Document
Proposed Extension of Existing Collection; Comment Request
The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclearance consultation program to provide the general public a...
SUPPLEMENTARY INFORMATION:
I. Background:
A Federal employee who sustains a work-related injury is entitled to receive compensation under the Federal Employees' Compensation Act (FECA). If that injury is caused under circumstances that create a legal liability in a third party to pay damages, the FECA authorizes the Secretary of Labor to require the employee to assign his or her right of action to the United States or to prosecute the action in his or her own name.
See5 U.S.C. 8131.
When the employee receives a payment for his or her damages, whether from a final court judgment on or a settlement of the action, section 8132 of the FECA (5 U.S.C. 8132) provides that the employee “shall refund to the United States that amount of compensation paid by the United States. . . .” To enforce the United States' statutory right of reimbursement, the Office of Workers' Compensation Programs (OWCP) has promulgated regulations. The regulations require a FECA beneficiary to report these types of payments (20 CFR 10.710) and submit the detailed information necessary to calculate the amount of the refund and surplus, if any, according to the formula in the statute (20 CFR 10.707(e)).
The information collected by Form CA-1108 and Form CA-1122 from the FECA beneficiary includes this information and is necessary to calculate the amount of the refund and surplus owed to the United States from the FECA beneficiary's settlement or judgment, as required in the statute and the regulations. This information collection is currently approved for use through November 30, 2018.
II. Review Focus:
The Department of Labor 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 Department of Labor seeks the approval for the extension of this currently approved information collection in order to exercise its responsibility to enforce the United States' right to this refund. The information collected with Form CA-1108 and Form CA-1122 is used by SOL personnel to determine the amount to be reimbursed to the United States out of the proceeds of an action asserted by an injured Federal employee against a liable third party for a compensable injury.
Agency:
Office of Workers' Compensation Program.
Type of Review:
Extension.
Title:
Statement of Recovery Forms.
OMB Number:
1240-0001.
Agency Number:
CA-1108 and CA-1122.
Affected Public:
Business or other for-profit, Individuals or households.
| Form |
Time to
complete
(min.) |
Frequency
of response |
Number of
respondents |
Number of
responses |
Hours
burden |
| CA-1108 Business Respondent |
30 |
1 |
928 |
928 |
464 |
| CA-1122 Individual Respondent |
15 |
1 |
10 |
10 |
3 |
| Totals |
NA |
NA |
938 |
938 |
467 |
Total Respondents:
938.
Total Annual Responses:
938.
Average Time per Response:
15-30 minutes.
Estimated Total Burden Hours:
467.
Frequency:
As needed.
Total Burden Cost (capital/startup):
$0.
Total Burden Cost (operating/maintenance):
$249.
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.
Dated: August 27, 2018.
Yoon Ferguson,
Agency Clearance Officer, Office of Workers' Compensation Programs, US Department of Labor.