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View ICR - OIRA Conclusion

OMB Control No: 1219-0152	ICR Reference No: 202512-1219-004
Status: Active	Previous ICR Reference No: 202303-1219-006
Agency/Subagency: DOL/MSHA	Agency Tracking No: 10/31/26 Exp
Title: Periodic Medical Surveillance Examinations for Coal Miners
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: 10/05/2026
	Date Received in OIRA: 08/26/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2029	36 Months From Approved	10/31/2026
Responses	761	0	797
Time Burden (Hours)	296	0	310
Cost Burden (Dollars)	228	0	239

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	761	797	-36
Annual Time Burden (Hours)	296	310	-14
Annual Cost Burden (Dollars)	228	239	-11

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: Number of Respondents: The estimated number of respondents decreases from 664 to 634 due to a decrease in the number of coal mines. Number of Responses: The estimated number of responses decreases from 797 to 761 due to a decrease in the number of respondents (coal mines). Annual Time Burden: The estimated annual time burden decreases from 310 to 296 hours due to a decrease in the number of responses. Annual Recordkeeping Costs: The estimated annual recordkeeping costs decreases from $239 to $228 due to a decrease in the number of responses.

Annual Cost to Federal Government: $0

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: Joanna Moore 202 693-9825 moore.joanna@dol.gov

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