Agency Information Collection Activity: Shoulder and Arm Conditions Disability Benefits Questionnaire (VA Form 21-0960M-12), 8568 [2017-01751]

Agencies

• DEPARTMENT OF VETERANS AFFAIRS

[Federal Register Volume 82, Number 16 (Thursday, January 26, 2017)]
[Notices]
[Page 8568]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-01751]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0802]


Agency Information Collection Activity: Shoulder and Arm 
Conditions Disability Benefits Questionnaire (VA Form 21-0960M-12)

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 proposed revision of 
a currently approved collection, and allow 60 days for public comment 
in response to the notice.
    VA Forms 21-0960M-12 is used to gather necessary information from a 
claimant's treating physician regarding the results of medical 
examinations.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before March 27, 2017.

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. 2900-0802'' in any correspondence. During the comment period, 
comments may be viewed online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 632-8924 
or FAX (202) 632-8925.

SUPPLEMENTARY INFORMATION: 
    Under the PRA of 1995 (Public Law 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: (Shoulder and Arm Conditions Disability Benefits 
Questionnaire (VA Form 21-0960M-12).
    OMB Control Number: 2900-0802.
    Type of Review: Extension of an approved collection.
    Abstract: VA Forms 21-0960M-12 is used to gather necessary 
information from a claimant's treating physician regarding the results 
of medical examinations.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 25,000 hours.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 50,000 per year.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-01751 Filed 1-25-17; 8:45 am]
 BILLING CODE 8320-01-P