Overpayment Recovery Questionnaire

ICR 201207-1240-003

OMB: 1240-0051

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2012-07-13
Supplementary Document
2009-02-25
Supplementary Document
2009-02-25
Supplementary Document
2009-02-25
IC Document Collections
IC ID
Document
Title
Status
38463 Modified
ICR Details
1240-0051 201207-1240-003
Historical Active 201003-1240-051
DOL/OWCP
Overpayment Recovery Questionnaire
Revision of a currently approved collection   No
Regular
Approved without change 12/11/2012
Retrieve Notice of Action (NOA) 10/29/2012
  Inventory as of this Action Requested Previously Approved
12/31/2015 36 Months From Approved 12/31/2012
3,088 0 4,020
3,088 0 4,020
1,482 0 1,889

Information collected with this form is used to evaluate the financial profile of OWCP beneficiaries who have been overpaid benefits, and their ability to repay. OWCP beneficiaries are typically retired coal miners disabled by black lung disease, Federal employees injured on the job, and their survivors.

US Code: 42 USC 7385j-2 Name of Law: Federal Coal Mine Health and Safety Act
   US Code: 5 USC 8129(b) Name of Law: Federal Coal Mine Health and Safety Act
   US Code: 5 USC 923(b) Name of Law: Federal Coal Mine Health and Safety Act of 1969
  
None

Not associated with rulemaking

  77 FR 40645 07/10/2012
77 FR 65580 10/29/2012
No

1
IC Title Form No. Form Name
Overpayment Recovery Questionnaire OWCP-20 Overpayment Recovery 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 3,088 4,020 0 0 -932 0
Annual Time Burden (Hours) 3,088 4,020 0 0 -932 0
Annual Cost Burden (Dollars) 1,482 1,889 0 0 -407 0
No
No
There was no change to the burden hours to the Black Lung (BL) related to instances where benefits checks were issued after a beneficiary's death and prior to receipt of notification of the death by the BL program. Under new Treasury procedures with post mortem overpayments, repayment of the debt is not the burden of the person that received a descendant's benefits. The burden is on the bank that improperly failed to close the account and paid out the money. Rather than using the OWCP-20 form that a claimant debtor would complete, these overpayments are recovered by using a protected need-to-know Department of the Treasury Web site service to collect from the liable bank. This service is currently called by Treasury PACER for Payment and Claims Enhanced Reconciliation and is commonly referred to as POL for PACER-On-Line. There has been no change in the annual responses. FOR DFEC. The number of newly identifiable overpayments has decreased over the last few years. Consequently, reduction in burden hours and costs associated with the requirement to complete this form has been reduced. DFEC attributes these reductions in part due to claimants and employing agencies reporting return to work promptly to DFEC. Additionally, the reduction is also due to DFEC staff, employing agencies, and claimants more promptly identifying and/or reporting changes in dependency which affects the entitled compensation rate. Presently, if a claimant has dependents, their FECA benefits to compensation are based on 3/4 of their weekly pay. However, if they have no dependents (as a result of divorce, death, no eligible children), the entitlement is reduced to two-thirds. While not affecting the burden, this ICR has been characterized as a revision because the agency has reformatted elements of Forms (e.g., replaced an obsolete logo with the DOL Seal, OMB Control Number, and removed references to the no longer existent Employment Standards Administration). Upon OMB's clearance of this request OWCP will update the forms to show the new expiration date.

$113,674
No
No
No
No
No
Uncollected
Yoon Ferguson 202 693-0701 ferguson.yoon@dol.gov

  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.
10/29/2012


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