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###### Department of Labor

###### Employment Standards Administration

# ACTION:

Notice.

# SUMMARY:

                        The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclearance consultation program to provide the general public and Federal agencies with an opportunity to comment on proposed and/or continuing collections of information in accordance with the Paperwork Reduction Act of 1995 (PRA95) [44 U.S.C. 3506(c)(2)(A)]. This program helps to ensure that requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly understood, and the impact of collection requirements on respondents can be properly assessed. Currently, the Employment Standards Administration is soliciting comments concerning its proposal to extend the Office of Management and Budget (OMB) approval of the Information Collection: Authorization for Release of Medical Information (CM-936). A copy of the proposed information collection request can be obtained by contacting the office listed below in the                         **ADDRESSES**                         section of this Notice.                    

# DATES:

Written comments must be submitted to the office listed in the addresses section below on or before June 1, 2009.

# ADDRESSES:

                        Mr. Steven D. Lawrence, U.S. Department of Labor, 200 Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone (202) 693-0292, fax (202) 693-1451, e-mail                         *Lawrence.Steven@dol.gov*. Please use only one method of transmission for comments (mail, fax, or e-mail).                    

# SUPPLEMENTARY INFORMATION:

## I. Background

                    The Black Lung Benefits Act, as amended, 30 U.S.C. 901*et seq.*                     and 20 CFR 725.405 require that all relevant medical evidence be considered before a decision can be made regarding a claimant's eligibility for benefits. The CM-936 is used by black lung claimants who wish to submit medical evidence to support their claim. The form provides the claimant's consent for medical institutions and private physicians to release medical information to the Division of Coal Mine Workers' Compensation (DCMWC). The form may be completed by the claimant and the claims examiner (CE). This information collection is currently approved for use through October 31, 2009.                

## II. Review Focus

The Department of Labor is particularly interested in comments which:
    - 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 submissions of responses.                

## III. Current Actions

The Department of Labor seeks the approval of the extension of this information collection in order to carry out its responsibility to assure payment of compensation benefits to injured workers at the proper rate.

*Type of Review:*                     Extension.                

*Agency*: Employment Standards Administration.                

*Titles*: Authorization for Release of Medical Information.                

*OMB Number*: 1215-0057.                

*Agency Numbers:*                     CM-936.                

*Affected Public*: Individual or households.                

*Total Respondents:*                     900.                

*Total Annual Responses:*                     900.                

*Estimated Total Burden Hours:*                     75.                

*Estimated Time per Response:*                     5 minutes.                

*Frequency:*                     Once.                

*Total Burden Cost (Capital/Startup):*                     $0.                

*Total Burden Cost (Operating/Maintenance):*                     $491.                

Comments submitted in response to this notice will be summarized and/or included in the request for Office of Management and Budget approval of the information collection request; they will also become a matter of public record.

Dated: March 30, 2009.

Hazel Bell,

Acting Chief, Branch of Management Review and Internal Control, Division of Financial Management, Office of Management, Administration and Planning, Employment Standards Administration.

[FR Doc. E9-7416 Filed 4-1-09; 8:45 am]

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