[Federal Register Volume 79, Number 130 (Tuesday, July 8, 2014)]
[Notices]
[Pages 38673-38674]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-15791]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0776]


Agency Information Collection (Disability Benefits 
Questionnaires--Group 2) Activity Under OMB Review

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits 
Administration (VBA), Department of Veterans Affairs, will submit the 
collection of information abstracted below to the Office of Management 
and Budget (OMB) for review and comment. The PRA submission describes 
the nature of the information collection and its expected cost and 
burden; it includes the actual data collection instrument.

[[Page 38674]]


DATES: Comments must be submitted on or before August 7, 2014.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 
17th St. NW., Washington, DC 20503 or sent through electronic mail to 
[email protected]. Please refer to ``OMB Control No. 2900-
0776'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7492 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0776.''
    Titles:
    a. Arteries and Veins Conditions (Vascular Diseases including 
Varicose Veins) Disability Benefits Questionnaire, VA Form 21-0960A-2.
    b. Hypertension Disability Benefits Questionnaire, VA Form 21-
0960A-3.
    c. Non-Ischemic Heart Disease (including Arrhythmias and Surgery, 
Disability Benefits Questionnaire, VA Form 21-0960A-4.
    d. Diabetic Peripheral Neuropathy (Diabetic Sensory-Motor 
Peripheral Neuropathy), Disability Benefits Questionnaire, VA Form 21-
0960C-4.
    e. Diabetes Mellitus Disability Benefits Questionnaire, VA Form 21-
0960E-1.
    f. Scar/Disfigurement Disability Benefits Questionnaire, VA Form 
21-0960F-1.
    g. Skin Diseases Disability Benefits Questionnaire, VA Form 21-
0960F-2.
    h. Amputations Disability Benefits Questionnaire, VA Form 21-0960M-
1.
    i. Muscle Injuries Disability Benefits Questionnaire, VA Form 21-
0960M-10.
    j. Temporomandibular Joint (TMJ) Conditions Disability Benefits 
Questionnaire, VA Form 21-0960M-15.
    k. Eye Conditions Disability Benefits Questionnaire, VA Form 21-
0960N-2.
    OMB Control Number: 2900-0776.
    Type of Review: Revision of a Currently Approved Collection.
    Abstract: Data collected on VA Form 21-0960 series will be used 
obtain information from claimants treating physician that is necessary 
to adjudicate a claim for disability benefits.
    An agency may not conduct or sponsor, and a person is not required 
to respond to a collection of information unless it displays a 
currently valid OMB control number. The Federal Register Notice with a 
60-day comment period soliciting comments on this collection of 
information was published on January 17, 2014, at pages 3275-3276.
    Affected Public: Individuals or households.
    Estimated Annual Burden:
    a. VA Form 21-0960A-2--10,000.
    b. VA Form 21-0960A-3--12,500.
    c. VA Form 21-0960A-4--10,000.
    d. VA Form 21-0960C-4--37,500.
    e. VA Form 21-0960E-1--18,750.
    f. VA Form 21-0960F-1- 6,250.
    g. VA Form 21-0960F-2--6,250.
    h. VA Form 21-0960M-1--12,500.
    i. VA Form 21-0960M-10--15,000.
    j. VA Form 21-0960M-15--3,750.
    k. VA Form 21-0960N-2--30,000.
    Estimated Average Burden Per Respondent:
    a. VA Form 21-0960A-2--30 minutes.
    b. VA Form 21-0960A-3--15 minutes.
    c. VA Form 21-0960A-4--30 minutes.
    d. VA Form 21-0960C-4--30 minutes.
    e. VA Form 21-0960E-1--15 minutes.
    f. VA Form 21-0960F-1--15 minutes.
    g. VA Form 21-0960F-2--15 minutes.
    h. VA Form 21-0960M-1--30 minutes.
    i. VA Form 21-0960M-10--30 minutes.
    j. VA Form 21-0960M-15--15 minutes.
    k. VA Form 21-0960N-2--45 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VA Form 21-0960A-2--20,000.
    b. VA Form 21-0960A-3--50,000.
    c. VA Form 21-0960A-4--20,000.
    d. VA Form 21-0960C-4--75,000.
    e. VA Form 21-0960E-1--75,000.
    f. VA Form 21-0960F-1--25,000.
    g. VA Form 21-0960F-2--25,000.
    h. VA Form 21-0960M-1--25,000.
    i. VA Form 21-0960M-10--30,000.
    j. VA Form 21-0960M-15--15,000.
    k. VA Form 21-0960N-2--40,000.

    Dated: July 1, 2014.

    By direction of the Secretary.
Crystal Rennie,
Department Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-15791 Filed 7-7-14; 8:45 am]
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