OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Energy Employees Occupational Illness Compensation Program Act Dose Reconstruction Interviews and Forms (EEOICPA)

ICR 201806-0920-006 · OMB 0920-0530 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0530 EEOICPA Dose Reconstruction Introductory Letters & Telephone Interview Form and Instruction Modified Available
Form OCAS-1 EEOICPA Dose Reconstruction Interviews Conclusion Form Form Unchanged Available
Privacy Act Checklist.doc Supplementary Document Uploaded 2018-07-03 Available
Attachment B.pdf Supplementary Document Uploaded 2018-06-18 Available
Supporting statement B 2018_05_14.docx Supporting Statement B Uploaded 2018-06-15 Available
Supporting statement A 2018_05_14 rev1 2018_05_25-clean.docx Supporting Statement A Uploaded 2018-07-05 Available
Attachment E.doc Supplementary Document Uploaded 2015-01-29 Available
Attachment A.3.pdf Supplementary Document Uploaded 2015-01-29 Available
Attachment A.2.pdf Supplementary Document Uploaded 2015-01-29 Available
Attachment A.1.pdf Supplementary Document Uploaded 2015-01-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
6981 EEOICPA Dose Reconstruction Introductory Letters & Telephone Interview Form and Instruction Modified
188308 EEOICPA Dose Reconstruction Interviews Conclusion Form Form Unchanged
ICR Details
0920-0530 201806-0920-006
Active 201501-0920-026
HHS/CDC 0920-0530
Energy Employees Occupational Illness Compensation Program Act Dose Reconstruction Interviews and Forms (EEOICPA)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 01/30/2019
Retrieve Notice of Action (NOA) 07/05/2018
  Inventory as of this Action Requested Previously Approved
01/31/2022 36 Months From Approved
7,200 0 0
3,900 0 0
0 0 0
NIOSH is charged with developing reasonable estimates of the radiation doses incurred occupationally by U.S. nuclear weapons workers with cancer that are covered by the Energy Employees Occupational Illness Compensation Program Act of 2000. These radiation dose reconstructions are completed using methods promulgated by HHS under 42 CFR 82. An essential data source for completing the dose reconstructions is the information collected through structured telephone interviews conducted with claimants, who may be energy employees or surviving family members. In some cases, if necessary, co-workers of the employee are interviewed. These individuals may have unique knowledge of work conditions, radiation protection measures, and monitoring practices that are not available from other sources. At the completion of the dose reconstruction process, claimants review the estimated radiation dose, and signify that they have no more relevant information to offer by submitting a conclusion form (OCAS-1). The expiration date lapsed before an extension could be completed so the program is seeking a reinstatement without change. There are no changes to the information collection instruments or the burden estimates.
US Code: 42 USC 7384 Name of Law: EEOICPA
   EO: EO 13179 Name/Subject of EO: Providing Compensation to America's Nuclear Weapons Workers
   US Code: 2 USC 82.10 Name of Law: Methods for Dose Reconstruction under EEOICPA
   PL: Pub.L. 106 - 398 3624 Name of Law: Energy Employees Occupational Illness Compensation Program Act
  
None
Not associated with rulemaking
  83 FR 7185 02/20/2018
83 FR 28233 06/18/2018
No
  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 7,200 0 0 7,200 0 0
Annual Time Burden (Hours) 3,900 0 0 3,900 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Reinstatement request with no burden hour changes.
$303,800
No
    Yes
    Yes
No
No
No
Uncollected
Kevin Joyce 404 639-1944 [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.
07/05/2018