[Federal Register Volume 79, Number 167 (Thursday, August 28, 2014)]
[Notices]
[Pages 51399-51400]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-20472]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0781)]


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

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs

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 revision, and allow 
60 days for public comment in response to the notice. This notice 
solicits comments for information needed to obtain medical 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 October 27, 2014.

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. 2900-0781'' in any correspondence. During the comment period, 
comments may be viewed online through 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. 3501-3521), 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 Nerve Conditions Disability Benefits Questionnaire, VA 
Form 21-0960-C-3.
    b. Narcolepsy Disability Benefits Questionnaire, VA Form 21-0960-C-
6.
    c. Peripheral Nerve Conditions (Not Including Diabetic Sensory-
Motor Peripheral Neuropathy) Disability Benefits Questionnaire, VA Form 
21-0960C-10.
    d. Fibromyalgia Disability Benefits Questionnaire, VA Form 21-0960-
C-7.
    e. Seizure Disorders (Epilepsy) Disability Benefits Questionnaire, 
VA Form 21-0960-C-11.
    f. Oral and Dental Conditions Including Mouth, Lips and Tongue

[[Page 51400]]

(Other than Temporomandibular Joint Conditions) Disability Benefits 
Questionnaire, VA Form 21-0960-D-1.
    g. Endocrine Diseases (other than Thyroid, Parathyroid or Diabetes 
Mellitus) Disability Benefits Questionnaire, VA Form 21-0960-E-2.
    h. Thyroid & Parathyroid Conditions Disability Benefits 
Questionnaire, VA Form 21-0960-E-3.
    l. Hernias (Including Abdominal, Inguinal, and Femoral Hernias) 
Disability Benefits Questionnaire, VA Form 21-0960-H-1.
    m. HIV-Related Illnesses Disability Benefits Questionnaire, VA Form 
21-0960-I-2.
    n. Infectious Diseases (other than HIV-Related Illness, Chronic 
Fatigue Syndrome, and Tuberculosis) Disability Benefits Questionnaire, 
VA Form 21-0960I-3.
    o. Systemic Lupus Erythematosus (SLE) and Other Autoimmune Diseases 
Disability Benefits Questionnaire, VA Form 21-0960-I-4.
    p. Nutritional Deficiencies Disability Benefits Questionnaire, VA 
Form 21-0960-I-5.
    q. Urinary Tract (including Bladder & Urethra) Conditions 
(excluding Male Reproductive System) Disability Benefits Questionnaire, 
VA Form 21-0960-J-4.
    r. Respiratory Conditions (other than Tuberculosis and Sleep Apnea) 
Disability Benefits Questionnaire, VA Form 21-0960-L-1.
    s. Loss of Sense of Smell and/or Taste Disability Benefits 
Questionnaire, VA Form 21-0960-N-3.
    t. Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, 
Larynx, and Pharynx Disability Benefits Questionnaire, VA Form 21-0960-
N-4.
    u. Chronic Fatigue Syndrome Disability Benefits Questionnaire, VA 
Form 21-0960-Q-1.
    OMB Control Number: 2900-0781.
    Type of Review: Revised collection.
    Abstract: Data collected on VA Form 21-0960 series will be used 
obtain information from claimants treating physician that is necessary 
to adjudicate a claim for disability benefits.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 53,750 hours.

(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: TOTAL: 160,000.

(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: August 25, 2014.

    By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, Department of Veterans Affairs.
[FR Doc. 2014-20472 Filed 8-27-14; 8:45 am]
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