[Federal Register Volume 78, Number 221 (Friday, November 15, 2013)]
[Notices]
[Page 68906]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-27356]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-NEW]


Agency Information Collection (Back (Thoracolumbar Spine) 
Conditions Disability Benefits Questionnaire) Under OMB Review

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits 
Administration (VBA), 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; it includes the actual data collection instrument.

DATES: Comments must be submitted on or before December 16, 2013.

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 Control No. 2900-
NEW (Back (Thoracolumbar Spine) Conditions Disability Benefits 
Questionnaire)'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7492 or email 
[email protected]. Please refer to ``OMB Control No. 2900-NEW (Back 
(Thoracolumbar Spine) Conditions Disability Benefits Questionnaire)''.

SUPPLEMENTARY INFORMATION: 
    Title: (Back (Thoracolumbar Spine) Conditions Disability Benefits 
Questionnaire), VA Form 21-0960M-14.
    OMB Control Number: 2900-NEW (Back (Thoracolumbar Spine) Conditions 
Disability Benefits Questionnaire).
    Type of Review: New data collection.
    Abstract: The VA Form 21-0960M-14, Back (Thoracolumbar Spine) 
Conditions Disability Benefits Questionnaire, will be used for 
disability compensation or pension claims which require an examination 
and/or receiving private medical evidence that may potentially be 
sufficient for rating purposes. The form will be used to gather 
necessary information from a claimant's treating physician regarding 
the results of medical examinations and related to the claimant's 
diagnosis of a Thoracolumbar spine condition. VA will gather medical 
information related to the claimant that is necessary to adjudicate the 
claim for VA disability benefits.
    Affected Public: Individuals or Households.
    Estimated Annual Burden: 37,500.
    Estimated Average Burden per Respondent: 45 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents: 50,000.

    Dated: November 12, 2013.

    By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of Veterans Affairs.
[FR Doc. 2013-27356 Filed 11-14-13; 8:45 am]
BILLING CODE 8320-01-P