82 FR 12703 - Agency Information Collection Activity (Wrist Conditions Disability Benefits Questionnaire (VA Form 21-0960M-16))

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 42 (March 6, 2017)

Page Range		12703-12704
FR Document		2017-04302

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 Form 21-0960 series is used to gather necessary information from a claimant's treating physician regarding the results of medical examinations. VA gathers medical information related to the claimant that is necessary to adjudicate the claim for VA disability benefits. The Disability Benefit Questionnaire title will include the name of the specific disability for which it will gather information. VAF 21-0960M- 16, Wrist Conditions Disability Benefits Questionnaire, will gather information related to the claimant's diagnosis of a wrist condition.

Federal Register, Volume 82 Issue 42 (Monday, March 6, 2017)

[Federal Register Volume 82, Number 42 (Monday, March 6, 2017)]
[Notices]
[Pages 12703-12704]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-04302]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0805]


Agency Information Collection Activity (Wrist Conditions 
Disability Benefits Questionnaire (VA Form 21-0960M-16))

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

[[Page 12704]]

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 Form 21-0960 series is used to gather necessary information from 
a claimant's treating physician regarding the results of medical 
examinations. VA gathers medical information related to the claimant 
that is necessary to adjudicate the claim for VA disability benefits. 
The Disability Benefit Questionnaire title will include the name of the 
specific disability for which it will gather information. VAF 21-0960M-
16, Wrist Conditions Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of a wrist condition.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before May 5, 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. 2900-0805'' 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: (Wrist Conditions Disability Benefits Questionnaire (VA Form 
21-0960M-16))
    OMB Control Number: 2900-0805.
    Type of Review: Extension of an approved collection.
    Abstract: VA Form 21-0960 series is used to gather necessary 
information from a claimant's treating physician regarding the results 
of medical examinations. VA gathers medical information related to the 
claimant that is necessary to adjudicate the claim for VA disability 
benefits. The Disability Benefit Questionnaire title will include the 
name of the specific disability for which it will gather information. 
VAF 21-0960M-16, Wrist Conditions Disability Benefits Questionnaire, 
will gather information related to the claimant's diagnosis of a wrist 
condition.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 20,000.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 40,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-04302 Filed 3-3-17; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 82, No. 42 / Monday, March 6, 2017 / Notices 12703

(2) the accuracy of VBA’s estimate of the proposed collection of certain collection of information on
burden of the proposed collection of information by the agency. Under the respondents, including through the use
information; (3) ways to enhance the Paperwork Reduction Act (PRA) of of automated collection techniques or
quality, utility, and clarity of the 1995, Federal agencies are required to the use of other forms of information
information to be collected; and (4) publish notice in the Federal Register technology.
ways to minimize the burden of the concerning each proposed collection of Title: (Neck (Cervical Spine)
collection of information on information, including each proposed Conditions Disability Benefits
respondents, including through the use revision of a currently approved Questionnaire (VA Form 21–0960M–
of automated collection techniques or collection, and allow 60 days for public 13)).
the use of other forms of information comment in response to the notice. OMB Control Number: 2900–0807.
technology. VA Form 21–0960 series is used to Type of Review: Extension of an
Title: (Ankle Conditions Disability gather necessary information from a approved collection.
Benefits Questionnaire (VA Form 21– claimant’s treating physician regarding Abstract: VA Form 21–0960 series is
0960M–16)). the results of medical examinations. VA used to gather necessary information
OMB Control Number: 2900–0806. gathers medical information related to from a claimant’s treating physician
Type of Review: Extension of an the claimant that is necessary to regarding the results of medical
approved collection. adjudicate the claim for VA disability examinations. VA gathers medical
Abstract: VA Form 21–0960 series is benefits. The Disability Benefit information related to the claimant that
used to gather necessary information Questionnaire title will include the is necessary to adjudicate the claim for
from a claimant’s treating physician name of the specific disability for which VA disability benefits. The Disability
regarding the results of medical it will gather information. VAF 21– Benefit Questionnaire title will include
examinations. VA gathers medical 0960M–13, Neck (Cervical Spine) the name of the specific disability for
information related to the claimant that Conditions Disability Benefits which it will gather information. VAF
is necessary to adjudicate the claim for Questionnaire, will gather information 21–0960M–13, Neck (Cervical Spine)
VA disability benefits. The Disability related to the claimant’s diagnosis of a Conditions Disability Benefits
Benefit Questionnaire title will include cervical spine condition. Questionnaire, will gather information
the name of the specific disability for DATES: Written comments and related to the claimant’s diagnosis of a
which it will gather information. VAF recommendations on the proposed cervical spine condition.
21–0960M–2, Ankle Conditions collection of information should be Affected Public: Individuals or
Disability Benefits Questionnaire, will received on or before May 5, 2017. households.
gather information related to the ADDRESSES: Submit written comments Estimated Annual Burden: 37,500.
claimant’s diagnosis of an ankle on the collection of information through Estimated Average Burden per
condition. Federal Docket Management System Respondent: 45 minutes.
Affected Public: Individuals or (FDMS) at www.Regulations.gov or to Frequency of Response: One time.
households. Nancy J. Kessinger, Veterans Benefits Estimated Number of Respondents:
Estimated Annual Burden: 15,000. Administration (20M33), Department of 50,000.
Estimated Average Burden per Veterans Affairs, 810 Vermont Avenue By direction of the Secretary.
Respondent: 30 minutes. NW., Washington, DC 20420 or email to Cynthia Harvey-Pryor,
Frequency of Response: One time. nancy.kessinger@va.gov. Please refer to
Department Clearance Officer, Office of
Estimated Number of Respondents: ‘‘OMB Control No. 2900–0807’’ in any Privacy and Records Management,
30,000. correspondence. During the comment Department of Veterans Affairs.
By direction of the Secretary. period, comments may be viewed online [FR Doc. 2017–04301 Filed 3–3–17; 8:45 am]
Cynthia Harvey-Pryor, through the FDMS.
BILLING CODE 8320–01–P
Department Clearance Officer, Office of FOR FURTHER INFORMATION CONTACT:
Privacy and Records Management, Nancy J. Kessinger at (202) 632–8924 or
Department of Veterans Affairs. FAX (202) 632–8925. DEPARTMENT OF VETERANS
[FR Doc. 2017–04300 Filed 3–3–17; 8:45 am] SUPPLEMENTAL INFORMATION: Under the AFFAIRS
BILLING CODE 8320–01–P PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
[OMB Control No. 2900–0805]
3501–21), Federal agencies must obtain
approval from the Office of Management Agency Information Collection Activity
DEPARTMENT OF VETERANS and Budget (OMB) for each collection of (Wrist Conditions Disability Benefits
AFFAIRS information they conduct or sponsor. Questionnaire (VA Form 21–0960M–
This request for comment is being made 16))
[OMB Control No. 2900–0807]
pursuant to Section 3506(c)(2)(A) of the
Agency Information Collection Activity PRA. AGENCY: Veterans Benefits
With respect to the following Administration, Department of Veterans
(Neck (Cervical Spine) Conditions
collection of information, VBA invites Affairs.
Disability Benefits Questionnaire (VA
comments on: (1) Whether the proposed ACTION: Notice.
Form 21–0960M–13))
collection of information is necessary
Veterans Benefits for the proper performance of VBA’s SUMMARY: The Veterans Benefits
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AGENCY:
Administration, Department of Veterans functions, including whether the Administration (VBA), Department of
Affairs. information will have practical utility; Veterans Affairs (VA), is announcing an
ACTION: Notice. (2) the accuracy of VBA’s estimate of the opportunity for public comment on the
burden of the proposed collection of proposed collection of certain
SUMMARY: The Veterans Benefits information; (3) ways to enhance the information by the agency. Under the
Administration (VBA), Department of quality, utility, and clarity of the Paperwork Reduction Act (PRA) of
Veterans Affairs (VA), is announcing an information to be collected; and (4) 1995, Federal agencies are required to
opportunity for public comment on the ways to minimize the burden of the publish notice in the Federal Register

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$12704 Federal Register / Vol. 82, No. 42 / Monday, March 6, 2017 / Notices concerning each proposed collection of period, comments may be viewed online OMB Control Number: 2900–0805. information, including each proposed through the FDMS. Type of Review: Extension of an revision of a currently approved FOR FURTHER INFORMATION CONTACT: approved collection. collection, and allow 60 days for public Nancy J. Kessinger at (202) 632–8924 or Abstract: VA Form 21–0960 series is comment in response to the notice. FAX (202) 632–8925. used to gather necessary information VA Form 21–0960 series is used to SUPPLEMENTARY INFORMATION: Under the from a claimant’s treating physician gather necessary information from a PRA of 1995 (Pub. L. 104–13; 44 U.S.C. regarding the results of medical claimant’s treating physician regarding 3501–21), Federal agencies must obtain examinations. VA gathers medical the results of medical examinations. VA approval from the Office of Management information related to the claimant that gathers medical information related to and Budget (OMB) for each collection of is necessary to adjudicate the claim for the claimant that is necessary to information they conduct or sponsor. VA disability benefits. The Disability adjudicate the claim for VA disability This request for comment is being made Benefit Questionnaire title will include benefits. The Disability Benefit pursuant to Section 3506(c)(2)(A) of the the name of the specific disability for Questionnaire title will include the PRA. which it will gather information. VAF name of the specific disability for which With respect to the following 21–0960M–16, Wrist Conditions it will gather information. VAF 21– collection of information, VBA invites Disability Benefits Questionnaire, will 0960M–16, Wrist Conditions Disability comments on: (1) Whether the proposed gather information related to the Benefits Questionnaire, will gather collection of information is necessary claimant’s diagnosis of a wrist information related to the claimant’s for the proper performance of VBA’s condition. diagnosis of a wrist condition. functions, including whether the Affected Public: Individuals or DATES: Written comments and information will have practical utility; households. recommendations on the proposed (2) the accuracy of VBA’s estimate of the Estimated Annual Burden: 20,000. collection of information should be burden of the proposed collection of Estimated Average Burden per received on or before May 5, 2017. information; (3) ways to enhance the Respondent: 30 minutes. ADDRESSES: Submit written comments quality, utility, and clarity of the Frequency of Response: One time. on the collection of information through information to be collected; and (4) Estimated Number of Respondents: Federal Docket Management System ways to minimize the burden of the 40,000. (FDMS) at www.Regulations.gov or to collection of information on Nancy J. Kessinger, Veterans Benefits respondents, including through the use By direction of the Secretary. Administration (20M33), Department of of automated collection techniques or Cynthia Harvey-Pryor, Veterans Affairs, 810 Vermont Avenue the use of other forms of information Department Clearance Officer, Office of NW., Washington, DC 20420 or email to technology. Privacy and Records Management, nancy.kessinger@va.gov. Please refer to Title: (Wrist Conditions Disability Department of Veterans Affairs. ‘‘OMB Control No. 2900–0805’’ in any Benefits Questionnaire (VA Form 21– [FR Doc. 2017–04302 Filed 3–3–17; 8:45 am] correspondence. During the comment 0960M–16)) BILLING CODE 8320–01–P asabaliauskas on DSK3SPTVN1PROD with NOTICES VerDate Sep<11>2014 19:24 Mar 03, 2017 Jkt 241001 PO 00000 Frm 00172 Fmt 4703 Sfmt 9990 E:\FR\FM\06MRN1.SGM 06MRN1$

Document Created: 2017-03-04 00:06:42
Document Modified: 2017-03-04 00:06:42

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 May 5, 2017.
Contact		Nancy J. Kessinger at (202) 632-8924 or FAX (202) 632-8925.
FR Citation		82 FR 12703