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SUPPORTING STATEMENT

FOR PAPERWORK REDUCTION ACT SUBMISSION

OMB Number: 1820-0563

A. Justification 

1. Explain the circumstances that make the collection of information necessary. Identify

any legal or administrative requirements that necessitate the collection. Attach a hard 

copy of the appropriate section of each statute and regulation mandating or authorizing 

the collection of information, or you may provide a valid URL link or paste the 

applicable section. Please limit pasted text to no longer than 3 pages. Specify the review 

type of the collection (new, revision, extension, reinstatement with change, 

reinstatement without change). If revised, briefly specify the changes. If a rulemaking is 

involved, make note of the sections or changed sections, if applicable.

Pursuant to Section 102 (c ) of Rehabilitation Act of 1973 as amended by the Workforce Innovation and 

Opportunity Act delineates the procedures under which an applicant or individual who is eligible for vocational 

rehabilitation (VR) services can appeal an adverse action of the state VR unit or agency. Section 102(c)(8)(A) 

of the Rehabilitation Act requires the Commissioner of the Rehabilitation Services Administration (RSA) to 

report on appeal activities each year when the Annual Report required by Section 13 of the Act on the 

Rehabilitation Act is sent to Congress. Section 102(c)(8)(B) specifies the data to be reported as follows:

1. a copy of the standards used by State reviewing officials for reviewing decisions made by impartial 

hearing officers;

2. information on the number of hearings and reviews sought from the impartial hearing officers and the 

State reviewing officials, including the type of complaints and the issues involved;

3. information on the number of hearing decisions made that were not reviewed by the State reviewing 

officials; and

4. information on the number of the hearing decisions that were reviewed by the State reviewing officials, 

and, based on such reviews, the number of hearing decisions that were—

i) sustained in favor of an applicant or eligible individual;

ii) sustained in favor of the designated State unit;

iii) reversed in whole or in part in favor of the applicant or eligible individual; and

iv) reversed in whole or in part in favor of the designated State unit.

The 1998 amendments to the Rehabilitation Act as amended by the Workforce Innovation an Opportunity Act 

specified two additional remedies for adverse actions, mediation and civil actions; any non-substantive changes 

based on rulemaking will be submitted to OMB for approval to use the final non-sub rule revisions. The RSA722 also collects information from states on these procedures. The Annual Report on Appeals Process (RSA722) is the information collection used by states to report this data to the Commissioner on an annual basis. 

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.

As stated previously, RSA collects this information annually from states and reports it in the Annual Report to 

Congress on the Rehabilitation Act. RSA also uses the data to monitor whether appeal processes in the state are 

operating according to each unit’s or agency's State Plan for Vocational Rehabilitation.

3. Describe whether, and to what extent, the collection of information involves the use of 

automated, electronic, mechanical, or other technological collection techniques or forms 
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of information technology, e.g. permitting electronic submission of responses, and the 

basis for the decision of adopting this means of collection. Also describe any

consideration given to using technology to reduce burden.

VR agencies complete and submit Form RSA-722 through RSA’s website, accessing the data collection directly 

through the internet by using the following URL: http://rsa.ed.gov. If online submission is not possible, VR 

agencies may either send an electronic version of the form or mail a hard copy to RSA. 

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 2

above.

RSA does not collect this or similar data and information through any other reporting instrument

5. If the collection of information impacts small businesses or other small entities, describe 

any methods used to minimize burden. A small entity may be (1) a small business which 

is deemed to be one that is independently owned and operated and that is not dominant 

in its field of operation; (2) a small organization that is any not-for-profit enterprise that 

is independently owned and operated and is not dominant in its field; or (3) a small 

government jurisdiction, which is a government of a city, county, town, township, 

school district, or special district with a population of less than 50,000.

Respondents are state VR agencies that do not qualify as "small businesses or other small entities."

6. Describe the consequences 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.

RSA is required to collect the data obtained through Form 722 annually. A less frequent collection would put 

RSA in violation of the reporting mandate in Section 102 of the Rehabilitation Act. 

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 than can be generalized to the universe of study;

 requiring the use of a 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 that unnecessarily impedes sharing of data with 

other agencies for compatible confidential use; or
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 requiring respondents to submit proprietary trade secrets, 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 is nothing in the RSA-722 and its instructions that require the collection to be conducted in the manner 

listed above.

8. As applicable, state that the Department has published the 60 and 30 Federal Register 

notices as required by 5 CFR 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 instruction and record keeping, 

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.

During its initial development, the Annual Report of Appeals Process was shared with the respondents 

themselves. There was agreement on the collection submitted at that time and no changes were made. RSA has 

sought additional comment on the form as it has requested subsequent extensions through the publication of 

Federal Register Notices. In addition, 60-day and 30-day Federal Register Notices were published, allowing the

public comment prior to OMB approval of this extension request.

9. Explain any decision to provide any payment or gift to respondents, other than 

remuneration of contractors or grantees with meaningful justification.

There are no payments or gifts provided to respondents.

10. Describe any assurance of confidentiality provided to respondents and the basis for the 

assurance in statute, regulation, or agency policy. If personally identifiable information 

(PII) is being collected, a Privacy Act statement should be included on the instrument. 

Please provide a citation for the Systems of Record Notice and the date a Privacy Impact 

Assessment was completed as indicated on the IC Data Form. A confidentiality

statement with a legal citation that authorizes the pledge of confidentiality should be 

provided. Requests for this information are in accordance with the following ED and 

OMB policies: Privacy Act of 1974, OMB Circular A-108 – Privacy Act 

Implementation – Guidelines and Responsibilities, OMB Circular A-130 Appendix I –

Federal Agency Responsibilities for Maintaining Records About Individuals, OMB M03-22 – OMB Guidance for Implementing the Privacy Provisions of the E-Government 

Act of 2002, OMB M-06-15 – Safeguarding Personally Identifiable Information, OM:6-

104 – Privacy Act of 1974 (Collection, Use and Protection of Personally Identifiable 

Information). If the collection is subject to the Privacy Act, the Privacy Act statement is 

deemed sufficient with respect to confidentiality. If there is no expectation of 

confidentiality, simply state that the Department makes no pledge about the 

confidentially of the data.
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Since the RSA-722 contains aggregated data, the data cannot be used to identify individuals who are applicants 

or eligible individuals for services from VR agencies. Therefore, confidentiality is assured.

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. The 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.

There are no questions of a sensitive nature contained in the RSA-722.

12. Provide estimates of the hour burden of the collection of information. The statement 

should:

 Indicate the number of respondents by affected public type (federal government, 

individuals or households, private sector – businesses or other for-profit, private 

sector – not-for-profit institutions, farms, state, local or tribal governments), 

frequency of response, annual hour burden, and an explanation of how the burden 

was estimated, including identification of burden type: recordkeeping, reporting or 

third party disclosure. All narrative should be included in item 12. 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.

 If this request for approval covers more than one form, provide separate hour burden 

estimates for each form and aggregate the hour burdens in the ROCIS IC Burden 

Analysis Table. (The table should at minimum include Respondent types, IC activity, 

Respondent and Responses, Hours/Response, and Total Hours)

 Provide estimates of annualized cost to respondents of 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 

14.

Annual Burden

Number of respondents 80

Frequency of response 1

Total annual responses 80

Hours per response 2.0

Total hours 160
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There are 80 state agencies in the United States and its territories. The 80 respondents submit the RSA-722 once a 

year. The annual burden is estimated at two hours per agency, or 160 hours because the number of individuals who 

file appeals has proven to be relatively small. One hour is used to collect data throughout the year by maintaining the 

equivalent of a tally and the other hour is devoted to recording and checking data on the RSA-722.

13. Provide an estimate of the total annual cost burden to respondents or record keepers 

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 services 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 acquiring and maintaining 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 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. Also, these estimates should 

not include the hourly costs (i.e., the monetization of the hours) captured above in 

Item 12

Total Annualized Capital/Startup Cost:

Total Annual Costs (O&M): 

Total Annualized Costs Requested:

States and territories incur no additional cost burden when submitting the PIP

14. Provide estimates of 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), 
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and 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 in a 

single table.

Annualized Estimated Respondent Costs:

Annual Operating Costs

(160 hours x $35* per hour) $ 5,600.00

Estimated Equipment Costs $ 500.00

Total Annualized Respondent Cost $ 6,100.00

* note: increased cost is consistent with hourly rate for state employees as reported in connection with recent 

RSA information collections, such as those for the VR Program Corrective Action Plan and VR Program 

Performance Improvement Plan.

15. Explain the reasons for any program changes or adjustments. Generally, adjustments in 

burden result from re-estimating burden and/or from economic phenomenon outside of 

an agency’s control (e.g., correcting a burden estimate or an organic increase in the size 

of the reporting universe). Program changes result from a deliberate action that 

materially changes a collection of information and generally are result of new statute or 

an agency action (e.g., changing a form, revising regulations, redefining the respondent 

universe, etc.). Burden changes should be disaggregated by type of change (i.e., 

adjustment, program change due to new statute, and/or program change due to agency

discretion), type of collection (new, revision, extension, reinstatement with change, 

reinstatement without change) and include totals for changes in burden hours, responses

and costs (if applicable).

There are no program changes or adjustments associated with this request. 

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16. For collections of information whose results will be published, outline plans for 

tabulation 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.

States must collect their data on an ongoing basis and must provide their data to RSA no later than 30 days 

following the end of the fiscal year (approximately October 30 of each year). This data then is included in a 

larger Annual Report to Congress on the activities conducted under the Rehabilitation Act. Development and 

transmittal of that report is not determined by this data.

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 expiration date will be displayed.

18. Explain each exception to the certification statement identified in the Certification of 

Paperwork Reduction Act.

There are no exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods
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This collection of information does not employ any statistical methods.