Supporting Statement - Part A
Application for DIC, Survivors Pension, and/or Accrued Benefits
Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)
Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child – In-Service Death Only
Control #2900-0004
Summary of Changes from Previously Approved Collection
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1. Need for the Information Collection
The Department of Veterans Affairs (VA) through its Veterans Benefits Administration (VBA) administers an integrated program of benefits and services, established by law, for Veterans, service personnel, and their dependents and/or beneficiaries. Title 38 U.S.C. 1151; 1310; 1541; 1542; 5101(a); and 5121 provides that a specific claim in the form provided by the Secretary must be filed for benefits to be paid to any individual under the laws administered by the Secretary.
This control number includes 3 prescribed forms which are used to by survivors of deceased Veterans to apply for benefits:
VA Form 21P-534EZ, Application for DIC, Survivors Pension, and/or Accrued Benefits
VA Form 21P-534, Application for Dependency and Indemnity Compensation, Survivors Pension and Accrued Benefits by a Surviving Spouse or Child (Including Death Compensation if Applicable)
VA Form 21P-534a, Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child – In-Service Death Only.
The VA Form 21P-534EZ is a revision.
VA Form 21P-534EZ has been updated to include:
Updated instructions.
Removed “Fully Developed Claim” (FDC) information from the instructions.
Removed the parenthesis from Question 1D.
Split 3H into two separate questions.
Split 3K (start and end dates) into two separate questions.
Add a note to Section IV.
Split 4D (start and end dates) into two separate questions.
Split 4M (start and end dates) into two separate questions.
Replace the note under Section V with a question, to include a check-box.
Split 5C (start and end dates) into two separate questions.
Split 5H (start and end dates) into two separate questions.
Split 5N (start and end dates) into two separate questions.
Split 5S (start and end dates) into two separate questions.
Add a note to Section VI.
Split 6R into two separate questions.
Split 7B into four separate questions.
Change the dollar amount in 9A to $75,000 from $25,000.
Realign the checkboxes in 9A vertically.
Change the wording of Question 9G.
Add checkboxes for “custodian” and “custodian’s spouse” to 9I(1) – 9L(1).
Split 10B(2) into two separate questions.
Split 10B(3) into two separate questions.
Split 10B(4) into two separate questions.
Split 10C(2) into two separate questions.
Split 10C(3) into two separate questions.
Split 10C(4) into two separate questions.
Split 10D(2) into two separate questions.
Split 10D(3) into two separate questions.
Split 10D(4) into two separate questions.
Split 10E(2) into two separate questions.
Split 10F(2) into two separate questions.
Split 10G(2) into two separate questions.
Split 10H(2) into two separate questions.
Split 10I(2) into two separate questions.
Removed “Fully Developed Claim” (FDC) information from Section XII.
Split 13B into two separate questions.
Split 13D into two separate questions.
Add “of the facility or” to Question 6 of the Worksheet (page 19).
Add two columns and a checkbox of “yes” and “no” to Question 9 of the Worksheet (page 19).
Change the wording of Question 11 of the Worksheet (page 19).
Change the wording of Question 12 of the Worksheet (page 19).
Change the wording of Question 13 of the Worksheet (page 19).
Change the wording of Question 12 of the Worksheet (page 20).
The 21P-534 is being discontinued; the discontinuance will have no negative impact on the collection.
No changes have been made to the VA Form 21P-534a.
The respondent burden has decreased due to the discontinuance of the 21P-534 from this collection.
2. Use of the Information
The VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. The VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active-duty service. The VA Form 21P-534EZ is used for the Fully Developed Claims (FDC) program for pension, DIC, and accrued claims. Without this information, determination of entitlement would not be possible.
3. Use of Information Technology
This collection is available in a fillable electronic format on the external, public-facing VA.gov website. VBA is hosting this form on a secure server and does not currently have the technology in place to allow for its complete submission. Validation edits are performed to assure data integrity. There currently is no utility process that will allow the data submitted on the form to be incorporated with an existing centralized legacy database.
4. Non-Duplication
The information obtained through this collection is unique and is not already available for use or adaptation from another cleared source.
5. Burden on Small Businesses
This information collection does not impose a significant economic impact on a substantial number of small businesses or entities.
6. Less Frequent Collection
The VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. The VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active-duty service. The VA Form 21P-534EZ is used for the Fully Developed Claims (FDC) program for pension claims, DIC and accrued claims. Without this information, determination of entitlement would not be possible.
7. Paperwork Reduction Act Guidelines
This collection of information does not require collection to be conducted in a manner inconsistent with the guidelines delineated in 5 CFR 1320.5(d)(2).
8. Consultation and Public Comments
Part A: PUBLIC NOTICE
A 60-Day Federal Register Notice (FRN) for the collection published on Tuesday, May 20, 2025. The 60-Day FRN citation is 90 FRN 21549.
No comments were received during the 60-Day Comment Period.
A 30-Day Federal Register Notice for the collection published on Thursday, July 24, 2025. The 30-Day FRN citation is 90 FRN 34971.
Part B: CONSULTATION
No additional consultation apart from soliciting public comments through the Federal Register was conducted for this submission.
9. Gifts or Payment
No payments or gifts are being offered to respondents as an incentive to participate in the collection.
10. Confidentiality
The records are maintained in the appropriate Privacy Act System of Records identified as “Compensation, Pension, Education, and Veteran Readiness and Employment Records-VA (58VA21/22/28),” published at 74 FR 29275 on June 19, 2009, and last amended at 87 FR 8740 (February 16, 2022).
11. Sensitive Questions
No questions considered sensitive are being asked in this collection.
12. Respondent Burden and its Labor Costs
Number of Respondents is estimated at 111,000 per year.
VA Form 21P-534EZ total is 110,000
VA Form 21-534a total is 1,000
Frequency of Response is one time.
Annual burden hours are 51,800 hours.
The estimated completion time for this collection is 28 minutes.
VA Form 21P-534EZ completion time is 40 minutes
VA Form 21-534a completion time is 15 minutes
VA cannot make further assumptions about the population of respondents because of the variability of factors such as the educational background and wage potential of respondents. Therefore, VBA used general wage data to estimate the respondents’ costs associated with completing the information collection.
The Bureau of Labor Statistics (BLS) gathers information on full-time wage and salary workers. According to the latest available BLS data, the mean hourly wage is $32.66 based on the BLS wage code – “00-0000 All Occupations.” This information was taken from the following website: https://data.bls.gov/oes/#/industry/000000.
Legally, respondents may not pay a person or business for assistance in completing the information collection. Therefore, there are no expected overhead costs for completing the information collection. VBA estimates the total cost to all respondents to be $1,691,788 (51,800 burden hours x $32.66 per hour).
13. Respondent Costs Other Than Burden Hour Costs
There are no annualized costs to respondents other than the labor burden costs addressed in Section 12 of this document to complete this collection.
14. Cost to the Federal Government
Grade |
Step |
Burden Time |
Fraction of Hour |
Hourly Rate |
Cost Per Response |
Total Responses |
Total |
9 |
3 |
20 |
0.33 |
$35.74 |
11.91 |
111,000 |
$ 1,322,380.00 |
Overhead at 100% Salary |
$ 1,322,380.00 |
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12 |
3 |
15 |
0.25 |
$51.83 |
12.96 |
111,000 |
$ 1,438,282.50 |
Overhead at 100% Salary |
$ 1,438,282.50 |
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|
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Processing / Analyzing Costs |
$ 5,521,325.00 |
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Printing and Production Cost |
$ 61,348.06 |
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Total Cost to Government |
$ 5,582,673.06 |
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Overhead costs are 100% of salary and are the same as the wage listed above and the amounts are included in the total.
Printing and production costs approximates the cost of printing this information collection per year. (Processing/Analyzing Cost total divided by $90).
Note: The hourly wage information above is based on the hourly 2024 General Schedule (Base) Pay (Pay & Leave : Salaries & Wages - OPM.gov). This rate does not include any locality adjustment as applicable.
The processing time estimates above are based on the actual amount of time employees of each grade level spend to process to completion a claim received on this form. The within-grade step (3) of each employee represents the average experience of employees within each grade.
15. Reasons for Change in Burden
The burden has decreased since the previous approval due to the discontinuance of the 21P-534 from this collection.
16. Publication of Results
The results of this information collection will not be published.
17. Non-Display of OMB Expiration Date
We are not seeking approval to omit the display of the expiration date of the OMB approval on the collection instrument.
18. Exceptions to “Certification for Paperwork Reduction Submissions”
We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Kaitlin Chiarelli |
| File Modified | 0000-00-00 |
| File Created | 2025-07-26 |