[Federal Register Volume 79, Number 219 (Thursday, November 13, 2014)]
[Notices]
[Pages 67545-67546]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-26767]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0778]


Agency Information Collection (Disability Benefits 
Questionnaires--Group 3) Activity 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 15, 2014.

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-
0778'' 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. 2900-0778.''

SUPPLEMENTARY INFORMATION: 
    Titles:
    a. Central Nervous System and Neuromusculo Diseases, Disability 
Benefits Questionnaire, VA Form 21-0960C-5.
    b. Headaches (Including Migraine Headaches), Disability Benefits 
Questionnaire, VA Form 21-0960C-8.
    c. Multiple Sclerosis (MS), Disability Benefits Questionnaire, VA 
Form 21-0960C-9.
    d. Esophageal Disorders (Including GERD), Disability Benefits 
Questionnaire, VA Form 21-0960G-1.
    e. Gallbladder and Pancreas Conditions, Disability Benefits 
Questionnaire, VA Form 21-0960G-2.
    f. Intestinal Disorders (Other Than Surgical or Infectious) 
(Including Irritable Bowel Syndrome, Crohn's

[[Page 67546]]

Disease, Ulcerative Colitis, and Diverticulitis) Disability Benefits 
Questionnaire, VA Form 21-0960G-3.
    g. Intestines Surgical and/or Infectious Intestinal Disorders 
(Bowel Resection, Colostomy, Ileostomy, Bacterial and Parasitic 
Infections) Disability Benefits Questionnaire, VA Form 21-0960G-4.
    h. Hepatitis, Cirrhosis and Other Liver Conditions, Disability 
Benefits Questionnaire, VA Form 21-0960G-5.
    i. Peritoneal Adhesions Disability Benefits Questionnaire, VA Form 
21-0960G-6.
    j. Stomach and Duodenal Conditions (Not Including GERD or 
Esophageal Disorders) Disability Benefits Questionnaire, VA Form 21-
0960G-7.
    k. Infectious Intestinal Disorders, Including Bacterial and 
Parasitic Infections Disability Benefits Questionnaire, VA Form 21-
0960G-8.
    l. Rectum and Anus Disability Benefits Questionnaire, VA Form 21-
0960H-2.
    m. Breast Conditions and Disorders Disability Benefits 
Questionnaire, VA Form 21-0960K-1.
    n. Gynecological Conditions Disability Benefits Questionnaire, VA 
Form 21-0960K-2.
    o. Sleep Apnea Disability Benefits Questionnaire, VA Form 21-0960L-
2.
    p. Osteomyelitis Disability Benefits Questionnaire, VA Form 21-
0960M-11.
    q. Ear Conditions (Including Vestibular and Infectious) Disability 
Benefits Questionnaire, VA Form 21-0960N-1.
    OMB Control Number: 2900-0778.
    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.
    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 on April 15, 2014, at pages 48296-48297.
    Affected Public: Individuals or households.
    Estimated Annual Burden:
    a. VA Form 21-0960C-5--5,000.
    b. VA Form 21-0960C-8--3,750.
    c. VA Form 21-0960C-9--7,500.
    d. VA Form 21-0960G-1--10,000.
    e. VA Form 21-0960G-2--1,250.
    f. VA Form 21-0960G-3--1,250.
    g. VA Form 21-0960G-4--1,250.
    h. VA Form 21-0960G-5--5,000.
    i. VA Form 21-0960G-6--1,250.
    j. VA Form 21-0960G-7--2,500.
    k. VA Form 21-0960G-8--1,250.
    l. VA Form 21-0960H-2--2,500.
    m. VA Form 21-0960K-1--7,500.
    n. VA Form 21-0960K-2--10,000.
    o. VA Form 21-0960L-2--1,250.
    p. VA Form 21-0960M-11--10,000.
    q. VA Form 21-0960N-1--6,250.
    Estimated Average Burden per Respondent:
    a. VA Form 21-0960C-5--30 minutes.
    b. VA Form 21-0960C-8--15 minutes.
    c. VA Form 21-0960C-9--45 minutes.
    d. VA Form 21-0960G-1--15 minutes.
    e. VA Form 21-0960G-2--15 minutes.
    f. VA Form 21-0960G-3--15 minutes.
    g. VA Form 21-0960G-4--15 minutes.
    h. VA Form 21-0960G-5--30 minutes.
    i. VA Form 21-0960G-6--15 minutes.
    j. VA Form 21-0960G-7--15 minutes.
    k. VA Form 21-0960G-8--15 minutes.
    l. VA Form 21-0960H-2--15 minutes.
    m. VA Form 21-0960K-1--15 minutes.
    n. VA Form 21-0960K-2--30 minutes.
    o. VA Form 21-0960L-2--15 minutes.
    p. VA Form 21-0960M-11--15 minutes.
    q. VA Form 21-0960N-1--15 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. VA Form 21-0960C-5--10,000.
    b. VA Form 21-0960C-8--15,000.
    c. VA Form 21-0960C-9--10,000.
    d. VA Form 21-0960G-1--40,000.
    e. VA Form 21-0960G-2--5,000.
    f. VA Form 21-0960G-3--5,000.
    g. VA Form 21-0960G-4--5,000.
    h. VA Form 21-0960G-5--10,000.
    i. VA Form 21-0960G-6--5,000.
    j. VA Form 21-0960G-7--10,000.
    k. VA Form 21-0960G-8--5,000.
    l. VA Form 21-0960H-2--10,000.
    m. VA Form 21-0960K-1--30,000.
    n. VA Form 21-0960K-2--20,000.
    o. VA Form 21-0960L2--5,000.
    p. VA Form 21-0960M-11--40,000.
    q. VA Form 21-0960N-1--25,000.

    Dated: November 6, 2014.

    By direction of the Secretary.
Crystal Rennie,
Department, Clearance Officer, Department of Veterans Affairs .
[FR Doc. 2014-26767 Filed 11-12-14; 8:45 am]
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