Claim for Reimbursement-Assisted Reemployment, CA-2231
OMB Control Number: 1240-0018
OMB Expiration Date: December 31, 2022
SUPPORTING STATEMENT FOR
CLAIM FOR REIMBURSEMENT-ASSISTED REEMPLOYMENT
FORM CA-2231
OMB CONTROL NO. 1240-0018
This ICR seeks to extend this information collection.
JUSTIFICATION
1. Explain the circumstances that make the collection of information necessary. Identify any legal or administrative requirements that necessitate the collection. Attach a copy of the appropriate section of each statute and regulation mandating or authorizing the collection of information.
The Office of Workers’ Compensation Programs (OWCP) administers the Federal Employees’ Compensation Act (FECA) under 5 U.S.C. 8101 et seq. This act provides vocational rehabilitation services to eligible workers with disabilities. Section 8104(a) of the FECA provides vocational rehabilitation to eligible injured workers to facilitate their return to work. The costs of providing these vocational rehabilitation services are paid from the Employees’ Compensation Fund. Annual appropriations language under the Consolidated Appropriations Act of 2022 (currently in Public Law 117-103), provides OWCP with legal authority to use amounts from the Fund to reimburse private sector employers for a portion of the salary of reemployed FECA claimants hired through OWCP’s assisted reemployment program. Additionally, 5 U.S.C. 8111 provides that an individual undergoing vocational rehabilitation under section 8104 may be paid additional compensation necessary for his maintenance, which is initiated by an employer for a claimant using form CA-2231, Employers’ Claim for Reimbursement Assisted Reemployment. This information collection is currently approved for use through December 2022.
See Federal Employees' Compensation Act | U.S. Department of Labor (dol.gov)
2. Indicate how, by whom, and for what purpose the information is to be used. Except for a new collection, indicate the actual use the agency has made of the information received from the current collection.
Information collected on Form CA-2231 provides OWCP with the necessary remittance information for the employer, documents the hours of work, certifies the payment of wages to the claimant for which reimbursement is sought, and summarizes the nature and costs of the wage reimbursement program for a prompt decision by OWCP.
Failure to collect this information would prevent timely and accurate reimbursement to employers, hinder the documentation of disbursements from the Fund, and obstruct implementation of the assisted reemployment program.
3. Describe whether, and to what extent, the collection of information involves the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology (e.g., permitting electronic submission of responses) and the basis for the decision to adopt this means of collection. Also, describe any consideration of using information technology to reduce burden.
In accordance with the Government Paperwork Elimination Act, the current Form CA-2231 is electronically interactive and posted on the Internet.
OWCP has developed two alternatives to mailing of documents. These applications are known as the Employee Compensation Operations and Management Portal (ECOMP) and the Disability Management Portal (DMP). These applications are internet based, and allow users the ability to submit a completed form electronically into the claimant’s case record. As of June 2020, the respondents are required to electronically submit their response to ECOMP or DMP. The use of these applications is of no cost to the public.
See: https://www.ecomp.dol.gov/; https://www.dmp.dol.gov/
4. Describe efforts to identify duplication. Show specifically why any similar information already available cannot be used or modified for use for the purposes described in Item A.2 above.
The information collected on this form is not duplicative of any information available elsewhere. The respondent is the only source of the data needed to process the reimbursement request.
5. If the collection of information impacts small businesses or other small entities, describe any methods used to minimize burden.
This information collection does not have a significant economic impact on a substantial number of small entities.
6. Describe the consequence to federal program or policy activities if the collection is not conducted or is conducted less frequently, as well as any technical or legal obstacles to reducing burden.
Please refer to Nos. 1 and 2 above. The information collected from private sector employers is the minimum needed to evaluate whether a reimbursement request meets the requirements of OWCP’s assisted reemployment program. Reimbursement requests cannot be processed by OWCP without the information collected.
7. Explain any special circumstances that would cause an information collection to be conducted in a manner:
requiring respondents to report information to the agency more often than quarterly;
requiring respondents to prepare a written response to a collection of information in fewer than 30 days after receipt of it;
requiring respondents to submit more than an original and two copies of any document;
requiring respondents to retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years;
in connection with a statistical survey, that is not designed to produce valid and reliable results that can be generalized to the universe of study;
requiring the use of statistical data classification that has not been reviewed and approved by OMB;
that includes a pledge of confidentiality that is not supported by authority established in statute or regulation, that is not supported by disclosure and data security policies that are consistent with the pledge, or which unnecessarily impedes sharing of data with other agencies for compatible confidential use; or
requiring respondents to submit proprietary, trade secret, or other confidential information unless the agency can demonstrate that it has instituted procedures to protect the information's confidentiality to the extent permitted by law.
There are no special circumstances for the collection of this information.
8. If applicable, provide a copy and identify the date and page number of publication in the Federal Register of the agency's notice, required by 5 C.F.R. 1320.8(d), soliciting comments on the information collection prior to submission to OMB. Summarize public comments received in response to that notice and describe actions taken by the agency in response to these comments. Specifically address comments received on cost and hour burden.
Describe efforts to consult with persons outside the agency to obtain their views on the availability of data, frequency of collection, the clarity of instructions and recordkeeping, disclosure, or reporting format (if any), and on the data elements to be recorded, disclosed, or reported.
Consultation with representatives of those from whom information is to be obtained or those who must compile records should occur at least once every 3 years -- even if the collection-of-information activity is the same as in prior periods. There may be circumstances that may preclude consultation in a specific situation. These circumstances should be explained.
A Federal Register Notice inviting public comment was published on August 2, 2022 (87 FR 47232). No comments were received.
9. Explain any decision to provide any payments or gifts to respondents, other than remuneration of contractors or grantees.
No payment or gift is made to respondents.
10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or agency policy.
The information collected by these forms is maintained in OWCP claim files which are fully protected under the Privacy Act. The applicable Privacy Act System of Records is DOL/GOVT-1 [81 FR 47418 (July 21, 2016)].
See DOL/GOVT-1 | U.S. Department of Labor.
The FECA establishes the system for processing and adjudicating claims that federal employees and other covered individuals file with the Department of Labor’s OWCP, seeking monetary, medical and similar benefits for injuries or deaths sustained while in the performance of duty. The records maintained in this system are created as a result of and are necessary to this process. The records provide information and verification about the individual’s employment-related injury and the resulting disabilities and/or impairments, if any, on which decisions awarding or denying benefits provided under the FECA must be based.
11. Provide additional justification for any questions of a sensitive nature, such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private. This justification should include the reasons why the agency considers the questions necessary, the specific uses to be made of the information, the explanation to be given to persons from whom the information is requested, and any steps to be taken to obtain their consent.
The form requests the respondent to supply a taxpayer identification number (TIN), which falls under the personally identifiable information. As noted above, the TIN may be used for identification to support debt collection efforts carried on by the federal government and for other purposes required or authorized by law.
12. Provide estimates of the hour burden of the collection of information. The statement should:
Indicate the number of respondents, frequency of response, annual hour burden, and an explanation of how the burden was estimated. Unless directed to do so, agencies should not conduct special surveys to obtain information on which to base hour burden estimates. Consultation with a sample (fewer than 10) of potential respondents is desirable. If the hour burden on respondents is expected to vary widely because of differences in activity, size, or complexity, show the range of estimated hour burden, and explain the reasons for the variance. Generally, estimates should not include burden hours for customary and usual business practices.1
If this request for approval covers more than one form, provide separate hour burden estimates for each form.
Provide estimates of annualized cost to respondents for the hour burdens for collections of information, identifying and using appropriate wage rate categories. The cost of contracting out or paying outside parties for information collection activities should not be included here. Instead, this cost should be included in Item 13.
Estimated Annualized Respondent Cost and Hour Burden
Activity |
Number of Respondents |
No. of Responses per Respondent |
Total Responses |
Average Burden (Hours) |
Total Annual Burden (Hours) |
Hourly Wage Rate* |
Monetized Value of Respondent Time |
14 |
4 |
56 |
.5 |
28 |
$22.89 |
$641.00 |
According to the records maintained by OWCP, there are approximately 14 respondents involved in the assisted reemployment program at any one time. During the past three years, an average of 56 Forms CA-2231 have been processed annually. This form is submitted quarterly from each employer requesting partial wage reimbursement. It is estimated that it takes ½ hour for a respondent to collect the information from its payroll records, fill in Form CA-2231, and return it to OWCP. The total annual hour burden, therefore, is estimated to be 28 hours (56 responses x 0.5 hours/response).
Using the current median hourly wage for payroll and timekeeping clerks ($22.89) as reported by the Bureau of Labor Statistics, the respondent annualized cost estimate for this collection is $641.00 ($22.89 X 28) = $640.92 or $641.00 (rounded).
https://www.bls.gov/oes/current/oes433051.htm
13. Provide an estimate of the total annual cost burden to respondents or recordkeepers resulting from the collection of information. (Do not include the cost of any hour burden shown in Items 12 and 14).
The cost estimate should be split into two components: (a) a total capital
and start up cost component (annualized over its expected useful life); and (b) a
total operation and maintenance and purchase of service component.
The estimates should take into account costs associated with generating,
maintaining, and disclosing or providing the information. Include descriptions of
methods used to estimate major cost factors including system and technology acquisition, expected useful life of capital equipment, the discount rate(s), and the time period over which costs will be incurred. Capital and start-up costs include, among other items, preparations for collecting information such as purchasing computers and software; monitoring, sampling, drilling and testing equipment; and record storage facilities.
If cost estimates are expected to vary widely, agencies should present ranges of cost burdens and explain the reasons for the variance. The cost of purchasing or contracting out information collection services should be a part of this cost burden estimate. In developing cost burden estimates, agencies may consult with a sample of respondents (fewer than 10), utilize the 60-day pre-OMB submission public comment process and use existing economic or regulatory impact analysis associated with the rulemaking containing the information collection, as appropriate.
Generally, estimates should not include purchases of equipment or services, or portions thereof, made: (1) prior to October 1, 1995, (2) to achieve regulatory compliance with requirements not associated with the information collection, (3) for reasons other than to provide information or keep records for the government, or (4) as part of customary and usual business or private practices.
Since June 2020, respondents have been instructed to use DMP in submitting their forms; consequently, there are no associated operation and maintenance costs connected with this information collection and the two alternatives OWCP has provided to mailing of documents mentioned in q. 3 have not been utilized in recent years.
14. Provide estimates of the annualized cost to the Federal Government. Also, provide a description of the method used to estimate cost, which should include quantification of hours, operational expenses (such as equipment, overhead, printing, and support staff), any other expense that would not have been incurred without this collection of information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 into a single table.
Approximately 56 requests received electronically are reviewed on an annual basis. Review of these forms averages about ½ hour. The request is reviewed by a Rehabilitation Specialist with an average grade of GS-12/Step 9, at an hourly pay rate of $48.17.
See SALARY TABLE 2022-RUS (opm.gov)
The computations are as follows:
Review Cost: 56 x (.5) x $48.17 = $1,348.76 or $1,349.00 (rounded)
Total Federal Costs:
Description |
Cost |
Review Cost |
$1,349.00 |
Annual ECOMP Track Pricing Hosting |
$8,143.002 |
TOTAL |
= $9,492.00 |
2The ECOMP cost is $285,000.00 for FY 2021. There are 35 forms which require OMB approval which can be downloaded through ECOMP. These forms are CA-2a, CA-5, CA-5b, CA-7, CA-12, CA-15, CA-16, CA-17, CA-20, CA-40, CA-41, CA-42, CA-155, CA-278, CA-721, CA-722, CA-1027, CA-1031, CA-1032, CA-1074, CA-1087, CA-1090, CA-1108, CA-1122, CA-1143, CA-1305, CA-1331, CA-2231, OWCP-5a, OWCP-5b, OWCP-5c, OWCP-16, OWCP-17, OWCP-20, and OWCP-44. The ECOMP figure used was based on the average cost for each of those collections, or 1/35 of $285,000.00, which is $8,142.86, or $8,143.00 rounded.
15. Explain the reasons for any program changes or adjustments.
The adjustments in the burden hours are due to a decrease in the number of participating employers. The previous approved number of annual respondents (16) decreased to approximately (14), which represents a decrease of 2 respondents. The previously approved number of burden hours was 32. The requested number of hours is 28, which is a decrease of 4 hours. There were no changes made to the form.
16. For collections of information whose results will be published, outline plans for tabulations, and publication. Address any complex analytical techniques that will be used. Provide the time schedule for the entire project, including beginning and ending dates of the collection of information, completion of report, publication dates, and other actions.
There are no plans to publish data collected under this request.
17. If seeking approval to not display the expiration date for OMB approval of the information collection, explain the reasons that display would be inappropriate.
The agency plans to display the expiration date for OMB approval of the information collection on all instruments.
18. Explain each exception to the certification statement.
There are no exceptions to the certification statement.
B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL METHODS.
Statistical methods are not used in these collections of information.
1 The FECA retention period for claims is 15 years as noted in the FECA’s record schedule. DAA-0271-2017-0003.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Sharpless, Marcus J - OWCP |
| File Modified | 0000-00-00 |
| File Created | 2022-10-14 |