Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act

ICR 200901-1215-002 · OMB 1215-0160 · Historical Active

Forms and Documents

Document	Type	Status	Availability
Form LS-201 proposed Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act	Form	Modified	Available
WORKSHEET FOR OMB NO 1215-0160 May 1 2009.doc	Supplementary Document	Uploaded 2009-05-01	Available
OMB - Supporting Statement for 1215-0160 May 1 2009.doc	Supporting Statement A	Uploaded 2009-05-01	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
43808	Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act	Form	Modified

ICR Details

OMB Control No: 1215-0160	ICR Reference No: 200901-1215-002
Status: Historical Active	Previous ICR Reference No: 200606-1215-001
Agency/Subagency: DOL/ESA	Agency Tracking No:
Title: Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act
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: 06/15/2009
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/18/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2012	36 Months From Approved	08/31/2009
Responses	175,374	0	182,068
Time Burden (Hours)	66,544	0	71,376
Cost Burden (Dollars)	66,587	0	65,000

Abstract: The regulations and forms cover the submission of information relating to the processing of claims for benefits under the Longshore Act and extensions.

Authorizing Statute(s): US Code: 33 USC 901 et seq. Name of Law: Longshore and Harbor Workers' Compensation 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:
	74 FR 7619	02/18/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 23207	05/18/2009
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Regulations Governing the Administration of the Longshore and Harbor Workers' Compensation Act	LS-204 proposed, LS-271 proposed, LS-200 proposed, LS-201 proposed, LS-513 proposed, LS-267 proposed, LS-203 proposed, LS-262 proposed, LS-274 proposed	Notice of Employee's Injury or Death , Report of Payments , Claimant's Statement , Employee's Claim for Compensation , Claim for Death Benefits , Application for Self-Insurance , Attending Physician's Supplementary Report , Report of Injury Experience of Insurance Carrier or Self-Insured Employer , Report of Earnings

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	175,374	182,068	-6,694
Annual Time Burden (Hours)	66,544	71,376	-4,832
Annual Cost Burden (Dollars)	66,587	65,000	1,587

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: Burden was reduced due to a decrease in the number of authorized insurance carriers and self-insured companies under the Act as well as a reduction in reporting under the Act.

Annual Cost to Federal Government: $331,431

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Cheryl Jordan 202 693-0289 [email protected]

Common Form ICR: No