Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 21-2680 Examination for Housebound Status or Permanent Need for Regular Aid and Attendance	Form	Modified	Available
30-Day (published) 2900-0721.pdf	Supplementary Document	Uploaded 2026-02-13	Repair queued
2025-22331, 60-Day FRN (2900-0721, VAF21-2680).pdf	Supplementary Document	Uploaded 2025-12-10	Available
2900-0721, Supporting Statement (VAF21-2680)(2-13-26).docx	Supporting Statement A	Uploaded 2026-02-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
185651	Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)	Form	Modified	Examination for Housebound Status or Permanent Need for Regular Aid and Attendance
185651	Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)	Form	Modified

ICR Details

OMB Control No: 2900-0721	ICR Reference No: 202512-2900-001
Status: Received in OIRA	Previous ICR Reference No: 202111-2900-009
Agency/Subagency: VA	Agency Tracking No: VBA-COMP-KM
Title: Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/13/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	112,587	103,915
Time Burden (Hours)	56,294	51,958
Cost Burden (Dollars)	0	0

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Abstract: VA Form 21-2680 is used to determine eligibility for the aid and attendance and/or housebound benefits. The purpose of this examination is to record manifestations and findings pertinent to the question of whether the claimant is housebound (confined to the home or immediate premises) or in need of the regular aid and attendance of another person. The report should be in sufficient detail for the VA decision makers to determine the extent that disease or injury produces physical or mental impairment, that loss of coordination or enfeeblement affects the ability: to dress and undress; to feed themselves; to attend to the wants of nature; or keep themselves ordinarily clean and presentable. Findings should be recorded to show whether the claimant is blind or bedridden. Whether the claimant seeks housebound or aid and attendance benefits, the report should reflect how well they ambulate, where they go, and what they are able to do during a typical day. Without this information, entitlement to these benefits cannot be determined.

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Authorizing Statute(s): US Code: 38 USC 1521(e) Name of Law: Veterans of a period of war
   US Code: 38 USC 1114 Name of Law: Rates of wartime disability compensation
   US Code: 38 USC 1115(1)(e) Name of Law: Additional compensation for dependents
   US Code: 38 USC 1311(d) Name of Law: Dependency and indemnity compensation to a surviving spouse
   US Code: 38 USC 1541(d) Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1541(e) Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1521(d) Name of Law: Veterans of a period of war
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 57131	12/09/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 6982	02/13/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Examination for Housebound Status or Permanent Need for Regular Aid and Attendance (VA Form 21-2680)	21-2680	Examination for Housebound Status or Permanent Need for Regular Aid and Attendance

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ICR Summary of Burden

table that charts list of burden

	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	112,587	103,915	0	8,672	0	0
Annual Time Burden (Hours)	56,294	51,958	0	4,336	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The respondent burden has increased due to the estimated number of receivables averaged over the past year.

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Annual Cost to Federal Government: $17,319,308

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 02/13/2026

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