82 FR 18537 - Agency Information Collection Activity Under OMB Review: Shoulder and Arm Conditions Disability Benefits Questionnaire

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 82, Issue 74 (April 19, 2017)

Page Range		18537-18538
FR Document		2017-07865

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 74 (Wednesday, April 19, 2017)

[Federal Register Volume 82, Number 74 (Wednesday, April 19, 2017)]
[Notices]
[Pages 18537-18538]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-07865]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0802]


Agency Information Collection Activity Under OMB Review: Shoulder 
and Arm Conditions Disability Benefits Questionnaire

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs./AGY>

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 May 19, 2017.

ADDRESSES: Submit written comments on the collection of information 
through

[[Page 18538]]

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-
0802'' 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-
0802'' in any correspondence.

SUPPLEMENTARY INFORMATION: 

    Authority: 44 U.S.C. 3501-21.
    Title: Shoulder and Arm Conditions Disability Benefits 
Questionnaire (VA Form 21-0960M-12).
    OMB Control Number: 2900-0802.
    Type of Review: Extension of a currently 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. 
VA Forms 21-0960M-12 is used to gather information related to the 
claimant's diagnosis of a shoulder or arm condition.
    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 82 FR 16, on January 26, 2017, page 8568.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 25,000.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 50,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise Records Service, Office of 
Quality and Compliance, Department of Veterans Affairs.
[FR Doc. 2017-07865 Filed 4-18-17; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 82, No. 74 / Wednesday, April 19, 2017 / Notices 18537

FOR FURTHER INFORMATION CONTACT: opportunity for public comment on the the use of other forms of information
Cynthia Harvey-Pryor, Enterprise proposed collection of certain technology.
Records Service (005R1B), Department information by the agency. Under the Title: Exam for Housebound Status or
of Veterans Affairs, 810 Vermont Paperwork Reduction Act (PRA) of Permanent Need for Regular Aid and
Avenue NW., Washington, DC 20420, 1995, Federal agencies are required to Attendance (VA Form 21–2680).
(202) 461–5870 or email cynthia.harvey- publish notice in the Federal Register OMB Control Number: 2900–0721.
pryor@va.gov. concerning each proposed collection of Type of Review: Extension of an
Please refer to ‘‘OMB Control No. information, including each proposed approved collection.
2900–0613.’’ revision of a currently approved Abstract: VA Form 21–2680 is used to
SUPPLEMENTARY INFORMATION: collection, and allow 60 days for public determine eligibility for the aid and
Title: Record Keeping at Flight comment in response to the notice. attendance and/or housebound benefit.
Schools. VA Form 21–2680 is used to This form is maintained in the veteran’s
OMB Control Number: 2900–0613. determine eligibility for the aid and claims folder. The purpose of this
Type of Review: Extension of a attendance and/or housebound benefit. examination is to record manifestations
currently approved collection. This form is maintained in the veteran’s and findings pertinent to the question of
Abstract: 2900–0613 is for claims folder. The purpose of this whether the claimant is housebound
information reports provided by examination is to record manifestations (confined to the home or immediate
educational institutions. VA will use and findings pertinent to the question of premises) or in need of the regular aid
data collected to determine if courses whether the claimant is housebound and attendance of another person.
offered by flights schools should be (confined to the home or immediate Affected Public: Individuals or
approved and to verify the accuracy of premises) or in need of the regular aid households.
VA educational payments made to and attendance of another person. Estimated Annual Burden: 7,000
students training at flight schools. hours.
DATES: Written comments and
An agency may not conduct or Estimated Average Burden per
recommendations on the proposed
sponsor, and a person is not required to Respondent: 30 minutes.
collection of information should be
respond to a collection of information Frequency of Response: One time.
received on or before June 19, 2017.
unless it displays a currently valid OMB Estimated Number of Respondents:
ADDRESSES: Submit written comments 14,000.
control number. The Federal Register
Notice with a 60-day comment period on the collection of information through
By direction of the Secretary.
soliciting comments on this collection Federal Docket Management System
Cynthia Harvey-Pryor,
of information was published on (FDMS) at www.Regulations.gov or to
Nancy J. Kessinger, Veterans Benefits Department Clearance Officer, Enterprise
Thursday, January 19, 2017, Volume 82, Records Service, Office of Quality and
No 12, pages 6728–6729. Administration (20M33), Department of
Compliance, Department of Veterans Affairs.
Affected Public: Businesses or other Veterans Affairs, 810 Vermont Avenue
[FR Doc. 2017–07861 Filed 4–18–17; 8:45 am]
for-profits, not-for-profit institutions. NW., Washington, DC 20420 or email to
BILLING CODE 8320–01–P
Estimated Annual Burden: 572 hours. nancy.kessinger@va.gov. Please refer to
Estimated Average Burden per ‘‘OMB Control No. 2900–0721’’ in any
Respondent: 20 minutes. correspondence. During the comment
DEPARTMENT OF VETERANS
Frequency of Response: Annual. period, comments may be viewed online
AFFAIRS
Estimated Number of Respondents: through the FDMS.
1717. FOR FURTHER INFORMATION CONTACT: [OMB Control No. 2900–0802]
Authority: 44 U.S.C. 3501–3521. Nancy J. Kessinger at (202) 632–8924 or
Agency Information Collection Activity
FAX (202) 632–8925.
By direction of the Secretary. Under OMB Review: Shoulder and Arm
SUPPLEMENTARY INFORMATION: Under the Conditions Disability Benefits
Cynthia Harvey-Pryor,
PRA of 1995 (Pub. L. 104–13; 44 U.S.C. Questionnaire
Department Clearance Officer, Enterprise
Records Service, Office of Quality and
3501–21), Federal agencies must obtain
approval from the Office of Management AGENCY: Veterans Benefits
Compliance, Department of Veterans Affairs.
and Budget (OMB) for each collection of Administration, Department of Veterans
[FR Doc. 2017–07860 Filed 4–18–17; 8:45 am]
information they conduct or sponsor. Affairs./AGY≤
BILLING CODE 8320–01–P
This request for comment is being made ACTION: Notice.
pursuant to Section 3506(c)(2)(A) of the
PRA. SUMMARY: In compliance with the
DEPARTMENT OF VETERANS Paperwork Reduction Act (PRA) of
AFFAIRS With respect to the following
collection of information, VBA invites 1995, this notice announces that the
[OMB Control No 2900–0721] comments on: (1) Whether the proposed Veterans Benefits Administration,
collection of information is necessary Department of Veterans Affairs, will
Agency Information Collection submit the collection of information
for the proper performance of VBA’s
Activity: Exam for Housebound Status abstracted below to the Office of
functions, including whether the
or Permanent Need for Regular Aid Management and Budget (OMB) for
information will have practical utility;
and Attendance review and comment. The PRA
(2) the accuracy of VBA’s estimate of the
burden of the proposed collection of submission describes the nature of the
jstallworth on DSK7TPTVN1PROD with NOTICES

AGENCY: Veterans Benefits
information; (3) ways to enhance the information collection and its expected
Administration, Department of Veterans
quality, utility, and clarity of the cost and burden and it includes the
Affairs.
information to be collected; and (4) actual data collection instrument.
ACTION: Notice.
ways to minimize the burden of the DATES: Comments must be submitted on
SUMMARY: The Veterans Benefits collection of information on or before May 19, 2017.
Administration (VBA), Department of respondents, including through the use ADDRESSES: Submit written comments
Veterans Affairs (VA), is announcing an of automated collection techniques or on the collection of information through

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18538 Federal Register / Vol. 82, No. 74 / Wednesday, April 19, 2017 / Notices

www.Regulations.gov, or to Office of DEPARTMENT OF VETERANS which it will gather information. VAF
Information and Regulatory Affairs, AFFAIRS 21–0960M–7, Hand and Finger
Office of Management and Budget, Attn: Conditions Disability Benefits
[OMB Control No. 2900–0809]
VA Desk Officer; 725 17th St. NW., Questionnaire, will gather information
Washington, DC 20503 or sent through Agency Information Collection Activity related to the claimant’s diagnosis of a
electronic mail to oira_submission@ Under OMB Review: Hand and Finger hand or finger condition.
omb.eop.gov. Please refer to ‘‘OMB Conditions Disability Benefits An agency may not conduct or
Control No. 2900–0802’’ in any Questionnaire sponsor, and a person is not required to
correspondence. respond to a collection of information
AGENCY: Veterans Benefits unless it displays a currently valid OMB
FOR FURTHER INFORMATION CONTACT:
Administration, Department of Veterans control number. The Federal Register
Cynthia Harvey-Pryor, Enterprise Affairs. Notice with a 60-day comment period
Records Service (005R1B), Department
ACTION: Notice. soliciting comments on this collection
of Veterans Affairs, 810 Vermont
of information was published at 82 FR
Avenue NW., Washington, DC 20420, SUMMARY: In compliance with the 43, on March 7, 2017, page 12912.
(202) 461–5870 or email cynthia.harvey- Paperwork Reduction Act (PRA) of Affected Public: Individuals or
pryor@va.gov. Please refer to ‘‘OMB 1995, this notice announces that the Households.
Control No. 2900–0802’’ in any Veterans Benefits Administration, Estimated Annual Burden: 15,000.
correspondence. Department of Veterans Affairs, will Estimated Average Burden per
SUPPLEMENTARY INFORMATION: submit the collection of information Respondent: 30 minutes.
abstracted below to the Office of Frequency of Response: One time.
Authority: 44 U.S.C. 3501–21.
Management and Budget (OMB) for Estimated Number of Respondents:
Title: Shoulder and Arm Conditions review and comment. The PRA 30,000.
Disability Benefits Questionnaire (VA submission describes the nature of the
Form 21–0960M–12). By direction of the Secretary.
information collection and its expected
OMB Control Number: 2900–0802. Cynthia Harvey-Pryor,
cost and burden and it includes the
Type of Review: Extension of a actual data collection instrument. Department Clearance Officer, Enterprise
currently approved collection. Records Service, Office of Quality and
DATES: Comments must be submitted on Compliance, Department of Veterans Affairs.
Abstract: VA Form 21–0960 series is or before May 19, 2017. [FR Doc. 2017–07864 Filed 4–18–17; 8:45 am]
used to gather necessary information ADDRESSES: Submit written comments BILLING CODE 8320–01–P
from a claimant’s treating physician on the collection of information through
regarding the results of medical www.Regulations.gov, or to Office of
examinations. VA gathers medical Information and Regulatory Affairs, DEPARTMENT OF VETERANS
information related to the claimant that Office of Management and Budget, Attn: AFFAIRS
is necessary to adjudicate the claim for VA Desk Officer; 725 17th St. NW.,
VA disability benefits. The Disability Washington, DC 20503 or sent through [OMB Control No. 2900–0779]
Benefit Questionnaire title will include electronic mail to oira_submission@
the name of the specific disability for omb.eop.gov. Please refer to ‘‘OMB Agency Information Collection
which it will gather information. VA Control No. 2900–0809’’ in any Activity: Hematologic and Lymphatic
Forms 21–0960M–12 is used to gather correspondence. Conditions, Including Leukemia
information related to the claimant’s Disability Benefits Questionnaire,
diagnosis of a shoulder or arm FOR FURTHER INFORMATION CONTACT: Amyotrophic Lateral Sclerosis (Lou
condition. Cynthia Harvey-Pryor, Enterprise Gehrig’s Disease) Disability Benefits
Records Service (005R1B), Department Questionnaire, Peripheral Nerve
An agency may not conduct or
of Veterans Affairs, 810 Vermont Conditions (Not Including Diabetic
sponsor, and a person is not required to
Avenue NW., Washington, DC 20420, Sensory-Motor Peripheral Neuropathy)
respond to a collection of information
(202) 461–5870 or email cynthia.harvey- Disability Benefits Questionnaire,
unless it displays a currently valid OMB
pryor@va.gov. Please refer to ‘‘OMB Persian Gulf and Afghanistan
control number. The Federal Register
Control No. 2900–0809’’ in any Infectious Diseases Disability Benefits
Notice with a 60-day comment period
correspondence. Questionnaire, Tuberculosis Disability
soliciting comments on this collection
of information was published at 82 FR SUPPLEMENTARY INFORMATION: Benefits Questionnaire, Kidney
16, on January 26, 2017, page 8568. Authority: 44 U.S.C. 3501–21. Conditions (Nephrology) Disability
Affected Public: Individuals or Title: Hand and Finger Conditions Benefits Questionnaire, Male
Households. Disability Benefits Questionnaire (VA Reproductive Organ Conditions
Estimated Annual Burden: 25,000. Form 21–0960M–7). Disability Benefits Questionnaire,
OMB Control Number: 2900–0809. Prostate Cancer Disability Benefits
Estimated Average Burden per Questionnaire, Eating Disorders
Respondent: 30 minutes. Type of Review: Extension of a
currently approved collection. Disability Benefits Questionnaire,
Frequency of Response: One time. Mental Disorders (Other Than PTSD
Abstract: VA Form 21–0960 series is
Estimated Number of Respondents: and Eating Disorders) Disability
used to gather necessary information
50,000. Benefits Questionnaire, Review Post
from a claimant’s treating physician
jstallworth on DSK7TPTVN1PROD with NOTICES

By direction of the Secretary. regarding the results of medical Traumatic Stress Disorder (PTSD)
Cynthia Harvey-Pryor, examinations. VA gathers medical Disability Benefits Questionnaire
Department Clearance Officer, Enterprise information related to the claimant that AGENCY: Veterans Benefits
Records Service, Office of Quality and is necessary to adjudicate the claim for Administration, Department of Veterans
Compliance, Department of Veterans Affairs. VA disability benefits. The Disability Affairs.
[FR Doc. 2017–07865 Filed 4–18–17; 8:45 am] Benefit Questionnaire title will include
ACTION: Notice.
BILLING CODE 8320–01–P the name of the specific disability for

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Document Created: 2018-11-14 09:43:49
Document Modified: 2018-11-14 09:43:49

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 May 19, 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- 0802'' in any correspondence.
FR Citation		82 FR 18537