Rehabilitation Plan and Award

ICR 201706-1240-002

OMB: 1240-0045

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2017-10-26
Supplementary Document
2017-06-27
Supplementary Document
2017-06-27
Supplementary Document
2017-06-27
Supplementary Document
2017-06-27
Supplementary Document
2017-06-27
Supplementary Document
2014-04-22
Supporting Statement A
2017-10-27
IC Document Collections
IC ID
Document
Title
Status
13717 Modified
ICR Details
1240-0045 201706-1240-002
Active 201403-1240-003
DOL/OWCP
Rehabilitation Plan and Award
Revision of a currently approved collection   No
Regular
Approved without change 12/18/2017
Retrieve Notice of Action (NOA) 10/30/2017
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved 12/31/2017
3,913 0 4,590
1,957 0 2,295
0 0 0

Form OWCP-16 is used by vocational rehabilitation counselors to submit an agreed upon rehabilitation plan to OWCP for approval, and documents OWCP's award of payment for any approved services.

US Code: 33 USC 901 et seq Name of Law: Longshore and Harbor Workers' Compensatinon Act (LHWCA)
   US Code: 5 USC 8101 et seq. Name of Law: Federal Employees' Compensation Act (FECA)
  
None

Not associated with rulemaking

  82 FR 37121 08/08/2017
82 FR 50163 10/30/2017
No

1
IC Title Form No. Form Name
Rehablitation Plan and Award OWCP-16 Rehabilitation Plan and Award

  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 3,913 4,590 0 0 -677 0
Annual Time Burden (Hours) 1,957 2,295 0 0 -338 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
Over the last three fiscal years (FY 2014 - 2016), open rehabilitation cases have averaged 3,913 per year, which is 677 less than the number reported (4,590) for the previous submission in 2014. This reported reduction in Rehabilitation Plans is due to the miscalculation of this number in the 2014 Supporting Statement. As a result of this adjustment in the total number of Rehabilitation Plans, burden hours have decreased 338 hours, from the previous submission of 2,295 to 1,957.

$524,712
No
    Yes
    Yes
No
No
No
Uncollected
Marcus Sharpless 202 693-0998 sharpless.marcus@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.
10/30/2017


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