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View ICR - OIRA Conclusion

OMB Control No: 1240-0032	ICR Reference No: 202601-1240-005
Status: Active	Previous ICR Reference No: 202304-1240-008
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: 08/28/2026
	Date Received in OIRA: 03/11/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2029	36 Months From Approved	08/31/2026
Responses	3,980	0	4,155
Time Burden (Hours)	995	0	1,039
Cost Burden (Dollars)	2,973	0	2,356

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3,980	4,155	-175
Annual Time Burden (Hours)	995	1,039	-44
Annual Cost Burden (Dollars)	2,973	2,356	617

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: Respondents: The number of respondents decreased from 4,155 to 3,980. The number of respondents decreased due to a decrease in forms processed. The following also decreased due to a decrease in number of forms received/responses. Responses: Responses have decreased from 4,155 to 3,980. Burden Hours: Burden hours have decreased from 1,039 to 995. Costs: Annual burden costs have increased from $2,356 to $2,973 due to postage rate increase.

Annual Cost to Federal Government: $52,238

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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