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OMB Control No: 1240-0033	ICR Reference No: 202604-1240-001
Status: Received in OIRA	Previous ICR Reference No: 202401-1240-003
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Coal Mine Operator Response to Schedule for Submission of Additional Evidence and Operator Response to Notice of Claim
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 10/16/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2026
Responses	11,470	5,294
Time Burden (Hours)	2,644	1,173
Cost Burden (Dollars)	2,923	1,096

Abstract: The OWCP, Division of Coal Mine Workers' Compensation (DCMWC) administers the Black Lung Benefits Act (30 U.S.C. 901 et seq.), which provides benefits to coal miners totally disabled due to pneumoconiosis and their surviving dependents. When the DCMWC makes a preliminary analysis of a claimant's eligibility for benefits, and if a coal mine operator has been identified as potentially liable for payment of those benefits, the responsible operator is notified of the preliminary analysis. Regulations codified at 20 CFR part 725 require that a coal mine operator be identified and notified of potential liability as early in the adjudication process as possible. Coal Mine Operator Response to Schedule for Submission of Additional Evidence (Form CM-2970) and Operator Response to Notice of Claim (Form CM-2970a) are used for claims filed after January 19, 2001, and indicate that the coal mine operator will submit additional evidence or respond to the notice of claim.

Authorizing Statute(s): US Code: 30 USC 901 Name of Law: Black Lung Benefits Act

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 34657	06/08/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 65788	10/16/2026
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim	CM-2970, CM-2970a	,

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	11,470	5,294	3,240	2,936
Annual Time Burden (Hours)	2,644	1,173	0	1,471
Annual Cost Burden (Dollars)	2,923	1,096	0	1,827

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: EXPLANATION OF CHANGE TOTALS Respondents: The number of respondents increased from 5,294 to 8,230. Responses: The number of responses increased from 8,082 to 11,470. OWCP issues more Notices of Claims than Schedules for the Submission of Additional Evidence because the miner can withdraw or abandon his claim before a Schedule for the Submission of Additional Evidence is issued. Reasons for notifying multiple employers in a single claim include, but are not limited to: the miner’s reporting of who his last coal mine employer was is different from who his Social Security Earnings Records indicate was the last operator to employ him, or the most recent employer is not financially capable of assuming liability for the claim and OWCP must notify the next most-recent coal mine employer. For the current iteration of this collection, OWCP has used the actual FY-25 response rates to each form to more precisely estimate the burden associated with this collection. Burden Hours: Burden hours have increased from 1,173 to 2,644. Costs: Annual burden costs have increased from $1,096 to $2,923.

Annual Cost to Federal Government: $54,139

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

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