Supporting statement B 1 27 15

Information Collection Request

EXTENSION

Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA)

Dose Reconstruction Interviews and Forms

OMB No. 0920-0530, expires 02/28/2015

Supporting Statement Part B

Submitted by:

David S. Sundin

Deputy Director

Division of Compensation Analysis and Support

National Institute for Occupational Safety and Health

Robert A. Taft Laboratories

4676 Columbia Parkway

Cincinnati, Ohio 45226

Phone (513) 533-6825

Fax (513) 533-6826

e-mail: DSundin@cdc.gov

January 7, 2015

Table of Contents

B. Collections of Information Employing Statistical Methods

B1. Respondent Universe and Sampling Methods

B2. Procedures for the Collection of Information

B3. Methods to Maximize Response Rates and Deal with Non-Response

B4. Tests of Procedures or Methods to be Undertaken

B5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

B. Collections of Information Employing Statistical Methods

This is a federally-mandated program. No statistical methods will be used, however; the following procedures listed in B.2 are used to collect information.

B.1 Respondent Universe and Sampling Methods

The respondent universe includes all claimants.

B.2 Procedures for the Collection of Information

In performance of its dose reconstruction responsibilities under the Act, NIOSH interviews claimants individually and provides them with the opportunity, through a structured interview, to assist NIOSH in documenting the work history of the employee (characterizing the actual work tasks performed), identifying incidents that may have resulted in undocumented radiation exposures, characterizing radiation protection and monitoring practices, and identifying co-workers and other witnesses to supplement or confirm information, if necessary. In this process, NIOSH uses a computer assisted telephone interview (CATI) system, which will allow interviews to be conducted more efficiently and quickly than would be the case with a paper-based interview instrument.

NIOSH uses the data collected in this process to complete an individual dose reconstruction that accounts for radiation dose, including unmonitored or inadequately monitored dose, incurred by the employee in the line of duty for DOE nuclear weapons production programs. After dose reconstruction, NIOSH provides a draft of the dose reconstruction report to the claimant and reviews the information used, methods, and results with the claimants. This is the final opportunity for the claimant to supplement the dose reconstruction record.

At the conclusion of the dose reconstruction process, the claimant is requested to submit to NIOSH a form (OCAS-1, Attachment D) to confirm that all information available to the claimant has been provided to NIOSH, and that the information is believed to be true. The form notifies the claimant that signing the form allows NIOSH to provide a final dose reconstruction report to DOL and closes the record on data to be used for the dose reconstruction. DOL will use data from the dose reconstruction report to determine the probability that the cancer(s) of the covered employee may have been caused by radiation doses incurred in the line of duty at a DOE or Atomic Weapons Employer (AWE) facility.

B.3. Methods to Maximize Response Rates and Deal with Nonresponse

This section does not apply to this data collection because 42 C.F.R. pt 82 implements a federally-mandated program requiring collection of this data.

B.4. Tests of Procedures or Methods to be Undertaken

This is a request for the extension of the Dose Reconstruction Telephone Interviews and OCAS-1 form under the Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA)– OMB No. 0920-0530 (expiration date: 2/28/2015). There are no changes to data collection or survey method.

B.5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

This project has been ongoing since NIOSH was given the statutory authority under EEOICPA (42 U.S.C. §§ 7384-7385). The project officer is available for consultation. His contact information is listed below.

Designed the data collection:

David S. Sundin

Deputy Director

Division of Compensation Analysis and Support, NIOSH

Robert A. Taft Laboratories

4676 Columbia Parkway

Cincinnati, Ohio 45226

513-533-6825

Will collect the data:

Kate Kimpan

Project Officer

Oak Ridge Associated Universities (ORAU)—Cincinnati Operations Office

4850 Smith Road, Suite 200

Cincinnati, OH 45212

Kate.Kimpan@orau.org

(513) 758-1636

Will analyze the data:

Ed Maher

Manager, Objective 3 (Dose Reconstruction Team)

Oak Ridge Associated Universities (ORAU) Team

526 Main Street

One Acton Place

Acton, MA 01720

emaher@oraucoc.org

(Manages approximately 33 employees on this project)

Pat Kraps

Manager, Objective 2 (Computer Assisted Telephone Interview, CATI, Team)

Oak Ridge Associated Universities (ORAU)—Cincinnati Operations Office

4850 Smith Road, Suite 200

Cincinnati, OH 45212

pkraps@oraucoc.org

(Manages approximately 13 employees on this project)