Fully Developed Claim (Express Compensation and Pension Claim Forms)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 21-526EZ Fully Developed Claim (Express Compensation and Pension Claim Forms)	Form and Instruction	Modified	Available
Supplemental Statement 526-527EZ.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2010-04-22	Available
2900-0747 justification.doc	Supporting Statement A	Uploaded 2010-04-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
191044	Fully Developed Claim (Express Compensation and Pension Claim Forms)	Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0747	ICR Reference No: 201004-2900-005
Status: Historical Active	Previous ICR Reference No: 200903-2900-005
Agency/Subagency: VA	Agency Tracking No: 2900-0747
Title: Fully Developed Claim (Express Compensation and Pension Claim Forms)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/02/2010
	Date Received in OIRA: 04/28/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2013	04/30/2013	04/30/2013
Responses	104,440	0	1,584
Time Burden (Hours)	43,517	0	132
Cost Burden (Dollars)	0	0	0

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Abstract: Public Law 110-389, Section 221(a)directs the Department of Veterans Affairs (VA) to carry out a one-year pilot program to assess the feasibility and advisability of expeditiously processing fully developed compensation and pension claims within 90 days after receipt of the claim. The law requires the claimant and the representative submit a certification in writing that is signed and dated by the claimant stating that, as of such date, no additional information or evidence is available or needs to be submitted in order for the claim to be adjudicated.

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Authorizing Statute(s): PL: Pub.L. 110 - 389 221 Name of Law: Veterans’ Benefits Improvement Act of 2008
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 220	11/17/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 17	01/27/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Fully Developed Claim (Express Compensation and Pension Claim Forms)	21-526EZ, 21-527EZ	Fully Developed Claim (Express Claim Notice) (Notice to Claimants of Information and Evidence Necessary to Substantiate a Claim for VA Non-Service Connected Live Pension ,   Fully Developed Claim (Express Claim Notice) (Notice to Claimants of Information and Evidence Necessary to Substantiate a Claim for VA Disability Live Compensation)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	104,440	1,584	0	102,856	0	0
Annual Time Burden (Hours)	43,517	132	0	43,385	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in burden is due to additional Regional Offices. Also VA Forms 21-526EZ, Fully Developed Claim (Express Compensation Claim), and 21-527EZ, Fully Developed Claim (Express Pension Claim), will replace the Certificate for Fully Developed Claim (VAF 21-0844). Both claims forms certification include the same information as VAF 21-0844, however, there is a substantial increase in the information provided and questions asked of claimants. These applications will still allow VA to process fully developed claims within 90 days of receipt as stated in the Federal Register notice for VAF 21-0844. A claim is considered fully developed when the claimant has no other information to submit and requires no additional VA assistance, except for obtaining federal records and ordering medical examinations.

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Annual Cost to Federal Government: $1,022

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/28/2010

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