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View ICR - OIRA Conclusion

OMB Control No: 1240-0032	ICR Reference No: 202304-1240-008
Status: Active	Previous ICR Reference No: 202008-1240-045
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Request for State or Federal Workers' Compensation Information
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 without change	Conclusion Date: 06/27/2023
	Date Received in OIRA: 05/25/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2026	36 Months From Approved	07/31/2023
Responses	4,155	0	6,000
Time Burden (Hours)	1,039	0	1,500
Cost Burden (Dollars)	2,356	0	3,480

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	4,155	6,000	-1,845
Annual Time Burden (Hours)	1,039	1,500	-461
Annual Cost Burden (Dollars)	2,356	3,480	-1,124

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 decreased from 6,000 to 4,155. The number of respondents decreased due to a decreased of claims filed. The following also decreased due to a decreased in number of forms received/responses. Responses: Responses have decreased from 6,000 to 4,155. Burden Hours: Burden hours have decreased from 1,500 to 1,039. Costs: Annual burden costs have decreased from $3,480 to $2,356.

Annual Cost to Federal Government: $48,593

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. No

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. 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? No

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

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