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View ICR - OIRA Conclusion

OMB Control No: 1240-0006	ICR Reference No: 202511-1240-002
Status: Active	Previous ICR Reference No: 202303-1240-003
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: War Hazards Compensation Act Claims, Benefits, and Notices
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/27/2026
	Date Received in OIRA: 03/17/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2029	36 Months From Approved	08/31/2026
Responses	2,528	0	1,264
Time Burden (Hours)	1,264	0	632
Cost Burden (Dollars)	5,840	0	2,427

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	2,528	1,264	1,264	0
Annual Time Burden (Hours)	1,264	632	632	0
Annual Cost Burden (Dollars)	5,840	2,427	0	3,413

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Respondents: The number of respondents increased from 7 to 14. This increase in respondents is due to the new WH-1 form being added to this collection. Responses: The number of responses increased from 1,264 to 2,528 due to the new WH-1 form being added to this collection Burden Hours: The total number of burden hours increase from 632 hours to 1,264 hours also due to the new WH-1 form being added to this collection. Costs to Respondents or Recordkeepers: Item 13 costs for this submission increased from $2,427.00 to $5,840.00 due to an increase in the mailing cost for first class mail and the increase in hourly rate for insurance claims and policy processing clerks.

Annual Cost to Federal Government: $71,744

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: Pamela Hamai 415 241-3350 hamai.pamela@dol.gov

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