Emergency Federal Register Notice

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FR Doc 2010-14316

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IFederal Register: June 15, 20L0 (Vofume 75, Number ]-14)l

INotices ]
IPage 33897-33898]
From the FederaL Register Online via
lDoCrD: fr15jn10-1661

GPO

Access Iwais'access.gpo.gov]

DEPARTMENT OF VETERANS AFFAIRS

IOMB

Control No. 2900--New (21-0960a-c)

l

Agency Request for Emergency Approval of an Informatj-on

Collection

AGENCY: Department

of Veterans Affairs.

ACTION: Notice and request

for

comments.

In compl-iance with the Paperwork Reduction Act (PRA) of 1995
(44 U.S.C. 350L-3521"), this notice announces that the United States
Department of Veterans Affairs (VA) will submit to the Office of
Management and Budget (OMB) the foltowing emergency proposal for the
coffection of information under the PRA. The reason for the emergency
clearance is to al-Iow VA to coll-ect information from private physicians
in the form of making availabl-e standardized disability benefits
questionnaires that private physicians can complete at the request and
consent of individuaÌ veterans applying for VA disability benefits. The
medicaÌ information provided by the private physicians wil-l be used as
supporting medical documentation for veterans' disabiÌity claims.
SUMMARY:

DATES: Comments should

be submitted on or before June 29,

2OIO.

Submit written comments on the collection of information
through http:/,/www.Requfations.qov or to VA's OMB Desk Officer' OMB
Human Resources and Housing Branch, New Executive Office Building, Room
10235, Vùashington, DC 20503 (202) 395-7316. Please refer to "OMB
ControL No. 2900-New (21--0960a-c)tt in any correspondence.

ADDRESSES:

Denise Mclamb, Enterprise Records
(005R1B),
Affairs, 810 Vermont Avenue,
Veterans
Department
of
Service
(202)
FAX (202) 273-0443 or e-mail
461,-7485,
DC
2O42Ot
V{ashington,
NVü.,
denise.mcfambGva.qov. Please refer to "OMB Control No' 2900-New (2I0960a-c) " in any correspondence.
FOR FURTHER INFORMATION CONTACT:

SUPPLEMENTARY ]NFORMATION

:

Titfes:
a. Ischemic Heart Disease (IHD) Disabi.l-ity Benefits Questionnaire,

VA Form 21-09604.

b. Hairy celf and other B-celt Leukemias Disability Benefits
Questionnaire, VA Form 21-09608.
c. Parkinsonrs Disease Disability Benefits Questionnaire, VA Form
2r-0960c.

Control Number: 2900--New (2L-0960a-c).
Type of Review: New collection.
Abstract: ln connection with The Agent Orange Act of I99I, Public
Law No. lO2-4, VA will pubtish a Final RuIe establishing presumptive
OMB

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FR Doc 2010-14316

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service connection for the foll-owing diseases based on herbicide
exposure: Hairy cell leukemia and other chronic B-cetl leukemias,
paixinson's disease, and ischemic heart disease. In order to more
expeditiousÌy process claims related to these three new presumptive
dileases, VA has designed three corresponding Disabitity Benefits
request and consent
euestionnaires for usã by private physicíans at the have
the option of
wilt
Veterans
VA
benefits.
for
õf veterans applying
providing these pi"áUifity Benefits Questionnaires to their private a
to VA in lieu of scheduling
þnysicians for completion and submission
ïA-medical examinatior,. Given the large number of claíms VA anticipates
for the three new presumptive diseases, the Disability Benefits
Questionnaires will assist in expediting claims processing because
veterans who choose to have the Disability Benefits
[ [Page 33898] l

Questíonnaires completed by private physicians will avoid any vA
examination scheduling delaYs.
Affected Public: Individuals or households'
Estinated Annual Burden:
a. Ischemic Heart Disease (IHD) Disability Benefits Questionnaire¡

VA Form 21-09604--13, 750.
b. Hairy cell and Other B-cett Leukemias Disabil-ity Benefits
Questionnaire, VA Form 2L-09608--500.
c. parkinson''s Disease Disability Benefits Questionnaire, VA Form
2L-0960C--1,250 .

EstimatedAverageBurdenperRespondent:].5minutes.
Frequency of Response: On occasion'
Estinated Number of ResPondents:
a. Ischemic Heart Disease (IHD) Disabifity Benefits Questionnaire,

VA Form 21-09604--55, 000.
b. Hairy cell- and other B-celL Leukenias Disability Benefits
Questionnaire, VA Form 21-09608--2,000'
c. parkinson's Disease Disability Benefits Questionnaire' VA Form
21-0960C--5, 000.

Dated: June L0, 2010.
By direction of the Secretary.
Denise Mclamb,
Program Analyst, Enterprise Records Service'
IFR Doc. 2010-143L6 Filed 6-14-10; 8:45 am]
BILLING CODE 8320-01-P

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