81 FR 96202 - Agency Information Collection Activity: Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire (VA Form 21-0960M-14)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 81, Issue 250 (December 29, 2016)

Page Range		96202-96202
FR Document		2016-31458

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 proposed revision of a currently approved collection, and allow 60 days for public comment in response to the notice. VA Forms 21-0960M-14 is used to gather necessary information from a claimant's treating physician regarding the results of medical examinations.

Federal Register, Volume 81 Issue 250 (Thursday, December 29, 2016)

[Federal Register Volume 81, Number 250 (Thursday, December 29, 2016)]
[Notices]
[Page 96202]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-31458]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0808]


Agency Information Collection Activity: Back (Thoracolumbar 
Spine) Conditions Disability Benefits Questionnaire (VA Form 21-0960M-
14)

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

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 proposed revision of 
a currently approved collection, and allow 60 days for public comment 
in response to the notice.
    VA Forms 21-0960M-14 is used to gather necessary information from a 
claimant's treating physician regarding the results of medical 
examinations.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before February 27, 2017.

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 (20M33), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420 or email to [email protected]. Please refer to ``OMB Control 
No. 2900-0808'' in any correspondence. During the comment period, 
comments may be viewed online through the 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. 3501-21), 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.
    Title: Back (Thoracolumbar Spine) Conditions Disability Benefits 
Questionnaire (VA Form 21-0960M-14).
    OMB Control Number: 2900-0808.
    Type of Review: Extension of an approved collection.
    Abstract: VA Forms 21-0960M-14 is used to gather necessary 
information from a claimant's treating physician regarding the results 
of medical examinations.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 37,500 hours.
    Estimated Average Burden Per Respondent: 45 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 50,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2016-31458 Filed 12-28-16; 8:45 am]
 BILLING CODE 8320-01-P

96202 Federal Register / Vol. 81, No. 250 / Thursday, December 29, 2016 / Notices

NW., Washington, DC 20420 or email to By direction of the Secretary. FOR FURTHER INFORMATION CONTACT:
nancy.kessinger@va.gov. Please refer to Cynthia Harvey-Pryor, Nancy J. Kessinger at (202) 632–8924 or
‘‘OMB Control No. 2900–0810’’ in any Department Clearance Officer, Office of FAX (202) 632–8925.
correspondence. During the comment Privacy and Records Management, SUPPLEMENTARY INFORMATION: Under the
period, comments may be viewed online Department of Veterans Affairs. PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
through the FDMS. [FR Doc. 2016–31459 Filed 12–28–16; 8:45 am] 3501–21), Federal agencies must obtain
FOR FURTHER INFORMATION CONTACT: BILLING CODE 8320–01–P approval from the Office of Management
Nancy J. Kessinger at (202) 632–8924 or and Budget (OMB) for each collection of
FAX (202) 632–8925. information they conduct or sponsor.
DEPARTMENT OF VETERANS This request for comment is being made
SUPPLEMENTARY INFORMATION: Under the AFFAIRS pursuant to Section 3506(c)(2)(A) of the
PRA of 1995 (Pub. L. 104–13; 44 U.S.C. PRA.
3501–21), Federal agencies must obtain [OMB Control No. 2900–0808] With respect to the following
approval from the Office of Management collection of information, VBA invites
and Budget (OMB) for each collection of Agency Information Collection comments on: (1) Whether the proposed
information they conduct or sponsor. Activity: Back (Thoracolumbar Spine) collection of information is necessary
This request for comment is being made Conditions Disability Benefits for the proper performance of VBA’s
pursuant to Section 3506(c)(2)(A) of the Questionnaire (VA Form 21–0960M–14) functions, including whether the
PRA. information will have practical utility;
AGENCY: Veterans Benefits
With respect to the following Administration, Department of Veterans (2) the accuracy of VBA’s estimate of the
collection of information, VBA invites Affairs. burden of the proposed collection of
comments on: (1) Whether the proposed information; (3) ways to enhance the
ACTION: Notice.
collection of information is necessary quality, utility, and clarity of the
for the proper performance of VBA’s SUMMARY: The Veterans Benefits information to be collected; and (4)
functions, including whether the Administration (VBA), Department of ways to minimize the burden of the
information will have practical utility; Veterans Affairs (VA), is announcing an collection of information on
(2) the accuracy of VBA’s estimate of the opportunity for public comment on the respondents, including through the use
burden of the proposed collection of proposed collection of certain of automated collection techniques or
information; (3) ways to enhance the information by the agency. Under the the use of other forms of information
quality, utility, and clarity of the Paperwork Reduction Act (PRA) of technology.
information to be collected; and (4) 1995, Federal agencies are required to Title: Back (Thoracolumbar Spine)
ways to minimize the burden of the publish notice in the Federal Register Conditions Disability Benefits
collection of information on concerning each proposed collection of Questionnaire (VA Form 21–0960M–
respondents, including through the use information, including each proposed 14).
of automated collection techniques or revision of a currently approved OMB Control Number: 2900–0808.
the use of other forms of information collection, and allow 60 days for public Type of Review: Extension of an
technology. comment in response to the notice. approved collection.
Title: (Foot Conditions Including VA Forms 21–0960M–14 is used to Abstract: VA Forms 21–0960M–14 is
Flatfoot (Pes Planus) Disability Benefits gather necessary information from a used to gather necessary information
Questionnaire (VA Form 21–0960M–6). claimant’s treating physician regarding from a claimant’s treating physician
OMB Control Number: 2900–0810. the results of medical examinations. regarding the results of medical
Type of Review: Extension of an DATES: Written comments and examinations.
approved collection. recommendations on the proposed Affected Public: Individuals or
collection of information should be households.
Abstract: VA Forms 21–0960M–6 is Estimated Annual Burden: 37,500
used to gather necessary information received on or before February 27, 2017.
hours.
from a claimant’s treating physician ADDRESSES: Submit written comments
Estimated Average Burden Per
regarding the results of medical on the collection of information through
Respondent: 45 minutes.
examinations. Federal Docket Management System
Frequency of Response: One time.
Affected Public: Individuals or (FDMS) at www.Regulations.gov or to
Estimated Number of Respondents:
households. Nancy J. Kessinger, Veterans Benefits
50,000.
Estimated Annual Burden: 40,000 Administration (20M33), Department of
Veterans Affairs, 810 Vermont Avenue By direction of the Secretary.
hours.
NW., Washington, DC 20420 or email to Cynthia Harvey-Pryor,
Estimated Average Burden per nancy.kessinger@va.gov. Please refer to Department Clearance Officer, Office of
Respondent: 30 minutes. ‘‘OMB Control No. 2900–0808’’ in any Privacy and Records Management,
Frequency of Response: One time. correspondence. During the comment Department of Veterans Affairs.
Estimated Number of Respondents: period, comments may be viewed online [FR Doc. 2016–31458 Filed 12–28–16; 8:45 am]
80,000. through the FDMS. BILLING CODE 8320–01–P
asabaliauskas on DSK3SPTVN1PROD with NOTICES

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Document Created: 2016-12-29 01:58:40
Document Modified: 2016-12-29 01:58:40

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Dates		Written comments and recommendations on the proposed collection of information should be received on or before February 27, 2017.
Contact		Nancy J. Kessinger at (202) 632-8924 or FAX (202) 632-8925.
FR Citation		81 FR 96202