Benefits Timeliness and Quality Review System

Forms and Documents

Document Name	Status
Form ETA 9055 Benefits Timeliness and Quality Review System Form and Instruction	Modified
1205-0359 Part A SS final January 2014.docx Supporting Statement A	2014-01-30
1205-0359 PART B Supporting Statement 11 2013.docx Supporting Statement B	2013-11-08
1205-0359 OCEO Approval 11 8 2013.pdf Supplementary Document	2013-11-08

IC Document Collections

IC ID	Document Title	Status
13147	Benefits Timeliness and Quality Review System Form and Instruction	Modified

ICR Details

OMB Control No: 1205-0359	ICR Reference No: 201307-1205-002
Status: Historical Active	Previous ICR Reference No: 201010-1205-005
Agency/Subagency: DOL/ETA	Agency Tracking No: 012-05-01-05-09-2035-00
Title: Benefits Timeliness and Quality Review System
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/25/2014
	Date Received in OIRA: 02/10/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	36 Months From Approved	03/31/2014
Responses	29,196	0	29,976
Time Burden (Hours)	38,692	0	39,892
Cost Burden (Dollars)	0	0	0

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Abstract: These reports provide data necessary to monitor state performance in administration of Unemployment Insurance as mandated by the Secretary of Labor.

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Authorizing Statute(s): PL: Pub.L. 109 - 91 303(a)(6) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42548	07/16/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 7702	02/10/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Benefits Timeliness and Quality Review System	ETA 9050, ETA 9056, ETA 9054, ETA 9055, ETA 9051, ETA 9052, ETA 9057	Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality ,   Section V Benefits Time Lapse and Quality

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	29,196	29,976	0	0	-780	0
Annual Time Burden (Hours)	38,692	39,892	0	0	-1,200	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Sample sizes for the nonmonetary and appeals quarterly reviews are determined by workload. Because of the change in workload, there has been a reclassification of some states from small to large resulting in a decrease in burden. For nonmonetary determination quality, sample sizes are set annually and depend on the volume of nonmonetary determinations reported to the Department of Labor on the ETA 9052 reports for the prior calendar year. States are classified as large or small based on this caseload. Large states are those that issued 100,000 or more nonmonetary determinations in the prior calendar year. Small states are those that issued fewer than 100,000 nonmonetary determinations in the prior calendar year. Large states will draw a minimum sample of 100 determinations (50 separation issues and 50 nonseparation issues) per quarter for review. Small states will draw a minimum sample of 60 determinations (30 separation issues and 30 nonseparation issues) per quarter for review. For lower authority appeals quality, all States (except those with a workload of more that 40,000 decisions in the prior fiscal year) will review a minimum of 20 randomly selected cases from each of the four quarters of the fiscal year. This is the minimum sample size needed for statistical validity of the results. The States, with annual workloads exceeding 40,000 cases will be required to select a 40 case sample per quarter to assure accurate results. The determination of sample size (20 or 40 cases per quarter) for each State for the calendar year will be made prior to end of the first quarter of each calendar year, based on the workload during the prior calendar year.

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Annual Cost to Federal Government: $635,026

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/10/2014

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