[Federal Register Volume 76, Number 144 (Wednesday, July 27, 2011)]
[Notices]
[Pages 45008-45009]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-18958]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-New; DBQs--Group 4]


Proposed Information Collection (Disability Benefits 
Questionnaires--Group 4) Activity: Comment Request

AGENCY: . Department of Veterans Affairs, Veterans Benefits 
Administration

ACTION: Notice.

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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 new 
collection and allow 60 days for public comment in response to the 
notice. This notice solicits comments for information needed to obtain 
medical

[[Page 45009]]

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 September 26, 2011.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J. Kessinger, Veterans Benefits 
Administration (20M33), Department of Veterans Affairs, 810 Vermont 
Avenue, NW., Washington, DC 20420 or e-mail to [email protected]. 
Please refer to ``OMB Control No. 2900-New (DBQs--Group 4)'' in any 
correspondence. During the comment period, comments may be viewed 
online through FDMS.

FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 461-9769 
or Fax (202) 275-5947.

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. Cranial Nerves Diseases Disability Benefits Questionnaire, VA 
Form 21-0960C3.
    b. Narcolepsy Disability Benefits Questionnaire, VA Form 21-0960C6.
    c. Fibromyalgia Disability Benefits Questionnaire, VA Form 21-
0960C7.
    d. Seizure Disorders (Epilepsy) Disability Benefits Questionnaire, 
VA Form 21-0960C11.
    e. Oral and Dental including Mouth, Lips, and Tongue (other than 
Temporomandibular Joint Conditions) Disability Benefits Questionnaire, 
VA Form 21-0960D1.
    f. Endocrine Diseases (other than Thyroid, Parathyroid or Diabetes 
Mellitus) Disability Benefits Questionnaire, VA Form 21-0960-E-2.
    g. Thyroid & Parathyroid Conditions Disability Benefits 
Questionnaire, VA Form 21-0960-E-3.
    h. Abdominal, Inguinal, and Femoral Hernias Disability Benefits 
Questionnaire, VA Form 21-0960-H-1.
    i. HIV-Related Illnesses Disability Benefits Questionnaire, VA Form 
21-0960-I-2 .
    j. Infectious Diseases Other Than HIV-Related Illness, Chronic 
Fatigue Syndrome, and Tuberculosis Disability Benefits Questionnaire, 
VA Form 21-0960-I-3.
    k. Systemic Lupus Erytematous (SLE) and Other Immune Disorders 
(except HIV) and Other Autoimmune Diseases (other than HIV and Diabetes 
Mellitus Type I) Disability Benefits Questionnaire, VA Form 21-0960-I-
4.
    l. Nutritional Deficiencies Disability Benefits Questionnaire, VA 
Form 21-0960-I-5.
    m. Urinary Tract (including Bladder & Urethra) Conditions 
(excluding Male Reproductive System) Disability Benefits Questionnaire, 
VA Form 21-0960-J-4.
    n. Respiratory Conditions (other than Tuberculosis and Sleep Apnea) 
Disability Benefits Questionnaire, VA Form 21-0960-L-1.
    o. Loss of Sense of Smell and/or Taste Disability Benefits 
Questionnaire, VA Form 21-0960-N-3.
    p. Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, 
Larynx, and Pharynx Disability Benefits Questionnaire, VA Form 21-0960-
N-4.
    q. Chronic Fatigue Syndrome Disability Benefits Questionnaire, VA 
Form 21-0960-Q-1.
    OMB Control Number: 2900-New (DBQs--Group 4).
    Type of Review: New collection.
    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:
    a. VAF 21-0960-C-3--5,000.
    b. VAF 21-0960-C-6--1,250.
    c. VAF 21-0960-C-7--1,250.
    d. VAF 21-0960-C-11--1,250.
    e. VAF 21-0960-D-1--1,250.
    f. VAF 21-0960-E-2--2,500.
    g. VAF 21-0960-E-3--2,500.
    h. VAF 21-0960-H-1--3,750.
    i. VAF 21-0960-I-2--1,250.
    j. VAF 21-0960-I-3--2,500.
    k. VAF 21-0960-I-4--2,500.
    l. VAF 21-0960-I-5--1,250.
    m. VAF 21-0960-J-4--3,750.
    n. VAF 21-0960-L-1--10,000.
    o. VAF 21-0960-N-3--1,250.
    p. VAF 21-0960-N-4--10,000.
    q. VAF 21-0960-Q-1--2,500.
    Estimated Average Burden per Respondent:
    a. VAF 21-0960-C-3--30 minutes.
    b. VAF 21-0960-C-6--15 minutes.
    c. VAF 21-0960-C-7--15 minutes.
    d. VAF 21-0960-C-11--15 minutes.
    e. VAF 21-0960-D-1--15 minutes.
    f. VAF 21-0960-E-2--15 minutes.
    g. VAF 21-0960-E-3--15 minutes.
    h. VAF 21-0960-H-1--15 minutes.
    i. VAF 21-0960-I-2--15 minutes.
    j. VAF 21-0960-I-3--15 minutes.
    k. VAF 21-0960-I-4--30 minutes.
    l. VAF 21-0960-I-5--15 minutes.
    m. VAF 21-0960-J-4--15 minutes.
    n. VAF 21-0960-L-1--30 minutes.
    o. VAF 21-0960-N-3--15 minutes.
    p. VAF 21-0960-N-4--30 minutes.
    q. VAF 21-0960-Q-1--15 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VAF 21-0960-C-3--10,000.
    b. VAF 21-0960-C-6--5,000.
    c. VAF 21-0960-C-7--5,000.
    d. VAF 21-0960-C-11--5,000.
    e. VAF 21-0960-D-1--5,000.
    f. VAF 21-0960-E-2--10,000.
    g. VAF 21-0960-E-3--10,000.
    h. VAF 21-0960-H-1--15,000.
    i. VAF 21-0960-I-2--5,000.
    j. VAF 21-0960-I-3--10,000.
    k. VAF 21-0960-I-4--5,000.
    l. VAF 21-0960-I-5--5,000.
    m. VAF 21-0960-J-4--15,000.
    n. VAF 21-0960-L-1--20,000.
    o. VAF 21-0960-N-3--5,000.
    p. VAF 21-0960-N-4--20,000.
    q. VAF 21-0960-Q-1--10,000.

    Dated: July 22, 2011.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011-18958 Filed 7-26-11; 8:45 am]
BILLING CODE 8320-01-P