Parties to LHWCA claims ask OWCP District Directors, who administer claims, to take a variety of routine actions, each depending on the claim. Currently, there is no uniform method for either requesting DD action or submitting the information necessary for the DD to evaluate the request. Parties submit the information in various formats. Capturing the required information in one form will save time, effort and cost for the federal government and simplify filing for the parties. The forms will also help OWCP properly classify different types of documents as it moves into a fully electronic case file environment and speed delivery of services to stakeholders.
US Code:
33 USC 939
Name of Law: Longshore and Harbor Workers' Compensation Act
Burden has been estimated by multiplying the estimated average response time with the estimated responses. The estimated responses were determined by a review of OWCP data maintained by the National Office, which reflect the number of requests made in FY2018, and the number of requests filed electronically. The response time is based on experience with the usual requests. The estimate takes into consideration that some cases require more information than others due to the complexity of the issues involved and the minute estimate should therefore be considered as an average time needed to gather the information, complete the form, obtain required signatures, and submit the required information.
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.
Form LS-4 Request for Intervention, Longshore and Harbor Workers' Compensation Act
1240-0NEW Supporting Statement (112519).docx
Request for Intervention, Longshore and Harbor Workers' Compensation Act