82 FR 12913 - Agency Information Collection Activity Under OMB Review: (Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire (VA Form 21-0960M-14)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 43 (March 7, 2017)

Page Range		12913-12914
FR Document		2017-04423

In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Benefits Administration, 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 and it includes the actual data collection instrument.

Federal Register, Volume 82 Issue 43 (Tuesday, March 7, 2017)

[Federal Register Volume 82, Number 43 (Tuesday, March 7, 2017)]
[Notices]
[Pages 12913-12914]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-04423]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0808]


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

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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

SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995, 
this notice announces that the Veterans Benefits Administration, 
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 and it 
includes the actual data collection instrument.

DATES: Comments must be submitted on or before April 6, 2017.

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

[[Page 12914]]

Control No. 2900-0808'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise 
Records Service (005R1B), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420, (202) 461-5870 or email 
[email protected]. Please refer to ``OMB Control No. 2900-
0808'' in any correspondence.

SUPPLEMENTARY INFORMATION: 
    Title: (Back (Thoracolumbar Spine) Conditions Disability Benefits 
Questionnaire (VA Form 21-0960M-14).
    OMB Control Number: 2900-0808.
    Type of Review: Extension of a currently 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.
    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 at Vol. 81, No. 250, Thursday, December 29, 
2016, page 96202.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 37,500.
    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. 2017-04423 Filed 3-6-17; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 82, No. 43 / Tuesday, March 7, 2017 / Notices 12913

Connection for Post-Traumatic Stress Paperwork Reduction Act (PRA) of Type of Review: Extension of an
Disorder (PTSD) Secondary to Personal 1995, Federal agencies are required to approved collection.
Assault (VA Form 21–0781a). publish notice in the Federal Register Abstract: VA Form 21–8940 is used
OMB Control Number: 2900–0659. concerning each proposed collection of by veterans to apply for increased VA
Type of Review: Revision of a information, including each proposed disability compensation based on the
currently approved collection. extension of a currently approved inability to secure or follow a
Abstract: VA Forms 21–0781 and collection, and allow 60 days for public substantially gainful occupation due to
21–0781a are used to gather specific comment in response to the notice. service connected disabilities. Without
information about in-service stressors, VA Form 21–8940 is used by veterans the information, entitlement to
so VA can assist claimants in obtaining to apply for increased VA disability individual unemployability benefits
credible supporting evidence that the compensation based on the inability to could not be determined.
claimed stressors occurred. In-service secure or follow a substantially gainful Affected Public: Individuals or
stressors reported by veterans must be occupation due to service connected households.
verifiable. VA cannot thoroughly disabilities. Without the information, Estimated Annual Burden: 18,000
research military records and other entitlement to individual hours.
sources of information for credible unemployability benefits could not be Estimated Average Burden per
supporting evidence unless the veteran determined. Respondent: 45 minutes.
provides VA with specific information DATES: Written comments and Frequency of Response: One time.
about the in-service stressors. The forms recommendations on the proposed Estimated Number of Respondents:
request information that is necessary to collection of information should be 24,000.
conduct meaningful research of records. received on or before May 8, 2017. By direction of the Secretary.
An agency may not conduct or ADDRESSES: Submit written comments Cynthia Harvey-Pryor,
sponsor, and a person is not required to on the collection of information through Department Clearance Officer, Office of
respond to a collection of information Federal Docket Management System Privacy and Records Management,
unless it displays a currently valid OMB (FDMS) at www.Regulations.gov or to Department of Veterans Affairs.
control number. The Federal Register Nancy J. Kessinger, Veterans Benefits [FR Doc. 2017–04346 Filed 3–6–17; 8:45 am]
Notice with a 60-day comment period Administration (20M33), Department of BILLING CODE 8320–01–P
soliciting comments on this collection Veterans Affairs, 810 Vermont Avenue
of information was published at 81 FR NW., Washington, DC 20420 or email to
241 on December 15, 2016, pages 90922 nancy.kessinger@va.gov. Please refer to DEPARTMENT OF VETERANS
and 90923. ‘‘OMB Control No. 2900–0404’’ in any AFFAIRS
Affected Public: Individuals or correspondence. During the comment [OMB Control No. 2900–0808]
Households. period, comments may be viewed online
Estimated Annual Burden: 17,780. through the FDMS. Agency Information Collection Activity
Estimated Average Burden per FOR FURTHER INFORMATION CONTACT: Under OMB Review: (Back
Respondent: 70 minutes. Nancy J. Kessinger at (202) 632–8924 or (Thoracolumbar Spine) Conditions
Frequency of Response: One time. FAX (202) 632–8925. Disability Benefits Questionnaire (VA
Estimated Number of Respondents: SUPPLEMENTARY INFORMATION: Under the Form 21–0960M–14)
15,240. PRA of 1995 (Pub. L. 104–13; 44 U.S.C.
By direction of the Secretary. AGENCY: Veterans Benefits
3501–21), Federal agencies must obtain
Administration, Department of Veterans
Cynthia Harvey-Pryor, approval from the Office of Management
Affairs.
Department Clearance Officer, Office of and Budget (OMB) for each collection of
Privacy and Records Management, information they conduct or sponsor. ACTION: Notice.
Department of Veterans Affairs. This request for comment is being made SUMMARY: In compliance with the
[FR Doc. 2017–04429 Filed 3–6–17; 8:45 am] pursuant to Section 3506(c)(2)(A) of the Paperwork Reduction Act (PRA) of
BILLING CODE 8320–01–P PRA. 1995, this notice announces that the
With respect to the following
Veterans Benefits Administration,
collection of information, VBA invites
Department of Veterans Affairs, will
DEPARTMENT OF VETERANS comments on: (1) Whether the proposed
submit the collection of information
AFFAIRS collection of information is necessary
abstracted below to the Office of
for the proper performance of VBA’s
[OMB Control No. 2900–0404] Management and Budget (OMB) for
functions, including whether the
review and comment. The PRA
Agency Information Collection information will have practical utility;
submission describes the nature of the
Activity: Application for Increased (2) the accuracy of VBA’s estimate of the
information collection and its expected
Compensation Based on burden of the proposed collection of
cost and burden and it includes the
Unemployability (VA Form 21–8940) information; (3) ways to enhance the
actual data collection instrument.
quality, utility, and clarity of the
AGENCY: Veterans Benefits information to be collected; and (4) DATES: Comments must be submitted on
Administration, Department of Veterans ways to minimize the burden of the or before April 6, 2017.
Affairs. collection of information on ADDRESSES: Submit written comments
on the collection of information through
sradovich on DSK3GMQ082PROD with NOTICES

ACTION: Notice. respondents, including through the use
of automated collection techniques or www.Regulations.gov, or to Office of
SUMMARY: The Veterans Benefits the use of other forms of information Information and Regulatory Affairs,
Administration (VBA), Department of technology. Office of Management and Budget, Attn:
Veterans Affairs (VA), is announcing an Title: Veteran’s Application for VA Desk Officer; 725 17th St. NW.,
opportunity for public comment on the Increased Compensation Based on Washington, DC 20503 or sent through
proposed collection of certain Unemployability (VA Form 8940). electronic mail to oira_submission@
information by the agency. Under the OMB Control Number: 2900–0404. omb.eop.gov. Please refer to ‘‘OMB

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12914 Federal Register / Vol. 82, No. 43 / Tuesday, March 7, 2017 / Notices

Control No. 2900–0808’’ in any 1995, this notice announces that the By direction of the Secretary:
correspondence. Veterans Benefits Administration, Cynthia Harvey-Pryor,
FOR FURTHER INFORMATION CONTACT: Department of Veterans Affairs, will Department Clearance Officer, Office of
Cynthia Harvey-Pryor, Enterprise submit the collection of information Privacy and Records Management,
abstracted below to the Office of Department of Veterans Affairs.
Records Service (005R1B), Department
of Veterans Affairs, 810 Vermont Management and Budget (OMB) for [FR Doc. 2017–04424 Filed 3–6–17; 8:45 am]
Avenue NW., Washington, DC 20420, review and comment. The PRA BILLING CODE 8320–01–P

(202) 461–5870 or email cynthia.harvey- submission describes the nature of the
pryor@va.gov. Please refer to ‘‘OMB information collection and its expected
Control No. 2900–0808’’ in any cost and burden and it includes the DEPARTMENT OF VETERANS
correspondence. actual data collection instrument. AFFAIRS
SUPPLEMENTARY INFORMATION: DATES: Comments must be submitted on [OMB Control No. 2900–0655]
Title: (Back (Thoracolumbar Spine) or before April 6, 2017.
Conditions Disability Benefits Agency Information Collection Activity
ADDRESSES: Submit written comments Under OMB Review (Residency
Questionnaire (VA Form 21–0960M– on the collection of information through
14). Verification Report—Veterans and
www.Regulations.gov, or to Office of Survivors (FL 21–914))
OMB Control Number: 2900–0808. Information and Regulatory Affairs,
Type of Review: Extension of a Office of Management and Budget, Attn: AGENCY: Veterans Benefits
currently approved collection. VA Desk Officer; 725 17th St. NW., Administration, Department of Veterans
Abstract: VA Forms 21–0960M–14 is Affairs.
Washington, DC 20503 or sent through
used to gather necessary information
electronic mail to oira_submission@ ACTION: Notice.
from a claimant’s treating physician
omb.eop.gov. Please refer to ‘‘OMB
regarding the results of medical SUMMARY: In compliance with the
Control No. 2900–0810’’ in any
examinations. Paperwork Reduction Act (PRA) of 1995
correspondence.
An agency may not conduct or (44 U.S.C. 3501–21), this notice
sponsor, and a person is not required to FOR FURTHER INFORMATION CONTACT: announces that the Veterans Benefits
respond to a collection of information Cynthia Harvey-Pryor, Enterprise Administration, Department of Veterans
unless it displays a currently valid OMB Records Service (005R1B), Department Affairs, will submit the collection of
control number. The Federal Register of Veterans Affairs, 810 Vermont information abstracted below to the
Notice with a 60-day comment period Avenue NW., Washington, DC 20420, Office of Management and Budget
soliciting comments on this collection (202) 461–5870 or email cynthia.harvey- (OMB) for review and comment. The
of information was published at Vol. 81, pryor@va.gov. Please refer to ‘‘OMB PRA submission describes the nature of
No. 250, Thursday, December 29, 2016, Control No. 2900–0810’’ in any the information collection and its
page 96202. correspondence. expected cost and burden and it
Affected Public: Individuals or includes the actual data collection
Households. SUPPLEMENTARY INFORMATION:
instrument.
Estimated Annual Burden: 37,500. Title: (Foot Conditions Including
Estimated Average Burden per Flatfoot (Pes Planus) Disability Benefits DATES: Comments must be submitted on
Respondent: 45 minutes. Questionnaire (VA Form 21–0960M–6). or before April 6, 2017.
Frequency of Response: One time. ADDRESSES: Submit written comments
Estimated Number of Respondents: OMB Control Number: 2900–0810.
on the collection of information through
50,000. Type of Review: Extension of a www.Regulations.gov, or to Office of
By direction of the Secretary. currently approved collection. Information and Regulatory Affairs,
Cynthia Harvey-Pryor, Abstract: VA Forms 21–0960M–6 is Office of Management and Budget, Attn:
Department Clearance Officer, Office of used to gather necessary information VA Desk Officer; 725 17th St. NW.,
Privacy and Records Management, from a claimant’s treating physician Washington, DC 20503 or sent through
Department of Veterans Affairs. regarding the results of medical electronic mail to oira_submission@
[FR Doc. 2017–04423 Filed 3–6–17; 8:45 am] examinations. omb.eop.gov. Please refer to ‘‘OMB
BILLING CODE 8320–01–P An agency may not conduct or Control No. 2900–0655’’ in any
sponsor, and a person is not required to correspondence.
respond to a collection of information FOR FURTHER INFORMATION CONTACT:
DEPARTMENT OF VETERANS unless it displays a currently valid OMB Cynthia Harvey-Pryor, Enterprise
AFFAIRS control number. The Federal Register Records Service (005R1B), Department
[OMB Control No. 2900–0810] Notice with a 60-day comment period of Veterans Affairs, 810 Vermont
soliciting comments on this collection Avenue NW., Washington, DC 20420,
Agency Information Collection Activity of information was published at Vol. 81, (202) 461–5870 or email cynthia.harvey-
Under OMB Review: (Foot Conditions No. 250, Thursday, December 29, 2016, pryor@va.gov. Please refer to ‘‘OMB
Including Flatfoot (Pes Planus) pages 96201 and 96202. Control No. 2900–0655’’ in any
Disability Benefits Questionnaire (VA Affected Public: Individuals or correspondence.
Form 21–0960M–6) Households. SUPPLEMENTARY INFORMATION:
sradovich on DSK3GMQ082PROD with NOTICES

AGENCY: Veterans Benefits Estimated Annual Burden: 40,000. Title: Residency Verification Report—
Administration, Department of Veterans Estimated Average Burden per Veterans and Survivors (FL 21–914).
Affairs. Respondent: 30 minutes. OMB Control Number: 2900–0655.
ACTION: Notice. Type of Review: Extension of a
Frequency of Response: One time. currently approved collection.
SUMMARY: In compliance with the Estimated Number of Respondents: Abstract: VA Form Letter 21–914
Paperwork Reduction Act (PRA) of 80,000. gathers the information necessary to

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Document Created: 2018-02-01 14:48:37
Document Modified: 2018-02-01 14:48:37

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		Comments must be submitted on or before April 6, 2017.
Contact		Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461-5870 or email [email protected] Please refer to ``OMB Control No. 2900- 0808'' in any correspondence.
FR Citation		82 FR 12913