Proposed Information Collection (Disability Benefits Questionnaire (Group 3)); Activity: Comment Request, 8129-8130 [2016-03207]

Download as PDF Federal Register / Vol. 81, No. 31 / Wednesday, February 17, 2016 / Notices or other diseases of the nose, throat, larynx, or pharynx; VAF 21–0960Q–1, Chronic Fatigue Syndrome Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of chronic fatigue syndrome. DATES: Written comments and recommendations on the proposed collection of information should be received on or before April 18, 2016. 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 nancy.kessinger@va.gov. Please refer to ‘‘OMB Control No. 2900–0781’’ in any correspondence. asabaliauskas on DSK5VPTVN1PROD with NOTICES 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. 3501–21), 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. Title: Disability Benefits Questionnaires (Group 4). OMB Control Number: 2900–0781. Type of Review: Revision of a currently approved collection. Abstract: The VA Form 21–0960 series will be used to gather necessary information from a claimant’s treating physician regarding the results of medical examinations. 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: 53,750. VerDate Sep<11>2014 19:05 Feb 16, 2016 Jkt 238001 Estimated Average Burden per Respondent i. VAF 21–0960C–3—30 minutes ii. VAF 21–0960C–6—15 minutes iii. VAF 21–0960C–7—15 minutes iv. VAF 21–0960C–11—15 minutes v. VAF 21–0960D–1—15 minutes vi. VAF 21–0960E–2—15 minutes vii. VAF 21–0960E–3—15 minutes viii. VAF 21–0960H–1—15 minutes ix. VAF 21–0960I–2—15 minutes x. VAF 21–0960I–3—15 minutes xi. VAF 21–0960I–4—30 minutes xii. VAF 21–0960I–5—15 minutes xiii. VAF 21–0960J–4—15 minutes xiv. VAF 21–0960L–1—30 minutes xv. VAF 21–0960N–3—15 minutes xvi. VAF 21–0960N–4—30 minutes xvii. VAF 21–0960Q–1—15 minutes Frequency of Response: One time. Estimated Number of Respondents: 160,000. By direction of the Secretary. Kathleen M. Manwell, Program Analyst, VA Privacy Service, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2016–03206 Filed 2–16–16; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0778] Proposed Information Collection (Disability Benefits Questionnaire (Group 3)); Activity: Comment Request Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: 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 revision of a currently approved collection, and allow 60 days for public comment in response to the notice. The VA Form 21–0960 series will be used to gather necessary information from a claimant’s treating physician regarding the results of medical examinations. VA will gather medical information related to the claimant that is necessary to adjudicate the claim for VA disability benefits. The DBQ title will include the name of the specific disability for which it will gather SUMMARY: PO 00000 Frm 00096 Fmt 4703 Sfmt 4703 8129 information. VAF 21–0960C–5, Central Nervous System and Neuromusculo Diseases Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a central nervous system disease; VAF 21–0960C–8, Headaches (Including Migraine Headaches) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of headaches; VAF 21–0960C–9, Multiple Sclerosis (MS) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of multiple sclerosis; VAF 21–0960G–1, Esophageal Disorders (including GERD, Hiatal Hernia, and Other Esophageal Disorders) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any esophageal disorders; VAF 21– 0960G–2, Gall Bladder and Pancreas Conditions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any gall bladder and pancreas condition; VAF 21–0960G–3, Intestinal Conditions (Other than Surgical or Infectious) Including Irritable Bowel Syndrome, Crohn’s Disease, Ulcerative Colitis, and Diverticulitis Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any intestinal conditions unrelated to surgery or infection; VAF 21–0960G–4, Infectious Intestinal Disorders (including Bacterial and Parasitic Infections) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any infectious intestinal condition; VAF 21–0960G–5, Hepatitis, Cirrhosis and other Liver Conditions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any liver condition; VAF 21–0960G–6, Peritoneal Adhesions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of peritoneal adhesions; VAF 21–0960G–7, Stomach and Duodenum Conditions (Not Including GERD or Esophageal Disorders) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any stomach or duodenum conditions; VAF 21–0960G–8, Intestinal Surgery (Bowel Resection, Colostomy, Ileostomy) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any surgical intestinal condition; VAF 21–0960H–2, Rectum and Anus Conditions (Including Hemorrhoids) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any rectum or E:\FR\FM\17FEN1.SGM 17FEN1 8130 Federal Register / Vol. 81, No. 31 / Wednesday, February 17, 2016 / Notices anus condition, which includes hemorrhoids; VAF 21–0960K–1 Breast Conditions and Disorders Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a breast condition or disorder; VAF 21–0960K–2 Gynecological Conditions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a gynecological condition; VAF 21–0960L–2, Sleep Apnea Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of sleep apnea; VAF 21–0960M–11, Osteomyelitis Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of osteomyelitis; VAF 21–0960N–1, Ear Conditions (Including Vestibular and Infectious) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of an ear disease. DATES: Written comments and recommendations on the proposed collection of information should be received on or before April 18, 2016. 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 nancy.kessinger@va.gov. Please refer to ‘‘OMB Control No. 2900–0778’’ in any correspondence. asabaliauskas on DSK5VPTVN1PROD with NOTICES 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. 3501–21), 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 VerDate Sep<11>2014 19:05 Feb 16, 2016 Jkt 238001 the use of other forms of information technology. Title: Disability Benefits Questionnaires (Group 3). OMB Control Number: 2900–0778. Type of Review: Revision of a currently approved collection. Abstract: The VA Form 21–0960 series will be used to gather necessary information from a claimant’s treating physician regarding the results of medical examinations. 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: 77,500. Estimated Average Burden per Respondent i. VAF 21–0960C–5—30 minutes ii. VAF 21–0960C–8—15 minutes iii. VAF 21–0960C–9—45 minutes iv. VAF 21–0960G–1—15 minutes v. VAF 21–0960G–2—15 minutes vi. VAF 21–0960G–3—15 minutes vii. VAF 21–0960G–4—15 minutes viii. VAF 21–0960G–5—30 minutes ix. VAF 21–0960G–6—15 minutes x. VAF 21–0960G–7—15 minutes xi. VAF 21–0960G–8—15 minutes xii. VAF 21–0960H–2—15 minutes xiii. VAF 21–0960K–1—15 minutes xiv. VAF 21–0960K–2—30 minutes xv. VAF 21–0960L–2—15 minutes xvi. VAF 21–0960M–11—15 minutes xvii. VAF 21–0960N–1—15 minutes Frequency of Response: One time. Estimated Number of Respondents: 250,000. By direction of the Secretary. Kathleen M. Manwell, Program Analyst, VA Privacy Service, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2016–03207 Filed 2–16–16; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0745] Agency Information Collection (Application for Fee or Roster Personnel Designation) Activity Under OMB Review Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501–3521), this notice announces that the Veterans Benefits SUMMARY: PO 00000 Frm 00097 Fmt 4703 Sfmt 4703 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 March 18, 2016. 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 oira_submission@ omb.eop.gov. Please refer to ‘‘OMB Control No. 2900–0745’’ 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 crystal.rennie@va.gov. Please refer to ‘‘OMB Control No. 2900– 0745.’’ SUPPLEMENTARY INFORMATION: Title: Request for Certificate of Veteran Status. OMB Control Number: 2900–0745. Type of Review: Revision of a currently approved collection. Abstract: Applicants complete VA form 26–8621a to apply for a position as a designate fee appraiser or compliance inspector. VA will use the data collected to determine the applicant’s experience in the real estate valuation field. 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 80 FR 63879 on October 21, 2015. Title: Request for Certificate of Veteran Status. OMB Control Number: 2900–0745. Type of Review: Revision of a currently approved collection. Abstract: Applicants complete VA form 26–8621a to apply for a position as a designate fee appraiser or compliance inspector. VA will use the data collected to determine the applicant’s experience in the real estate valuation field. Affected Public: Individuals or households. Estimated Annual Burden: 4 hours. Estimated Average Burden per Respondent: 10 minutes. Frequency of Response: One-time. E:\FR\FM\17FEN1.SGM 17FEN1

Agencies

[Federal Register Volume 81, Number 31 (Wednesday, February 17, 2016)]
[Notices]
[Pages 8129-8130]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-03207]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0778]


Proposed Information Collection (Disability Benefits 
Questionnaire (Group 3)); Activity: Comment Request

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

-----------------------------------------------------------------------

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 revision of 
a currently approved collection, and allow 60 days for public comment 
in response to the notice.
    The VA Form 21-0960 series will be used to gather necessary 
information from a claimant's treating physician regarding the results 
of medical examinations. VA will gather medical information related to 
the claimant that is necessary to adjudicate the claim for VA 
disability benefits. The DBQ title will include the name of the 
specific disability for which it will gather information. VAF 21-0960C-
5, Central Nervous System and Neuromusculo Diseases Disability Benefits 
Questionnaire, will gather information related to the claimant's 
diagnosis of a central nervous system disease; VAF 21-0960C-8, 
Headaches (Including Migraine Headaches) Disability Benefits 
Questionnaire, will gather information related to the claimant's 
diagnosis of headaches; VAF 21-0960C-9, Multiple Sclerosis (MS) 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of multiple sclerosis; VAF 21-0960G-1, 
Esophageal Disorders (including GERD, Hiatal Hernia, and Other 
Esophageal Disorders) Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of any esophageal 
disorders; VAF 21-0960G-2, Gall Bladder and Pancreas Conditions 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of any gall bladder and pancreas condition; 
VAF 21-0960G-3, Intestinal Conditions (Other than Surgical or 
Infectious) Including Irritable Bowel Syndrome, Crohn's Disease, 
Ulcerative Colitis, and Diverticulitis Disability Benefits 
Questionnaire, will gather information related to the claimant's 
diagnosis of any intestinal conditions unrelated to surgery or 
infection; VAF 21-0960G-4, Infectious Intestinal Disorders (including 
Bacterial and Parasitic Infections) Disability Benefits Questionnaire, 
will gather information related to the claimant's diagnosis of any 
infectious intestinal condition; VAF 21-0960G-5, Hepatitis, Cirrhosis 
and other Liver Conditions Disability Benefits Questionnaire, will 
gather information related to the claimant's diagnosis of any liver 
condition; VAF 21-0960G-6, Peritoneal Adhesions Disability Benefits 
Questionnaire, will gather information related to the claimant's 
diagnosis of peritoneal adhesions; VAF 21-0960G-7, Stomach and Duodenum 
Conditions (Not Including GERD or Esophageal Disorders) Disability 
Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of any stomach or duodenum conditions; VAF 21-
0960G-8, Intestinal Surgery (Bowel Resection, Colostomy, Ileostomy) 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of any surgical intestinal condition; VAF 21-
0960H-2, Rectum and Anus Conditions (Including Hemorrhoids) Disability 
Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of any rectum or

[[Page 8130]]

anus condition, which includes hemorrhoids; VAF 21-0960K-1 Breast 
Conditions and Disorders Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of a breast condition 
or disorder; VAF 21-0960K-2 Gynecological Conditions Disability 
Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of a gynecological condition; VAF 21-0960L-2, 
Sleep Apnea Disability Benefits Questionnaire, will gather information 
related to the claimant's diagnosis of sleep apnea; VAF 21-0960M-11, 
Osteomyelitis Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of osteomyelitis; VAF 
21-0960N-1, Ear Conditions (Including Vestibular and Infectious) 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of an ear disease.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before April 18, 2016.

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 nancy.kessinger@va.gov. Please refer to ``OMB Control 
No. 2900-0778'' in any correspondence.

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. 3501-21), 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.
    Title: Disability Benefits Questionnaires (Group 3).
    OMB Control Number: 2900-0778.
    Type of Review: Revision of a currently approved collection.
    Abstract: The VA Form 21-0960 series will be used to gather 
necessary information from a claimant's treating physician regarding 
the results of medical examinations. 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: 77,500.

Estimated Average Burden per Respondent

i. VAF 21-0960C-5--30 minutes
ii. VAF 21-0960C-8--15 minutes
iii. VAF 21-0960C-9--45 minutes
iv. VAF 21-0960G-1--15 minutes
v. VAF 21-0960G-2--15 minutes
vi. VAF 21-0960G-3--15 minutes
vii. VAF 21-0960G-4--15 minutes
viii. VAF 21-0960G-5--30 minutes
ix. VAF 21-0960G-6--15 minutes
x. VAF 21-0960G-7--15 minutes
xi. VAF 21-0960G-8--15 minutes
xii. VAF 21-0960H-2--15 minutes
xiii. VAF 21-0960K-1--15 minutes
xiv. VAF 21-0960K-2--30 minutes
xv. VAF 21-0960L-2--15 minutes
xvi. VAF 21-0960M-11--15 minutes
xvii. VAF 21-0960N-1--15 minutes

    Frequency of Response: One time.
    Estimated Number of Respondents: 250,000.

    By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records 
Management, Department of Veterans Affairs.
[FR Doc. 2016-03207 Filed 2-16-16; 8:45 am]
 BILLING CODE 8320-01-P
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