Notice of Disagreement

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
30-day Notice 8.3.2015.docx	Supplementary Document	Uploaded 2015-08-04	Repair queued
60-day Federal Register Notice 021815.pdf	Supplementary Document	Uploaded 2015-07-07	Available
2015 Supporting Statement NOD 52215.doc	Supporting Statement A	Uploaded 2015-06-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28952	Notice of Disagreement		Modified

ICR Details

OMB Control No: 2900-0674	ICR Reference No: 201412-2900-006
Status: Historical Active	Previous ICR Reference No: 201112-2900-004
Agency/Subagency: VA	Agency Tracking No: 2900-0674
Title: Notice of Disagreement
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/28/2015
	Date Received in OIRA: 08/17/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2018	36 Months From Approved	09/30/2015
Responses	122,487	0	135,505
Time Burden (Hours)	122,487	0	135,505
Cost Burden (Dollars)	0	0	0

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Abstract: Appellate review of the denial of Department of Veterans Affairs (VA) benefits is initiated by a claimant, or his/her representative, filing a Notice of Disagreement. A Notice of Disagreement is a written communication that expresses dissatisfaction/disagreement with an adjudicative determination by the agency of original jurisdiction (AOJ) and a desire to contest the result. An agency may not conduct or sponor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published at 80 FR 8764, 02/18/2015.

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Authorizing Statute(s): US Code: 38 USC 7105 Name of Law: Part V. Boards, Administrations, and Services
  

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:
	80 FR 8764	02/18/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 47563	08/07/2015
Did the Agency receive public comments on this ICR? Yes

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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
Notice of Disagreement

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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	122,487	135,505	0	-13,018	0	0
Annual Time Burden (Hours)	122,487	135,505	0	-13,018	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There are no program changes. Adjustments reflect a change in the number of Notices of Disagreement filed.

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Annual Cost to Federal Government: $2,661,879

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]? No

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: 08/17/2015

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