Request for a Medical Exception to the COVID-19 Vaccination Requirement

ICR 202112-3060-003

OMB: 3060-1295

Federal Form Document

IC Document Collections
ICR Details
3060-1295 202112-3060-003
Received in OIRA 202111-3060-001
FCC OWD
Request for a Medical Exception to the COVID-19 Vaccination Requirement
No material or nonsubstantive change to a currently approved collection   No
Emergency 11/08/2021
12/07/2021
  Requested Previously Approved
05/31/2022 05/31/2022
100 100
50 50
0 0

This submission is being made for proposed non-substantive changes to an existing information collection pursuant to 44 U.S.C. § 3507. This submission seeks to modify FCC Form 5643 to correct a non-substantive typographical error. The Form Number was corrected to read “FCC-5643” instead of the erroneous “FCC-5634.” There are no changes in the burdens and no costs are associated with this information collection. Pursuant to Executive Order 14043, Federal employees must be fully vaccinated against COVID-19 by November 22, 2021. FCC employees may request reasonable accommodation from the vaccination requirement due to a documented medical necessity. Employees seeking consideration of such reasonable accommodation requests must provide a release form to permit the FCC to seek relevant information from their medical provider to support the employee's request. This process must be completed by November 22, 2021. This process will not be able to occur without the collection of information from employee physicians to scrutinize the legitimacy of such reasonable accommodation requests.
The Federal Communications Commission (Commission or FCC) requests Office of Management and Budget (OMB) approval to submit the information collection described herein under the “emergency processing” provisions of the Paperwork Reduction Act (PRA) of 1995, 5 CFR 1320.13. The Commission is requesting clearance for a new information collection entitled [OMB Control Number 3060-XXXX], Request for a Medical Exception to the COVID-19 Vaccination Requirement, FCC Form 5643. For the reasons explained below, We respectfully request OMB approval for this new information collection at the earliest possible time. The information collection requirements to be reported under this new collection are the result of requirements imposed by an Executive Order issued by President Biden regarding mandatory COVID-19 vaccination among Federal employees. On September 9, 2021, President Biden issued Executive Order 14043 to protect the health and safety of the Federal workforce and to promote the efficiency of the civil service. Pursuant to the Executive Order and implementing guidance, the Federal Communications Commission (FCC) informed its workforce that, other than in limited circumstances where a reasonable accommodation is legally required, all employees need to be fully vaccinated against COVID-19 by November 22, 2021, regardless of where they are working.

EO: EO 14043 Name/Subject of EO: Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
   US Code: 29 USC 791 Name of Law: The Rehabilitation Act of 1973, as amended
   EO: EO 13164 Name/Subject of EO: Requiring Federal Agencies to Establish Procedures to Facilitate the Provision of Reasonable Accommo
   EO: EO 13164 Name/Subject of EO: Equal Employment Opportunity Commission’s Policy Guidance
  
None

Not associated with rulemaking

No

  Total Request 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 100 100 0 0 0 0
Annual Time Burden (Hours) 50 50 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
Yes
Kenneth Heredia 202 418-7986 kenneth.heredia@fcc.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.
12/07/2021


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