calculations and attendant perceived decrease in overall number of responses. . Burden Hours: Burden hours have decreased from 2,042 to 1,790. Costs: Annual burden costs have decreased from $2,842 to $1,673. These costs also decreased, in part, due to the 20% increase in electronic submissions for both forms. Other cost (Monetized Value of Respondent Time) increased from $35,102 to $39,201 due to the increase in the national mean hourly wage for Office and Administrative Support Occupations from $17.19 to $21.90.

Annual Cost to Federal Government: $34,739

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? No

Agency Contact: Marcela Meneses 304 420-1232 meneses.marcela@dol.gov

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