EE-24 (Durable Medical Equipment Authorization)

Division of Energy Employees Occupational Illnesses Compensation (DEEOIC) Authorization Request Forms

OMB: 1240-0060

IC ID: 243775

Information Collection (IC) Details

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EE-24 (Durable Medical Equipment Authorization)
 
No Modified
 
Mandatory
 
20 CFR 30.400(c) 20 CFR 30.400(a) 20 CFR 30.700

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EE-24 Durable Medical Equipment Authorization Request EE-24 Durable Medical Equipment Authorization Request.pdf https://owcpmed.dol.gov/ Yes Yes Fillable Fileable

Workforce Management Worker Safety

DOL/OWCP-11  81 FR 25765

3,333 43
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 20,000 0 0 18,300 0 1,700
Annual IC Time Burden (Hours) 3,333 0 0 3,050 0 283
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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