30-Day FRN (2900-0809)

30-day FRN - 2900-0809 (2017).pdf

Hand and Finger Conditions Disability Benefits Questionnaire (VA Form 21-0960M-7)

30-Day FRN (2900-0809)

OMB: 2900-0809

Document [pdf]
Download: pdf | pdf
18538

Federal Register / Vol. 82, No. 74 / Wednesday, April 19, 2017 / Notices

www.Regulations.gov, or to Office of
Information and Regulatory Affairs,
Office of Management and Budget, Attn:
VA Desk Officer; 725 17th St. NW.,
Washington, DC 20503 or sent through
electronic mail to oira_submission@
omb.eop.gov. Please refer to ‘‘OMB
Control No. 2900–0802’’ in any
correspondence.
Cynthia Harvey-Pryor, Enterprise
Records Service (005R1B), Department
of Veterans Affairs, 810 Vermont
Avenue NW., Washington, DC 20420,
(202) 461–5870 or email [email protected]. Please refer to ‘‘OMB
Control No. 2900–0802’’ in any
correspondence.
SUPPLEMENTARY INFORMATION:

jstallworth on DSK7TPTVN1PROD with NOTICES

Authority: 44 U.S.C. 3501–21.

Title: Shoulder and Arm Conditions
Disability Benefits Questionnaire (VA
Form 21–0960M–12).
OMB Control Number: 2900–0802.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 21–0960 series is
used to gather necessary information
from a claimant’s treating physician
regarding the results of medical
examinations. VA gathers medical
information related to the claimant that
is necessary to adjudicate the claim for
VA disability benefits. The Disability
Benefit Questionnaire title will include
the name of the specific disability for
which it will gather information. VA
Forms 21–0960M–12 is used to gather
information related to the claimant’s
diagnosis of a shoulder or arm
condition.
An agency may not conduct or
sponsor, 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 82 FR
16, on January 26, 2017, page 8568.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 25,000.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
50,000.
By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise
Records Service, Office of Quality and
Compliance, Department of Veterans Affairs.
BILLING CODE 8320–01–P

VerDate Sep<11>2014

15:06 Apr 18, 2017

Jkt 241001

[OMB Control No. 2900–0809]

Agency Information Collection Activity
Under OMB Review: Hand and Finger
Conditions Disability Benefits
Questionnaire
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

FOR FURTHER INFORMATION CONTACT:

[FR Doc. 2017–07865 Filed 4–18–17; 8:45 am]

DEPARTMENT OF VETERANS
AFFAIRS

In compliance with the
Paperwork Reduction Act (PRA) of
1995, this notice announces that the
Veterans Benefits Administration,
Department of Veterans Affairs, will
submit the collection of information
abstracted below to the Office of
Management and Budget (OMB) for
review and comment. The PRA
submission describes the nature of the
information collection and its expected
cost and burden and it includes the
actual data collection instrument.
DATES: Comments must be submitted on
or before May 19, 2017.
ADDRESSES: Submit written comments
on the collection of information through
www.Regulations.gov, or to Office of
Information and Regulatory Affairs,
Office of Management and Budget, Attn:
VA Desk Officer; 725 17th St. NW.,
Washington, DC 20503 or sent through
electronic mail to oira_submission@
omb.eop.gov. Please refer to ‘‘OMB
Control No. 2900–0809’’ in any
correspondence.
SUMMARY:

FOR FURTHER INFORMATION CONTACT:

Cynthia Harvey-Pryor, Enterprise
Records Service (005R1B), Department
of Veterans Affairs, 810 Vermont
Avenue NW., Washington, DC 20420,
(202) 461–5870 or email [email protected]. Please refer to ‘‘OMB
Control No. 2900–0809’’ in any
correspondence.
SUPPLEMENTARY INFORMATION:

Authority: 44 U.S.C. 3501–21.

Title: Hand and Finger Conditions
Disability Benefits Questionnaire (VA
Form 21–0960M–7).
OMB Control Number: 2900–0809.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 21–0960 series is
used to gather necessary information
from a claimant’s treating physician
regarding the results of medical
examinations. VA gathers medical
information related to the claimant that
is necessary to adjudicate the claim for
VA disability benefits. The Disability
Benefit Questionnaire title will include
the name of the specific disability for

PO 00000

Frm 00123

Fmt 4703

Sfmt 4703

which it will gather information. VAF
21–0960M–7, Hand and Finger
Conditions Disability Benefits
Questionnaire, will gather information
related to the claimant’s diagnosis of a
hand or finger condition.
An agency may not conduct or
sponsor, 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 82 FR
43, on March 7, 2017, page 12912.
Affected Public: Individuals or
Households.
Estimated Annual Burden: 15,000.
Estimated Average Burden per
Respondent: 30 minutes.
Frequency of Response: One time.
Estimated Number of Respondents:
30,000.
By direction of the Secretary.
Cynthia Harvey-Pryor,
Department Clearance Officer, Enterprise
Records Service, Office of Quality and
Compliance, Department of Veterans Affairs.
[FR Doc. 2017–07864 Filed 4–18–17; 8:45 am]
BILLING CODE 8320–01–P

DEPARTMENT OF VETERANS
AFFAIRS
[OMB Control No. 2900–0779]

Agency Information Collection
Activity: Hematologic and Lymphatic
Conditions, Including Leukemia
Disability Benefits Questionnaire,
Amyotrophic Lateral Sclerosis (Lou
Gehrig’s Disease) Disability Benefits
Questionnaire, Peripheral Nerve
Conditions (Not Including Diabetic
Sensory-Motor Peripheral Neuropathy)
Disability Benefits Questionnaire,
Persian Gulf and Afghanistan
Infectious Diseases Disability Benefits
Questionnaire, Tuberculosis Disability
Benefits Questionnaire, Kidney
Conditions (Nephrology) Disability
Benefits Questionnaire, Male
Reproductive Organ Conditions
Disability Benefits Questionnaire,
Prostate Cancer Disability Benefits
Questionnaire, Eating Disorders
Disability Benefits Questionnaire,
Mental Disorders (Other Than PTSD
and Eating Disorders) Disability
Benefits Questionnaire, Review Post
Traumatic Stress Disorder (PTSD)
Disability Benefits Questionnaire
Veterans Benefits
Administration, Department of Veterans
Affairs.
ACTION: Notice.
AGENCY:

E:\FR\FM\19APN1.SGM

19APN1


File Typeapplication/pdf
File Modified2017-04-19
File Created2017-04-19

© 2024 OMB.report | Privacy Policy