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View ICR - OIRA Conclusion

OMB Control No: 1240-0042	ICR Reference No: 202406-1240-003
Status: Active	Previous ICR Reference No: 202105-1240-002
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Notice of Controversion of Right to Compensation
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: 08/26/2024
	Date Received in OIRA: 07/24/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2027	36 Months From Approved	08/31/2024
Responses	23,928	0	19,250
Time Burden (Hours)	5,982	0	4,813
Cost Burden (Dollars)	1,858	0	2,118

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	23,928	19,250	4,678
Annual Time Burden (Hours)	5,982	4,813	1,169
Annual Cost Burden (Dollars)	1,858	2,118	-260

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: Time burden has increased due to an increase in claims with an attendant increase in the actual number of controversion forms filed by employers in response to the claims. Cost burden to respondents has decreased despite the increase in both number of responses and postage costs because a larger percentage of respondents are filing their LS-207 forms electronically.

Annual Cost to Federal Government: $92,703

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: John Palmerin 415 241-3478 palmerin.john@dol.gov

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