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Agency Information Collection Activities; Submission for OMB Review; Comment Request; Employer's First Report of Injury or Occupational Disease and Employer's Supplementary Report of Accident or Occupational Illness

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Information about this document as published in the Federal Register.

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The Department of Labor (DOL) hereby announces the submission of the Office of Workers' Compensation Programs (OWCP) sponsored information collection request (ICR) titled, “Employer's First Report of Injury or Occupational Disease and Employer's Supplementary Report of Accident or Occupational Illness,” to the Office of Management and Budget (OMB) for Start Printed Page 79027review and approval for continued use in accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35).


Submit comments on or before January 18, 2011.


A copy of this ICR, with applicable supporting documentation; including a description of the likely respondents, proposed frequency of response, and estimated total burden may be obtained from the Web site,​public/​do/​PRAMain or by contacting Michel Smyth by telephone at 202-693-4129 (this is not a toll-free number) or sending an e-mail to

Submit comments about this request to the Office of Information and Regulatory Affairs, Attn: OMB Desk Officer for the Department of Labor, Office of Workers' Compensation Programs (OWCP), Office of Management and Budget, Room 10235, Washington, DC 20503, Telephone: 202-395-6929/Fax: 202-395-6881 (these are not toll-free numbers), e-mail:

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Contact Michel Smyth by telephone at 202-693-4129 (this is not a toll-free number) or by e-mail at

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The OWCP administers the Longshore and Harbor Workers' Compensation Act. The Act provides benefits to workers injured in maritime employment on the navigable waters of the United States or in an adjoining area customarily used by an employee in loading, unloading, repairing or building a vessel. In addition, several acts extend coverage to certain other employees.

Longshore Act section 30(a) provides that an employer having knowledge of a disease or injury related to an employee's employment must file a report of the disease or injury to the Secretary of Labor within 10 days after the date of injury or death. See also 20 CFR 702.201. Form LS-202 requests information the employer must report regarding the injury. Longshore Act section 30(b) provides that the employer is required to furnish additional necessary reports regarding an employee's injury. Form LS-210 is used as a supplementary report after the employer's first report to report additional periods of lost-time from work. Proper filing of Forms LS-202 and LS-210 meet the statutory requirements.

These information collections are subject to the PRA. A Federal agency generally cannot conduct or sponsor a collection of information, and the public is generally not required to respond to an information collection, unless it is currently approved by the OMB under the PRA and displays a currently valid OMB Control Number. In addition, notwithstanding any other provisions of law, no person shall generally be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 5 CFR 1320.5(a) and 1320.6. The DOL obtains OMB approval for these information collections under OMB Control Number 1240-0003. The current OMB approval is scheduled to expire on December 31, 2010; however, it should be noted that information collections submitted to the OMB receive a month-to-month extension while they undergo review. For additional information, see the related notice published in the Federal Register on July 30, 2010 (75 FR 44991).

Interested parties are encouraged to send comments to the OMB, Office of Information and Regulatory Affairs at the address shown in the ADDRESSES section within 30 days of publication of this notice in the Federal Register. In order to ensure appropriate consideration, comments should reference OMB Control Number 1240-0003. The OMB is particularly interested in comments that:

  • Evaluate whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information will have practical utility;
  • Evaluate the accuracy of the agency's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used;
  • Enhance the quality, utility, and clarity of the information to be collected; and
  • Minimize the burden of the collection of information on those who are to respond, including through the use of appropriate automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses.

Agency: Office of Workers' Compensation Programs (OWCP).

Title of Collection: Employer's First Report of Injury or Occupational Disease and Employer's Supplementary Report of Accident or Occupational Illness.

OMB Control Number: 1240-0003.

Affected Public: Private sector, businesses or other for profits and not-for-profit institutions.

Total Estimated Number of Respondents: 21,083.

Total Estimated Number of Responses: 21,083.

Total Estimated Annual Burden Hours: 5271.

Total Estimated Annual Costs Burden: $9909.

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Dated: December 13, 2010.

Michel Smyth,

Departmental Clearance Officer.

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[FR Doc. 2010-31696 Filed 12-16-10; 8:45 am]