Supporting Statement for VAF 21-0307 09-21-12-- rev 2-11-13

Supporting Statement for VA Form 21-0307

Award Attachment for Certain Children with Disabilities Born of Vietnam Veterans

(2900-0577)

A. Justification

1. The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services established by law for veterans, service personnel, and their dependents and/or beneficiaries. 38 U.S.C. 1805 provides for payment of benefits for a child with spina bifida who is the natural child of a veteran who served in the Republic of Vietnam during the Vietnam era. 38 U.S.C. 1815 provides for payment of benefits for a child with certain birth defects who is the natural child of a female veteran who served in the Republic of Vietnam during the Vietnam era. 38 U.S.C. 1803 and 1804 provide information about ancillary benefits. This form is used to provide children who have been awarded benefits with necessary information about ancillary benefits to include VA health care and vocational training programs.

2. VA Form 21-0307 is used to provide these children who have spina bifida or certain birth defects with information about VA health care and vocational training and gives the steps they must take to apply for such benefits. It would be impossible to provide information to them about these programs without this form.

3. VA Form 21-0307 is an information sheet and it is available on the One-VA Website in an electronic format for downloading by claimants. This form is for information only and has no fill-in, although it does provide information about benefits, in order to obtain which claimants may voluntarily provide information.

4. Program reviews were conducted to identify potential areas of duplication; however, none were found to exist. There is no known Department or Agency which maintains the necessary information, nor is it available from other sources within our Department.

5. The collection of information does not involve small businesses or entities.

6. VA Form 21-0307 provides information to a child of a Vietnam veteran with spina bifida or certain birth defects to inform them of potential entitlement to VA health care benefits and vocational training programs. Without the information provided on this form, potentially eligible children would not be able to apply for these benefits and VA could not authorize them.

7. There is no special circumstance requiring collection in a manner inconsistent with 5 CFR 1320.6 guidelines.

8. The Department notice was published in the Federal Register on October 4, 2012, page 60746. No comments were received. No comments were received.

9. No payments or gifts to respondents have been made under this collection of information.

10. We are complying with the provisions of 38 U. S. C.5701 and the Privacy Act of 1974, and 5 U. S. C. 522a. The records are maintained in the appropriate Privacy System of Records identified “Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28),” published at 74 FR 29275 on June 19, 2009, and last amended 75 FR 22187 (April 27, 2010).

11. There are no questions of a sensitive nature.

12. Estimate of Information Collection Burden.

a. Number of Respondents is estimated at 75 per year.

b. Frequency of Response is one time for most beneficiaries.

c. Annual burden is 19 hours.

d. The estimated completion time of 15 minutes is based on review by staff personnel and previous usage of this form.

e. The total estimated cost to respondents is $285 (19 x $15 per hour).

13. This submission does not involve any recordkeeping costs.

14. Estimated Costs to the Federal Government:

a. Processing/Analyzing costs $2,103

(GS- 9/5 @ $28.04 x 75 x 60/60 minutes = $2,103)

b. Printing and production cost ($45 per thousand) $45

c. Total cost to government $2,148

15. There is no change in the reporting burden.

16. The information collection is not for publication or tabulation use.

17. The collection instrument, VA Form 21-0307, may be reproduced and/or stocked by the respondents and veterans service organizations. This VA form does not display an expiration date, and if required to do so would result in unnecessary waste of existing stocks of this form. This form is submitted to OMB every 3 years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collecting, processing and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on VA Form 21-0307.

18. This submission does not contain any exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

1. The Veterans Benefits Administration does not collect information employing statistical methods.