OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Barriers to Occupational Injury Reporting by Workers: A NEISS Telephone Interview Survey

ICR 201201-0920-008 · OMB 0920-0939 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Barriers to occupational injury reporting by workers Form New Repair queued
111208_SupportStatement_SectionB_Barriers.docx Supporting Statement B Uploaded 2012-01-19 Available
AppF IRB approval.docx Supplementary Document Uploaded 2012-01-19 Available
AppE Topical experts.docx Supplementary Document Uploaded 2012-01-19 Available
AppC Barriers pre-interview letter 120502.docx Supplementary Document Uploaded 2012-05-09 Available
AppB 111006_FRN60day_Barriers.docx Supplementary Document Uploaded 2012-01-19 Available
AppA 29 USC 669.docx Supplementary Document Uploaded 2012-01-19 Available
ICR0920-11JY NIOSH Barriers SuppStat_A_NIOSH response 120526.docx Supporting Statement A Uploaded 2012-05-31 Available
IC Document Collections
IC IDCollectionTypeStatusForm
200876 Barriers to occupational injury reporting by workers Form New
ICR Details
0920-0939 201201-0920-008
Historical Active
HHS/CDC
Barriers to Occupational Injury Reporting by Workers: A NEISS Telephone Interview Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 06/04/2012
Retrieve Notice of Action (NOA) 01/23/2012
  Inventory as of this Action Requested Previously Approved
06/30/2014 24 Months From Approved
600 0 0
300 0 0
0 0 0
The NEISS occupational supplement (NEISS-Work) and injury supplement (NEISS-AIP) are collected by the Consumer Product Safety Commission and capture people who were treated in emergency departments for work-related and non-work-related injuries. This project will uses cases from these supplements to identify potential participants for a phone interview of employed persons to assess incentives and disincentives to reporting work-related injuries.
PL: Pub.L. 91 - 596 20 Name of Law: Occupational Safety and Health Act
  
None
Not associated with rulemaking
  76 FR 51981 08/19/2011
77 FR 2729 01/19/2012
Yes
1
IC Title Form No. Form Name
Barriers to occupational injury reporting by workers None Appendix D Barriers to Reporting Questionnaire
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 600 0 0 600 0 0
Annual Time Burden (Hours) 300 0 0 300 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.
$84,850
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/23/2012