[Federal Register Volume 79, Number 158 (Friday, August 15, 2014)]
[Notices]
[Pages 48296-48297]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-19392]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0778]
Proposed Information Collection (Disability Benefits
Questionnaires--Group 3) Activity: Comment Request
AGENCY: Veterans Benefits Administration, Department of Veterans
Affairs.
ACTION: Notice.
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[[Page 48297]]
SUMMARY: The Veterans Benefits Administration (VBA), Department of
Veterans Affairs (VA), is announcing an opportunity for public comment
on the proposed collection of certain information by the agency. Under
the Paperwork Reduction Act (PRA) of 1995, Federal agencies are
required to publish notice in the Federal Register concerning each
proposed collection of information, including each revised collection
and allow 60 days for public comment in response to the notice. This
notice solicits comments for information needed to obtain medical
evidence to adjudicate a claim for disability benefits.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before October 14, 2014.
ADDRESSES: Submit written comments on the collection of information
through Federal Docket Management System (FDMS) at www.Regulations.gov
or to Nancy J. Kessinger, Veterans Benefits Administration (20M35),
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC
20420 or email to [email protected]. Please refer to ``OMB Control
No. 2900-0778'' in any correspondence. During the comment period,
comments may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 632-8924
or FAX (202) 632-8925.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44
U.S.C. 3501-3521), Federal agencies must obtain approval from the
Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. This request for comment is being
made pursuant to Section 3506(c)(2)(A) of the PRA.
With respect to the following collection of information, VBA
invites comments on: (1) Whether the proposed collection of information
is necessary for the proper performance of VBA's functions, including
whether the information will have practical utility; (2) the accuracy
of VBA's estimate of the burden of the proposed collection of
information; (3) ways to enhance the quality, utility, and clarity of
the information to be collected; and (4) ways to minimize the burden of
the collection of information on respondents, including through the use
of automated collection techniques or the use of other forms of
information technology.
Titles:
a. Central Nervous System and Neuromusculo Diseases, Disability
Benefits Questionnaire, VA Form 21-0960C-5.
b. Headaches (Including Migraine Headaches), Disability Benefits
Questionnaire, VA Form 21-0960C-8.
c. Multiple Sclerosis (MS), Disability Benefits Questionnaire, VA
Form 21-0960C-9.
d. Esophageal Disorders (Including GERD), Hiatal Hernia and Other
Esophageal Disorders Disability Benefits Questionnaire, VA Form 21-
0960G-1.
e. Gallbladder and Pancreas Conditions, Disability Benefits
Questionnaire, VA Form 21-0960G-2.
f. Intestinal Disorders (Other Than Surgical or Infectious)
(Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative
Colitis, and Diverticulitis) Disability Benefits Questionnaire, VA Form
21-0960G-3.
g. Infectious Intestinal Disorders (including Bacterial and
Parasitic Infections) Disability Benefits Questionnaire, VA Form 21-
0960G-4.
h. Hepatitis, Cirrhosis and Other Liver Conditions, Disability
Benefits Questionnaire, VA Form 21-0960G-5.
i. Peritoneal Adhesions Disability Benefits Questionnaire, VA Form
21-0960G-6.
j. Stomach and Duodenal Conditions (Not Including GERD or
Esophageal Disorders) Disability Benefits Questionnaire, VA Form 21-
0960G-7.
k. Rectum and Anus (Including Hemorrhoids) Disability Benefits
Questionnaire, VA Form 21-0960H-2.
l. Breast Conditions and Disorders Disability Benefits
Questionnaire, VA Form 21-0960K-1.
m. Gynecological Conditions Disability Benefits Questionnaire, VA
Form 21-0960K-2.
n. Sleep Apnea Disability Benefits Questionnaire, VA Form 21-0960L-
2.
o. Osteomyelitis Disability Benefits Questionnaire, VA Form 21-
0960M-11.
p. Ear Conditions (Including Vestibular and Infectious) Disability
Benefits Questionnaire, VA Form 21-0960N-1.
OMB Control Number: 2900-0778.
Type of Review: Revision.
Abstract: Data collected on VA Form 21-0960 series will be used to
obtain information from claimants treating physician that is necessary
to adjudicate a claim for disability benefits.
Affected Public: Individuals or households.
Estimated Annual Burden: 77,500.
a. VAF 21-0960C-5--5,000.
b. VAF 21-0960C-8--3,750.
c. VAF 21-0960C-9--7,500.
d. VAF 21-0960G-1--10,000.
e. VAF 21-0960G -2--1,250.
f. VAF 21-0960G-3--1,250.
g. VAF 21-0960G-4--1,250.
h. VAF 21-0960G-5--5,000.
i. VAF 21-0960G-6--1,250.
j. VAF 21-0960G-7--2,500.
k. VAF 21-0960G-8--1,250
l. VAF 21-0960H-2--2,500.
m. VAF 21-0960K-1--7,500.
n. VAF 21-0960K-2--10,000.
o. VAF 21-0960L-2--1,250.
p. VAF 21-0960M-11--10,000.
q. VAF 21-0960N-1--6,250.
Estimated Average Burden Per Respondent:
a. VAF 21-0960C-5--30 minutes.
b. VAF 21-0960C-8--15 minutes.
c. VAF 21-0960C-9--45 minutes.
d. VAF 21-0960G-1--15 minutes.
e. VAF 21-0960G -2--15 minutes.
f. VAF 21-0960G-3--15 minutes.
g. VAF 21-0960G-4--15 minutes.
h. VAF 21-0960G-5--30 minutes.
i. VAF 21-0960G-6--15 minutes.
j. VAF 21-0960G-7--15 minutes.
k. VAF 21-0960G-8--15 minutes.
l. VAF 21-0960H-2--15 minutes.
m. VAF 21-0960K-1--15 minutes
n. VAF 21-0960K-2--30 minutes
o. VAF 21-0960L-2--15 minutes.
p. VAF 21-0960M-11--15 minutes.
q. VAF 21-0960N-1--15 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents: 250,000.
a. VAF 21-0960C-5--10,000.
b. VAF 21-0960C-8--15,000.
c. VAF 21-0960C-9--10,000.
d. VAF 21-0960G-1--40,000.
e. VAF 21-0960G -2--5,000.
f. VAF 21-0960G-3--5,000.
g. VAF 21-0960G-4--5,000.
h. VAF 21-0960G-5--10,000.
i. VAF 21-0960G-6- 5,000.
j. VAF 21-0960G-7- 10,000.
k. VAF 21-0960G-8--5,000.
l. VAF 21-0960H-2--10,000.
m. VAF 21-0960K-1--30,000.
n. VAF 21-0960K-2--20,000.
o. VAF 21-0960L-2--5,000.
p. VAF 21-0960M-11--40,000.
q. VAF 21-0960N-1--25,000.
Dated: August 12, 2014.
By direction of the Secretary:
Crystal Rennie,
Department Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-19392 Filed 8-14-14; 8:45 am]
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