OMB control number

Camp Lejeune Family Member Program - Reimbursement of Certain Medical Expenses

OMB 2900-0822 · VA.

OMB 2900-0822

Under 38 U.S.C. 1787, VA is required to furnish hospital care and medical services to the family members of certain veterans who were stationed at Camp Lejeune between 1953 and 1987. In order to furnish such care, VA must collect necessary information from the family members to ensure that they meet the requirements of the law. The specific hospital care and medical services that VA must provide are for a number of illnesses and conditions connected to exposure to contaminated drinking water while at Camp Lejeune. VA will furnish Camp Lejeune family members with hospital care and medical services for 15 illnesses and conditions that are life threatening and require immediate medical intervention. The forms in this collection will be used to determine eligibility and reimbursement for this medical care. Some minor changes to the wording in VA Form 10-10068b have been made to clarify the information being collected from the treating physician. Also, VA Form 10-10068b may now be used up to two times annually per patient, and there is an associated increase in the estimated burden hours.

The latest form for Camp Lejeune Family Member Program - Reimbursement of Certain Medical Expenses expires 2028-09-30 and is listed under ICR 202504-2900-009.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 10-10068c Camp Lejeune Family Member Program - Information Update Form	Form and Instruction
Form 10-10068c Camp Lejeune Family Member Program - Information Update Form	Form and Instruction
Form 10-10068b Camp Lejeune Family Member Program - Treating Physician Report	Form and Instruction
Form 10-10068b Camp Lejeune Family Member Program - Treating Physician Report	Form and Instruction
Form 10-10068a Camp Lejeune Family Member Program - Claim Form	Form and Instruction
Form 10-10068a Camp Lejeune Family Member Program - Claim Form	Form and Instruction
Form 10-10068 Camp Lejeune Family Member Program - Application	Form and Instruction
Form 10-10068 Camp Lejeune Family Member Program - Application	Form and Instruction
VHA 30-Day FRN_Public Comment Response_2900-0822_CLFMP_08192025.pdf	Supplementary Document
VHA 60-day FRN_Public Comment Response_2900-0822_CLFMP_08072025.pdf (document unavailable)	Supplementary Document
PC_202504-2900-009_080525_100215_1.pdf (document unavailable)	Public Comments
VA-2025-VACO-0001-0062.pdf (document unavailable)	Public Comments
30-day FRN_2900-0822_Camp Lejeune Family Member Program_pub 08012025.pdf	Supplementary Document
60-day FRN_2900-0822_Camp Lejeune Family Member Program_pub 05292025.pdf	Supplementary Document
60-day FRN_2900-0822_Camp Lejeune Family Member Program_pub 05292025.pdf	Supplementary Document
SSA_2900-0822_Camp Lejeune Family Member Prog - Reimb of Medical Exp _updated Aug 2025.docx	Supporting Statement A
SSA_2900-0822_Camp Lejeune Family Member Prog - Reimb of Medical Exp _updated Aug 2025.docx	Supporting Statement A
Camp Lejeune Family Member Program - Information Update Form	Form and Instruction
Camp Lejeune Family Member Program - Information Update Form	Form and Instruction
Camp Lejeune Family Member Program - Treating Physician Report	Form and Instruction
Camp Lejeune Family Member Program - Treating Physician Report	Form and Instruction
Camp Lejeune Family Member Program - Claim Form	Form and Instruction
Camp Lejeune Family Member Program - Claim Form	Form and Instruction
Camp Lejeune Family Member Program - Application	Form and Instruction
Camp Lejeune Family Member Program - Application	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202504-2900-009	Revision of a currently approved collection	2025-08-01
202112-2900-006	Reinstatement without change of a previously approved collection	2022-07-20	Approved without change
201412-2900-005	Reinstatement with change of a previously approved collection	2015-05-18	Approved without change
201403-2900-015	New collection (Request for a new OMB Control Number)	2014-03-26	Approved with change

OMB Details

Camp Lejeune Family Member Program - Application

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
Form	Name	Electronic access	Type
Form 10-10068	Camp Lejeune Family Member Program - Application	Fillable Printable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.