Request for a Medical Exemption to the COVID-19 Vaccination Requirement
Extension without change of a currently approved collection
No
Regular
06/24/2022
Requested
Previously Approved
36 Months From Approved
06/30/2022
2,000
2,000
333
333
0
0
Consistent with Executive Order 14043, of September 9, 2021, âRequiring Coronavirus Disease 2019 Vaccination for Federal Employees, and included within the Safer Federal Workforce Task Force Guidance mandating all Federal employees be vaccinated by November 22, 2021, the Department of Commerce (DOC) has established specific safety protocols for individuals fully vaccinated and not fully vaccinated against coronavirus disease 2019 (COVID-19). Individuals who are not fully vaccinated against COVID-19 by November 22, 2021, or who choose not to provide this information will be required to comply with applicable OMB. OPM and USDA guidance for individuals not fully vaccinated against COVID-19, including wearing masks regardless of the transmission rate in a given area, physical distancing, regular screening testing, and adhering to applicable travel requirements. USDA employees may request an exemption on the basis of a medical condition or circumstance. Exemptions will be granted in limited circumstances and only where legally required. The Medical Exemption Form will be provided directly to the individuals who are requesting a medical exemption.
EO: EO 14043 Name/Subject of EO: Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
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.
Request for a Medical Exemption to the COVID -19 Vaccination Requirement
SuptStmt 0503-0027.docx
opm-sorn-govt-10-employee-medical-file-systems-records (1).pdf
Federal Register, Volume 86 Issue 213 (Monday, November 8, 2021).html
Request for a Medical Exemption to the COVID -19 Vaccination Requirement