Information Collection

Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire

IC 206553 under ICR 201304-2900-009 · OMB 2900-0801.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0801 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 21-0960M-3 Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire	Form
21-0960M-3 Non-Degenerative Arthritis (including inflammatory, auto 21-0960M-3.pdf www.va.gov/vaforms/	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire

Agency IC Tracking Number:

2900-NEW VBA-COMP-DB

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 38 CFR 3.326 38 CFR 3.351

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-0960M-3	Non-Degenerative Arthritis (including inflammatory, autoimmune, crystalline and infections arthritis) and Dysbaric Osteonecrosis Disability Benefits Questionnaire	21-0960M-3.pdf	http://www.va.gov/vaforms/	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records

Title: Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)

FR Citation: 75 FR 29275

Number of Respondents: 100,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	25,000	25,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.