60-day FRN

2900-NEW (21-0960M-14)(60-day).pdf

Back (Thoracolumbar Spine)Conditions Disability Benefits Questionnaire (21-0960M-14)

60-day FRN

OMB: 2900-0808

Document [pdf]
Download: pdf | pdf
36308

Federal Register / Vol. 78, No. 116 / Monday, June 17, 2013 / Notices

(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.
SUPPLEMENTARY INFORMATION:
Title: Shoulder and Arm Conditions
Disability Benefits Questionnaire, VA
Form 21–0960M–12.
OMB Control Number: 2900–NEW
(Shoulder and Arm Conditions
Disability Benefits Questionnaire).
Type of Review: New data collection.
Abstract: The VA Form 21–0960M–
12, Shoulder and Arm Conditions
Disability Benefits Questionnaire, will
be used for disability compensation or
pension claims which require an
examination and/or receiving private
medical evidence that may potentially
be sufficient for rating purposes. The
form will be used to gather necessary
information from a claimant’s treating
physician regarding the results of
medical examinations and information
related to the claimant’s diagnosis of a
shoulder or arm condition. VA will
gather medical information related to
the claimant that is necessary to
adjudicate the claim for VA disability
benefits.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 25,000.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
50,000.
Dated: June 11, 2013.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of
Veterans Affairs.
[FR Doc. 2013–14223 Filed 6–14–13; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS

mstockstill on DSK4VPTVN1PROD with NOTICES

[OMB Control No. 2900—NEW]

Proposed Information Collection:
(Back (Thoracolumbar Spine)
Conditions Disability Benefits
Questionnaire) Activity: Comment
Request
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

VerDate Mar<15>2010

20:38 Jun 14, 2013

Jkt 229001

The Veterans Benefits
Administration (VBA) 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 new
collection, and allow 60 days for public
comment in response to the notice. This
notice solicits comments on information
needed to adjudicate the claim for VA
disability benefits related to a claimant’s
diagnosis of a back condition.

SUMMARY:

Written comments and
recommendations on the proposed
collection of information should be
received on or before August 16, 2013.

DATES:

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 (20M35), Department of
Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420 or email
[email protected]. Please refer to
‘‘OMB Control No. 2900—NEW
(Collection (Back (Thoracolumbar
Spine) Conditions Disability Benefits
Questionnaire)’’ in any correspondence.
During the comment period, comments
may be viewed online through the
FDMS.

ADDRESSES:

FOR FURTHER INFORMATION CONTACT:

Nancy J. Kessinger at (202) 632–8924 or
Fax (202) 632–8925.
Under the
PRA of 1995 (Public Law 104–13; 44
U.S.C. 3501–3521), Federal agencies
must obtain approval from 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.

SUPPLEMENTARY INFORMATION:

SUPPLEMENTARY INFORMATION:

PO 00000

Frm 00149

Fmt 4703

Sfmt 4703

Title: (Back (Thoracolumbar Spine)
Conditions Disability Benefits
Questionnaire, VA Form 21–0960M–14.
OMB Control Number: 2900–NEW
(Back (Thoracolumbar Spine)
Conditions Disability Benefits
Questionnaire).
Type of Review: New data collection.
Abstract: The VA Form 21–0960M–
14, Back (Thoracolumbar Spine)
Conditions Disability Benefits
Questionnaire, will be used for
disability compensation or pension
claims which require an examination
and/or receiving private medical
evidence that may potentially be
sufficient for rating purposes. The form
will be used to gather necessary
information from a claimant’s treating
physician regarding the results of
medical examinations and related to the
claimant’s diagnosis of a Thoracolumbar
spine condition. VA will gather medical
information related to the claimant that
is necessary to adjudicate the claim for
VA disability benefits.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 37,500.
Estimated Average Burden per
Respondent: 45 minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
50,000.
Dated: June 11, 2013.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, U.S. Department of
Veterans Affairs.
[FR Doc. 2013–14198 Filed 6–14–13; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900—NEW]

Proposed Information Collection
(Elbow and Forearm Conditions
Disability Benefits Questionnaire)
Activity: Comment Request
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

The Veterans Benefits
Administration (VBA) 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
new collection, and allow 60 days for

SUMMARY:

E:\FR\FM\17JNN1.SGM

17JNN1


File Typeapplication/pdf
File Modified2013-06-15
File Created2013-06-15

© 2024 OMB.report | Privacy Policy