Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)

ICR 202009-2900-013

OMB: 2900-0404

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
2900-0404 202009-2900-013
Received in OIRA 201611-2900-005
Veteran's Application for Increased Compensation Based on Unemployability (VA Form 21-8940)
Reinstatement with change of a previously approved collection   No
Regular 05/13/2021
  Requested Previously Approved
36 Months From Approved
19,609 0
14,707 0
0 0

VA Form 21-8940 is used by veterans to apply for increased VA disability compensation based on the inability to secure or follow a substantially gainful occupation due to service-connected disabilities. Without this information, entitlement to individual unemployability benefits could not be determined.

US Code: 38 USC 1163 Name of Law: Trial work periods and vocational rehabilitation for certain veterans with total disability ratings.

Not associated with rulemaking

  86 FR 13968 03/11/2021
86 FR 26258 05/13/2021

  Total Request 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 19,609 0 0 -4,391 0 24,000
Annual Time Burden (Hours) 14,707 0 0 -3,293 0 18,000
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Miscellaneous Actions
The respondent burden has decreased due to the estimated number of receivables averaged over the past year.

Maribel Aponte 202 266-4688 [email protected]


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:
    (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;
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.

© 2024 | Privacy Policy