Justia Department Of Veterans Affairs Agency Information Collection Activity: Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) Disability Benefits Questionnaire, Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits Questionnaire, Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire, Tuberculosis Disability Benefits Questionnaire, Kidney Conditions (Nephrology) Disability Benefits Questionnaire, Male Reproductive Organ Conditions Disability Benefits Questionnaire, Prostate Cancer Disability Benefits Questionnaire, Eating Disorders Disability Benefits Questionnaire, Mental Disorders (Other Than PTSD and Eating Disorders) Disability Benefits Questionnaire, Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire, 18538-18540 [2017-07863]

Agency Information Collection Activity: Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) Disability Benefits Questionnaire, Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits Questionnaire, Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire, Tuberculosis Disability Benefits Questionnaire, Kidney Conditions (Nephrology) Disability Benefits Questionnaire, Male Reproductive Organ Conditions Disability Benefits Questionnaire, Prostate Cancer Disability Benefits Questionnaire, Eating Disorders Disability Benefits Questionnaire, Mental Disorders (Other Than PTSD and Eating Disorders) Disability Benefits Questionnaire, Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire, 18538-18540 [2017-07863]

Download as PDF 18538 Federal Register / Vol. 82, No. 74 / Wednesday, April 19, 2017 / Notices 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. 2900–0802’’ in any correspondence. Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461–5870 or email cynthia.harveypryor@va.gov. Please refer to ‘‘OMB Control No. 2900–0802’’ in any correspondence. SUPPLEMENTARY INFORMATION: jstallworth on DSK7TPTVN1PROD with NOTICES Authority: 44 U.S.C. 3501–21. Title: Shoulder and Arm Conditions Disability Benefits Questionnaire (VA Form 21–0960M–12). OMB Control Number: 2900–0802. Type of Review: Extension of a currently 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. VA Forms 21–0960M–12 is used to gather information related to the claimant’s diagnosis of a shoulder or arm condition. 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 82 FR 16, on January 26, 2017, page 8568. Affected Public: Individuals or Households. Estimated Annual Burden: 25,000. Estimated Average Burden per Respondent: 30 minutes. Frequency of Response: One time. Estimated Number of Respondents: 50,000. By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. BILLING CODE 8320–01–P VerDate Sep<11>2014 15:06 Apr 18, 2017 Jkt 241001 [OMB Control No. 2900–0809] Agency Information Collection Activity Under OMB Review: Hand and Finger Conditions Disability Benefits Questionnaire Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: FOR FURTHER INFORMATION CONTACT: [FR Doc. 2017–07865 Filed 4–18–17; 8:45 am] DEPARTMENT OF VETERANS AFFAIRS In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the Veterans Benefits Administration, 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 and it includes the actual data collection instrument. DATES: Comments must be submitted on or before May 19, 2017. 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. 2900–0809’’ in any correspondence. SUMMARY: FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461–5870 or email cynthia.harveypryor@va.gov. Please refer to ‘‘OMB Control No. 2900–0809’’ in any correspondence. SUPPLEMENTARY INFORMATION: Authority: 44 U.S.C. 3501–21. Title: Hand and Finger Conditions Disability Benefits Questionnaire (VA Form 21–0960M–7). OMB Control Number: 2900–0809. Type of Review: Extension of a currently 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 PO 00000 Frm 00123 Fmt 4703 Sfmt 4703 which it will gather information. VAF 21–0960M–7, Hand and Finger Conditions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a hand or finger condition. 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 82 FR 43, on March 7, 2017, page 12912. Affected Public: Individuals or Households. Estimated Annual Burden: 15,000. Estimated Average Burden per Respondent: 30 minutes. Frequency of Response: One time. Estimated Number of Respondents: 30,000. By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. [FR Doc. 2017–07864 Filed 4–18–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0779] Agency Information Collection Activity: Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease) Disability Benefits Questionnaire, Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits Questionnaire, Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire, Tuberculosis Disability Benefits Questionnaire, Kidney Conditions (Nephrology) Disability Benefits Questionnaire, Male Reproductive Organ Conditions Disability Benefits Questionnaire, Prostate Cancer Disability Benefits Questionnaire, Eating Disorders Disability Benefits Questionnaire, Mental Disorders (Other Than PTSD and Eating Disorders) Disability Benefits Questionnaire, Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: E:\FR\FM\19APN1.SGM 19APN1 Federal Register / Vol. 82, No. 74 / Wednesday, April 19, 2017 / Notices 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 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– 0960B–2, Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any hematologic or lymphatic condition; VAF 21–0960C– 2, Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of amyotrophic lateral sclerosis; VAF 21– 0960C–10, Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral neuropathy) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a peripheral nerve disorder; VAF 21–0960I–1, Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of an infectious disease due to service in the Persian Gulf or Afghanistan; VAF 210960–I–6, Tuberculosis Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of tuberculosis; VAF 21–0960J–1, Kidney Conditions (Nephrology) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of kidney disease; VAF 21– 0960J–2, Male Reproductive Organ Conditions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a condition affecting the male reproductive organ; VAF 21–0960J–3, Prostate Cancer Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of prostate cancer; VAF 21–0960P–1, Eating Disorders Disability Benefits jstallworth on DSK7TPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 15:06 Apr 18, 2017 Jkt 241001 Questionnaire, will gather information related to the claimant’s diagnosis of an eating disorder; VAF 21–0960P–2, Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire will gather information related to the claimant’s diagnosis of any mental disorder with the exception of PTSD; VAF 21–0960P–3, Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of PTSD. DATES: Written comments and recommendations on the proposed collection of information should be received on or before June 19, 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. 2900–0779’’ 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, 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. Authority: Public Law 104–13; 44 U.S.C. 3501–21. Title: (Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire (VA Form 21–0960B–2), Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease) Disability Benefits Questionnaire (VA PO 00000 Frm 00124 Fmt 4703 Sfmt 4703 18539 Form 21–0960C–2), Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits Questionnaire (VA Form 21–0960C–10), Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire (VA Form 21–0960I–1), Tuberculosis Disability Benefits Questionnaire (VA Form 21–0960I–6), Kidney Conditions (Nephrology) Disability Benefits Questionnaire (VA Form 21–0960J–1), Male Reproductive Organ Conditions Disability Benefits Questionnaire (VA Form 21–0960J–2), Prostate Cancer Disability Benefits Questionnaire (VA Form 21–0960J–3), Eating Disorders Disability Benefits Questionnaire (VA Form 21–0960P–1), Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire (VA Form 21–0960P–2), Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire (VA Form 21–0960P–3)) OMB Control Number: 2900–0779. 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 21–0960B–2, Hematologic and Lymphatic Conditions, Including Leukemia Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of any hematologic or lymphatic condition; VAF 21–0960C–2, Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of amyotrophic lateral sclerosis; VAF 21– 0960C–10, Peripheral Nerve Conditions (Not Including Diabetic Sensory-Motor Peripheral neuropathy) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a peripheral nerve disorder; VAF 21–0960I–1, Persian Gulf and Afghanistan Infectious Diseases Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of an infectious disease due to service in the Persian Gulf or Afghanistan; VAF 210960–I–6, Tuberculosis Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of tuberculosis; VAF 21–0960J–1, Kidney Conditions (Nephrology) Disability E:\FR\FM\19APN1.SGM 19APN1 18540 Federal Register / Vol. 82, No. 74 / Wednesday, April 19, 2017 / Notices Benefits Questionnaire, will gather information related to the claimant’s diagnosis of kidney disease; VAF 21– 0960J–2, Male Reproductive Organ Conditions Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of a condition affecting the male reproductive organ; VAF 21–0960J–3, Prostate Cancer Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of prostate cancer; VAF 21–0960P–1, Eating Disorders Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of an eating disorder; VAF 21–0960P–2, Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire will gather information related to the claimant’s diagnosis of any mental disorder with the exception of PTSD; VAF 21–0960P–3, Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire, will gather information related to the claimant’s diagnosis of PTSD. Affected Public: Individuals or households. Estimated Annual Burden: 127,917. Estimated Average Burden per Respondent: 25 minutes. Frequency of Response: One time. Estimated Number of Respondents: 307,000. By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. [FR Doc. 2017–07863 Filed 4–18–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS National Cemetery Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: In compliance with the Paperwork Reduction Act (PRA) of 1995, this notice announces that the National Cemetery Administration (NCA), 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 jstallworth on DSK7TPTVN1PROD with NOTICES 15:06 Apr 18, 2017 Jkt 241001 Willie Lewis, National Cemetery Administration (NCA), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461– 4242 or email willie.lewis@va.gov. SUPPLEMENTARY INFORMATION: Title: Gravesite Reservation Questionnaire (2-year). OMB Control Number: 2900–0546. Type of Review: Revision of a currently approved collection. Abstract: The information is needed to determine if individuals holding gravesite set-asides wish to retain their set-aside or their wish to relinquish it. 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. Affected Public: Individual or House Holds. Estimated Annual Burden: 4,166 hours. Estimated Average Burden per Respondent: 10 minutes each. Frequency of Response: One-time. Estimated Number of Respondents: 25,000. By direction of the Secretary. Cynthia Harvey-Pryor, Department Clearance Officer, Enterprise Records Service, Office of Quality and Compliance, Department of Veterans Affairs. Agency Information Collection Activity: Gravesite Reservation Questionnaire VerDate Sep<11>2014 FOR FURTHER INFORMATION CONTACT: Authority: 44 U.S.C. 3501–3521. [OMB Control No. 2900–0546] SUMMARY: expected cost and burden; it includes the actual data collection instrument. DATES: Comments must be submitted on or before June 19, 2017. 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. 2900–0546 in any correspondence. [FR Doc. 2017–07859 Filed 4–18–17; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0253] Agency Information Collection Activity Under OMB Review: Non-Supervised Lender’s Nomination and Recommendation of Credit Underwriter Veterans Benefits Administration, Department of Veterans Affairs. AGENCY: PO 00000 Frm 00125 Fmt 4703 Sfmt 4703 ACTION: Notice. In compliance with the Paperwork Reduction Act (PRA) of 1995, 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 May 19, 2017. 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. 2900–0253’’ in any correspondence. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 461–5870 or email cynthia.harveypryor@va.gov. Please refer to ‘‘OMB Control No. 2900–0253.’’ SUPPLEMENTARY INFORMATION: SUMMARY: Authority: 44 U.S.C. 3501–3521. Title: Nonsupervised Lender’s Nomination and Recommendation of Credit Underwriter. OMB Control Number: 2900–0253. Type of Review: Extension of a currently approved collection. Abstract: The standards established by the Secretary require that a lender have a qualified underwriter review all loans to be closed on an automatic basis to determine that the loan meets VA’s credit underwriting standards. To determine if the lender’s nominee is qualified to make such a determination, VA has developed VA Form 26–8736a which contains information that VA considers crucial to the evaluation of the underwriter’s experience. This form will be completed by the lender and the lender’s nominee for underwriter and then submitted to VA for approval. 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 82 FR Page 8564 on January 26, 2017. E:\FR\FM\19APN1.SGM 19APN1

Agencies

DEPARTMENT OF VETERANS AFFAIRS

[Federal Register Volume 82, Number 74 (Wednesday, April 19, 2017)]
[Notices]
[Pages 18538-18540]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-07863]


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

DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0779]


Agency Information Collection Activity: Hematologic and Lymphatic 
Conditions, Including Leukemia Disability Benefits Questionnaire, 
Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) Disability 
Benefits Questionnaire, Peripheral Nerve Conditions (Not Including 
Diabetic Sensory-Motor Peripheral Neuropathy) Disability Benefits 
Questionnaire, Persian Gulf and Afghanistan Infectious Diseases 
Disability Benefits Questionnaire, Tuberculosis Disability Benefits 
Questionnaire, Kidney Conditions (Nephrology) Disability Benefits 
Questionnaire, Male Reproductive Organ Conditions Disability Benefits 
Questionnaire, Prostate Cancer Disability Benefits Questionnaire, 
Eating Disorders Disability Benefits Questionnaire, Mental Disorders 
(Other Than PTSD and Eating Disorders) Disability Benefits 
Questionnaire, Review Post Traumatic Stress Disorder (PTSD) Disability 
Benefits Questionnaire

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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

[[Page 18539]]

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 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 21-0960B-
2, Hematologic and Lymphatic Conditions, Including Leukemia Disability 
Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of any hematologic or lymphatic condition; VAF 21-
0960C-2, Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of amyotrophic lateral sclerosis; VAF 21-
0960C-10, Peripheral Nerve Conditions (Not Including Diabetic Sensory-
Motor Peripheral neuropathy) Disability Benefits Questionnaire, will 
gather information related to the claimant's diagnosis of a peripheral 
nerve disorder; VAF 21-0960I-1, Persian Gulf and Afghanistan Infectious 
Diseases Disability Benefits Questionnaire, will gather information 
related to the claimant's diagnosis of an infectious disease due to 
service in the Persian Gulf or Afghanistan; VAF 210960-I-6, 
Tuberculosis Disability Benefits Questionnaire, will gather information 
related to the claimant's diagnosis of tuberculosis; VAF 21-0960J-1, 
Kidney Conditions (Nephrology) Disability Benefits Questionnaire, will 
gather information related to the claimant's diagnosis of kidney 
disease; VAF 21-0960J-2, Male Reproductive Organ Conditions Disability 
Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of a condition affecting the male reproductive 
organ; VAF 21-0960J-3, Prostate Cancer Disability Benefits 
Questionnaire, will gather information related to the claimant's 
diagnosis of prostate cancer; VAF 21-0960P-1, Eating Disorders 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of an eating disorder; VAF 21-0960P-2, Mental 
Disorders (other than PTSD and Eating Disorders) Disability Benefits 
Questionnaire will gather information related to the claimant's 
diagnosis of any mental disorder with the exception of PTSD; VAF 21-
0960P-3, Review Post Traumatic Stress Disorder (PTSD) Disability 
Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of PTSD.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before June 19, 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. 2900-0779'' 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, 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.
    Authority: Public Law 104-13; 44 U.S.C. 3501-21.
    Title: (Hematologic and Lymphatic Conditions, Including Leukemia 
Disability Benefits Questionnaire (VA Form 21-0960B-2), Amyotrophic 
Lateral Sclerosis (Lou Gehrig's Disease) Disability Benefits 
Questionnaire (VA Form 21-0960C-2), Peripheral Nerve Conditions (Not 
Including Diabetic Sensory-Motor Peripheral Neuropathy) Disability 
Benefits Questionnaire (VA Form 21-0960C-10), Persian Gulf and 
Afghanistan Infectious Diseases Disability Benefits Questionnaire (VA 
Form 21-0960I-1), Tuberculosis Disability Benefits Questionnaire (VA 
Form 21-0960I-6), Kidney Conditions (Nephrology) Disability Benefits 
Questionnaire (VA Form 21-0960J-1), Male Reproductive Organ Conditions 
Disability Benefits Questionnaire (VA Form 21-0960J-2), Prostate Cancer 
Disability Benefits Questionnaire (VA Form 21-0960J-3), Eating 
Disorders Disability Benefits Questionnaire (VA Form 21-0960P-1), 
Mental Disorders (other than PTSD and Eating Disorders) Disability 
Benefits Questionnaire (VA Form 21-0960P-2), Review Post Traumatic 
Stress Disorder (PTSD) Disability Benefits Questionnaire (VA Form 21-
0960P-3))
    OMB Control Number: 2900-0779.
    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 21-0960B-2, Hematologic and Lymphatic Conditions, Including 
Leukemia Disability Benefits Questionnaire, will gather information 
related to the claimant's diagnosis of any hematologic or lymphatic 
condition; VAF 21-0960C-2, Amyotrophic Lateral Sclerosis (Lou Gehrig's 
Disease) Disability Benefits Questionnaire, will gather information 
related to the claimant's diagnosis of amyotrophic lateral sclerosis; 
VAF 21-0960C-10, Peripheral Nerve Conditions (Not Including Diabetic 
Sensory-Motor Peripheral neuropathy) Disability Benefits Questionnaire, 
will gather information related to the claimant's diagnosis of a 
peripheral nerve disorder; VAF 21-0960I-1, Persian Gulf and Afghanistan 
Infectious Diseases Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of an infectious 
disease due to service in the Persian Gulf or Afghanistan; VAF 210960-
I-6, Tuberculosis Disability Benefits Questionnaire, will gather 
information related to the claimant's diagnosis of tuberculosis; VAF 
21-0960J-1, Kidney Conditions (Nephrology) Disability

[[Page 18540]]

Benefits Questionnaire, will gather information related to the 
claimant's diagnosis of kidney disease; VAF 21-0960J-2, Male 
Reproductive Organ Conditions Disability Benefits Questionnaire, will 
gather information related to the claimant's diagnosis of a condition 
affecting the male reproductive organ; VAF 21-0960J-3, Prostate Cancer 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of prostate cancer; VAF 21-0960P-1, Eating 
Disorders Disability Benefits Questionnaire, will gather information 
related to the claimant's diagnosis of an eating disorder; VAF 21-
0960P-2, Mental Disorders (other than PTSD and Eating Disorders) 
Disability Benefits Questionnaire will gather information related to 
the claimant's diagnosis of any mental disorder with the exception of 
PTSD; VAF 21-0960P-3, Review Post Traumatic Stress Disorder (PTSD) 
Disability Benefits Questionnaire, will gather information related to 
the claimant's diagnosis of PTSD.
    Affected Public: Individuals or households.
    Estimated Annual Burden: 127,917.
    Estimated Average Burden per Respondent: 25 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents: 307,000.

    By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise Records Service, Office of 
Quality and Compliance, Department of Veterans Affairs.
[FR Doc. 2017-07863 Filed 4-18-17; 8:45 am]
 BILLING CODE 8320-01-P

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