Information Collection

Decision Review Request: Supplemental Claim (VA Form 20-0995)

IC 244441 under ICR 202011-2900-001 · OMB 2900-0886.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0886 can be found here:

Documents and Forms

Document Name Document Type
Form 20-0995 Decision Review Request: Supplemental Claim (VA Form 20-0995) Form
20-0995 DECISION REVIEW REQUEST: SUPPLEMENTAL CLAIM VA Form 20-0995 (508 CONFORMANT 12-23-20).pdf www.va.gov/vaforms Form
20-0995 DECISION REVIEW REQUEST: SUPPLEMENTAL CLAIM VA Form 20-0995 (508 CONFORMANT 12-23-20).pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Decision Review Request: Supplemental Claim (VA Form 20-0995)	Agency IC Tracking Number:	VBA-OAR-YA

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.2501

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	20-0995	DECISION REVIEW REQUEST: SUPPLEMENTAL CLAIM	VA Form 20-0995 (508 CONFORMANT 12-23-20).pdf	www.va.gov/vaforms	Yes	No	Fillable Fileable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58/VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records	FR Citation: 84 FR 4138

Number of Respondents: 265,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	265,000	265,000
Annual IC Time Burden (Hours)	66,250	66,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.