Medical Certification for COVID-19 Vaccine Exception for Prospective Employees with Job Offer

UNITED STATES OF AMERICA

Federal Trade Commission
WASHINGTON, D.C. 20580

Office of the Executive Director

Sharon Block
Acting Administrator
Office of Information and Regulatory Affairs
Office of Management and Budget
725 17th Street, NW
Washington, DC 20503
Re: Emergency Clearance Request under the
Paperwork Reduction Act
Dear Ms. Block:
I am the Federal Trade Commission’s COVID-19 Pandemic Response Team Leader. We
are submitting an emergency clearance request for authority under the Paperwork Reduction Act
to collect information from(1) individuals that receive a job offer to be FTC employers relating to their vaccination
status and, if they seek a medical exception,
(2) medical providers on part two of the form on which such prospective employees seek
a medical exception to the requirement for a COVID-19 vaccination or a delay
because of a temporary condition or medical circumstance. 1
The FTC needs information requested on the job offer letter to determine if the prospective
employee complies with the vaccination requirement and, separately if a medical exception is
sought, information from their medical provider to effectively evaluate the prospective
employee’s reasonable accommodation request.
The FTC requests a 180-day emergency clearance to obtain this information. During the
180-day emergency clearance period, the FTC will work to establish a regular clearance
submission. As this request for approval concerns an urgent safety need, the FTC is also seeking
This request technically revises an existing clearance for OMB Control Number 3084-0170, which
authorized information collections from medical providers for federal employees that request a medical
exception to the vaccination requirement. That clearance has been approved by OMB through May 31,
2022.
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OMB’s approval to waive the need for the Federal Register Notices otherwise required by 5
C.F.R. 1320.5(a)(l)(iv) and 1320.8(d)(l) prior to publication and implementation of this
disclosure.
Special circumstances exist that require an emergency clearance pursuant to 5 CFR
1320.13(a). Executive Order 14,043 directed the Safer Federal Workforce Task Force to issue
guidance within 7 days of the date of that order (Sept. 9, 2021) on implementation by federal
agencies covered by the order. The Task Force thereafter directed that Federal employees must
be fully vaccinated by November 22, 2021, other than in limited circumstances where the law
requires an exception. Agencies were also directed to require that individuals who start their
government service after November 22, 2021, be fully vaccinated prior to their start date, except
in limited circumstances where an accommodation is legally required.
Thus, the collection of information is needed prior to the expiration of time periods
ordinarily required by the PRA statute and implementing rules and is essential to the mission of
the FTC. 5 CFR 1320.13(a)(1)(i)-(ii). Additionally, public harm is reasonably likely to result if
normal clearance procedures are followed. 5 CFR 1320.13(a)(2)(i). This information is being
collected and maintained to promote the safety of Federal buildings and the Federal workforce
consistent with the above-referenced authorities, the COVID-19 Workplace Safety: Agency
Model Safety Principles established by the Safer Federal Workforce Task Force, and guidance
from Centers for Disease Control and Prevention and the Occupational Safety and Health
Administration.
Please feel free to contact Richard Gold at (202) 326-3355 or via email at rgold@ftc.gov
if you have any questions.
Respectfully,
signed by DAVID ROBBINS
DAVID ROBBINS Digitally
Date: 2021.11.29 19:39:31 -05'00'

David Robbins
Executive Director