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

Documents and Forms

Document Name Document Type
Form VA Form 20-0995 Decision Review Request: Supplemental Claim (VA Form 20-0995) Form
VA Form 20-0995 Decision Review Request: Supplemental Claim 20-0995(4-22-24).pdf www.va.gov/vaforms Form
VA Form 20-0995 Decision Review Request: Supplemental Claim 20-0995(4-22-24).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:

Is this a Common Form? No		IC Status: Modified

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	VA Form 20-0995	Decision Review Request: Supplemental Claim	20-0995(4-22-24).pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title: 58/VA21/22/28, Compensation, Pension, Education and Veteran Readiness and Employment Records	FR Citation: 89 FR 28853

Number of Respondents: 640,477	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	Previously Approved
Annual Number of Responses for this IC	640,477	375,477	265,000
Annual IC Time Burden (Hours)	160,119	93,869	66,250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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