Disabled Veterans Application for Vocational Rehabilitation and 38 CFR 21.30 (VA Form 28-1900)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 28-1900 APPLICATION FOR VOCATIONAL REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES (Chapter 31, Title 38, U. S. C.)	Form	Modified	Available
Supporting Statement VAF 28-1900 FINAL.docx	Supporting Statement A	Uploaded 2019-11-01	Available
30-Day FRN - 2900-0009 (2019).pdf	Supplementary Document	Uploaded 2019-04-30	Available
60-Day FRN - 2900-0009 (2019).pdf	Supplementary Document	Uploaded 2019-03-13	Available
Justification for Expired VAF 28.docx	Supplementary Document	Uploaded 2019-01-24	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
28085	Application for Vocational Rehabilitation for Veterans with Service-connected Disabilities (Chapter 31, Title 38 U.S.C.)(28-1900)	Form	Modified	APPLICATION FOR VOCATIONAL REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES (Chapter 31, Title 38, U. S. C.)

ICR Details

OMB Control No: 2900-0009	ICR Reference No: 201708-2900-031
Status: Historical Active	Previous ICR Reference No: 201312-2900-001
Agency/Subagency: VA	Agency Tracking No: VBA-VR&E-YA
Title: Disabled Veterans Application for Vocational Rehabilitation and 38 CFR 21.30 (VA Form 28-1900)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/05/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/28/2019
Terms of Clearance: In any subsequent extension or revision request, VA will consult with its Privacy Office to ensure that the Privacy Act statement meets all applicable requirements.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved
Responses	128,515	0	0
Time Burden (Hours)	21,419	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Veterans with compensable service-connected disabilities use VA Form 28-1900 to apply for vocational rehabilitation under 38 U.S.C. chapter 31. The application obtains information used to determine eligibility for this benefit, to schedule an appointment for an evaluation, and to help determine entitlement.

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Authorizing Statute(s): US Code: 38 USC 5101(a) Name of Law: Claims and forms
   US Code: 38 USC 501(a)(1) Name of Law: Rules and regulations
   US Code: 38 USC chapter 31 Name of Law: Training and Rehabilitation For Veterans with Service-Connected Disabilities
  

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:
	84 FR 4610	02/15/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 16765	04/22/2019
Did the Agency receive public comments on this ICR? No

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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
Application for Vocational Rehabilitation for Veterans with Service-connected Disabilities (Chapter 31, Title 38 U.S.C.)(28-1900)	28-1900	APPLICATION FOR VOCATIONAL REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES (Chapter 31, Title 38, U. S. C.)

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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	128,515	0	0	60,671	0	67,844
Annual Time Burden (Hours)	21,419	0	0	4,458	0	16,961
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: There was a significant increase in the number of respondents that caused the increase of the burden.

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Annual Cost to Federal Government: $5,339,948

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 05/28/2019

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