Burden time and cost have
increased due to an increase in the number of claims controverted
and subsequent controversion forms filed. Burden cost has been
reduced since forms can now be submitted electronically using our
Secure Electronic Access Portal (SEAPortal), however, a
miscalculation of the cost burden in the previous submission has
resulted in an increase in cost burden showing in this
submission.
$64,803
No
Yes
Yes
No
No
No
No
Cheryl Jordan 202 693-0289
jordan.cheryl@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.