[Federal Register Volume 84, Number 214 (Tuesday, November 5, 2019)]
[Notices]
[Pages 59652-59653]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-24083]
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DEPARTMENT OF LABOR
Office of Workers' Compensation Programs
Proposed Extension of Existing Collection; Comment Request
AGENCY: Division of Federal Employees' Compensation, Office of Workers'
Compensation Programs, Labor.
ACTION: Notice.
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SUMMARY: The Department of Labor (DOL), as part of its continuing
effort to reduce paperwork and respondent burden, conducts a
preclearance consultation program to provide the general public and
Federal agencies with an opportunity to comment on proposed and/or
continuing collections of information in accordance with the paperwork
Reduction Act of 1995 (PRA95). This program helps to ensure that
requested data can be provided in the desired format, reporting burden
[[Page 59653]]
(time and financial resources) is minimized, collection instruments are
clearly understood, and the impact of collection requirements on
respondents can be properly assessed.
Currently, the Office of Workers' Compensation Programs is
soliciting comments concerning the proposed collection: Death Gratuity
Forms CA-40, CA-41, and CA-42. A copy of the proposed information
collection request can be obtained by contacting the office listed
below in the addresses section of this Notice.
DATES: Written comments must be submitted to the office listed in the
addresses section below on or before January 6, 2020.
ADDRESSES: You may submit comments by mail, delivery service, or by
hand to Anjanette Suggs, U.S. Department of Labor, 200 Constitution
Ave. NW, Room S-3323, Washington, DC 20210; by fax, (202) 354-9660, or
email to [email protected]. Please use only one method of
transmission for comments (mail or email).
SUPPLEMENTARY INFORMATION:
I. Background
The DOL is requesting an approval of an extension of this
information collection. This information collection is essential to the
mission of DOL and the Office of Workers' Compensation Programs (OWCP),
the information collected through forms CA-40, CA-41 and CA-42 is used
by claims examiners in OWCP to determine a person's entitlement to any
or all of the death gratuity payment provided by 5 U.S.C. Sec. 8102a.
The National Defense Authorization Act for Fiscal Year 2008, Public Law
110-181, was enacted on January 28, 2008. Section 1105 of Public Law
110-181 amended the Federal Employees' Compensation Act (FECA) creating
a new section, 5 U.S.C. 8102a effective upon enactment. This section
establishes a FECA death gratuity benefit of up to $100,000 for
eligible beneficiaries of federal employees and Non-Appropriated Fund
Instrumentality (NAFI) employees who die from injuries incurred in
connection with service with an Armed Force in a contingency operation.
5 U.S.C. 8102a also permits agencies to authorize retroactive payment
of the death gratuity for employees who died on or after October 7,
2001 in service with an Armed Force in the theater of operations of
Operation Enduring Freedom and Operation Iraqi Freedom. 5 U.S.C. 8102a
also allows federal employees to vary the order of precedence of
beneficiaries or to name alternate beneficiaries. 20 CFR 10.909 and
10.911 provides that forms CA-40, CA-41, and CA-42 are used to
designate beneficiaries and initiate the payment process for death
gratuity benefits. See 5 U.S.C. 8145 and 8149.
Form CA-40 is an optional form that requests the information
necessary from the employee to accomplish this variance and to name
alternate beneficiaries only if the employee wishes to do so. Form CA-
41 provides the means for those named beneficiaries and possible
recipients to file claims for those benefits and requests information
from such claimants so that OWCP may determine their eligibility for
payment. Further, the statute and regulations require agencies to
notify OWCP immediately upon the death of a covered employee. CA-42
provides the means to accomplish this notification and requests
information necessary to administer any claim for benefits resulting
from such a death.
II. Review Focus
The DOL is particularly interested in comments which:
* Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
* Evaluate the accuracy of the agency's estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used;
* enhance the quality, utility and clarity of the information to be
collected; and
* minimize the burden of the collection of information on those who
are to respond, including through the use of appropriate automated,
electronic, mechanical, or other technological collection techniques or
other forms of information technology, e.g., permitting electronic
submissions of responses.
III. Current Actions
The DOL seeks the approval for the extension of this currently
approved information collection in order to carry out its
responsibility to meet the statutory requirements of the Federal
Employees' Compensation Act.
Agency: Office of Workers' Compensation Programs.
Type of Review: Extension.
Title: Death Gratuity Forms.
OMB Number: 1240-0017.
Agency Number: CA-40, CA-41, and CA-42.
Affected Public: Individuals or households; Businesses or other
for-profit.
Total Respondents: 4.
Total Annual Responses: 4.
Estimated Total Burden Hours: 3.
Estimated Time per Response: 30 minutes.
Frequency: On occasion.
Total Burden Cost (capital/startup): $84.
Total Burden Cost (operating/maintenance): $2.
Comments submitted in response to this notice will be summarized
and/or included in the request for Office of Management and Budget
approval of the information collection request; they will also become a
matter of public record.
Anjanette Suggs,
Agency Clearance Officer, Office of Workers' Compensation Programs,
U.S. Department of Labor.
[FR Doc. 2019-24083 Filed 11-4-19; 8:45 am]
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