Agency Information Collection Activity (Wrist Conditions Disability Benefits Questionnaire (VA Form 21-0960M-16)), 12703-12704 [2017-04302]

Agencies

• DEPARTMENT OF VETERANS AFFAIRS

[Federal Register Volume 82, Number 42 (Monday, March 6, 2017)]
[Notices]
[Pages 12703-12704]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-04302]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0805]


Agency Information Collection Activity (Wrist Conditions 
Disability Benefits Questionnaire (VA Form 21-0960M-16))

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

[[Page 12704]]

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 Form 21-0960 series is used to gather necessary information from 
a claimant's treating physician regarding the results of medical 
examinations. VA gathers medical information related to the claimant 
that is necessary to adjudicate the claim for VA disability benefits. 
The Disability Benefit Questionnaire title will include the name of the 
specific disability for which it will gather information. VAF 21-0960M-
16, Wrist Conditions Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of a wrist condition.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before May 5, 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. 2900-0805'' 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 (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: (Wrist Conditions Disability Benefits Questionnaire (VA Form 
21-0960M-16))
    OMB Control Number: 2900-0805.
    Type of Review: Extension of an approved collection.
    Abstract: VA Form 21-0960 series is used to gather necessary 
information from a claimant's treating physician regarding the results 
of medical examinations. VA gathers medical information related to the 
claimant that is necessary to adjudicate the claim for VA disability 
benefits. The Disability Benefit Questionnaire title will include the 
name of the specific disability for which it will gather information. 
VAF 21-0960M-16, Wrist Conditions Disability Benefits Questionnaire, 
will gather information related to the claimant's diagnosis of a wrist 
condition.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 20,000.
    Estimated Average Burden per Respondent: 30 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 40,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Office of Privacy and Records Management, 
Department of Veterans Affairs.
[FR Doc. 2017-04302 Filed 3-3-17; 8:45 am]
 BILLING CODE 8320-01-P