[Federal Register Volume 75, Number 114 (Tuesday, June 15, 2010)]
[Notices]
[Pages 33897-33898]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-14316]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900--New (21-0960a-c)]


Agency Request for Emergency Approval of an Information 
Collection

AGENCY: Department of Veterans Affairs.

ACTION: Notice and request for comments.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-3521), this notice announces that the United States 
Department of Veterans Affairs (VA) will submit to the Office of 
Management and Budget (OMB) the following emergency proposal for the 
collection of information under the PRA. The reason for the emergency 
clearance is to allow VA to collect information from private physicians 
in the form of making available standardized disability benefits 
questionnaires that private physicians can complete at the request and 
consent of individual veterans applying for VA disability benefits. The 
medical information provided by the private physicians will be used as 
supporting medical documentation for veterans' disability claims.

DATES: Comments should be submitted on or before June 29, 2010.

ADDRESSES: Submit written comments on the collection of information 
through http://www.Regulations.gov or to VA's OMB Desk Officer, OMB 
Human Resources and Housing Branch, New Executive Office Building, Room 
10235, Washington, DC 20503 (202) 395-7316. Please refer to ``OMB 
Control No. 2900-New (21-0960a-c)'' in any correspondence.

FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue, 
NW., Washington, DC 20420, (202) 461-7485, FAX (202) 273-0443 or e-mail 
[email protected]. Please refer to ``OMB Control No. 2900-New (21-
0960a-c)'' in any correspondence.

SUPPLEMENTARY INFORMATION:
    Titles:
    a. Ischemic Heart Disease (IHD) Disability Benefits Questionnaire, 
VA Form 21-0960A.
    b. Hairy Cell and Other B-Cell Leukemias Disability Benefits 
Questionnaire, VA Form 21-0960B.
    c. Parkinson's Disease Disability Benefits Questionnaire, VA Form 
21-0960C.
    OMB Control Number: 2900--New (21-0960a-c).
    Type of Review: New collection.
    Abstract: In connection with The Agent Orange Act of 1991, Public 
Law No. 102-4, VA will publish a Final Rule establishing presumptive 
service connection for the following diseases based on herbicide 
exposure: Hairy cell leukemia and other chronic B-cell leukemias, 
Parkinson's disease, and ischemic heart disease. In order to more 
expeditiously process claims related to these three new presumptive 
diseases, VA has designed three corresponding Disability Benefits 
Questionnaires for use by private physicians at the request and consent 
of veterans applying for VA benefits. Veterans will have the option of 
providing these Disability Benefits Questionnaires to their private 
physicians for completion and submission to VA in lieu of scheduling a 
VA medical examination. Given the large number of claims VA anticipates 
for the three new presumptive diseases, the Disability Benefits 
Questionnaires will assist in expediting claims processing because 
veterans who choose to have the Disability Benefits

[[Page 33898]]

Questionnaires completed by private physicians will avoid any VA 
examination scheduling delays.
    Affected Public: Individuals or households.
    Estimated Annual Burden:
    a. Ischemic Heart Disease (IHD) Disability Benefits Questionnaire, 
VA Form 21-0960A--13,750.
    b. Hairy Cell and Other B-Cell Leukemias Disability Benefits 
Questionnaire, VA Form 21-0960B--500.
    c. Parkinson's Disease Disability Benefits Questionnaire, VA Form 
21-0960C--1,250.
    Estimated Average Burden per Respondent: 15 minutes.
    Frequency of Response: On occasion.
    Estimated Number of Respondents:
    a. Ischemic Heart Disease (IHD) Disability Benefits Questionnaire, 
VA Form 21-0960A--55,000.
    b. Hairy Cell and Other B-Cell Leukemias Disability Benefits 
Questionnaire, VA Form 21-0960B--2,000.
    c. Parkinson's Disease Disability Benefits Questionnaire, VA Form 
21-0960C--5,000.

    Dated: June 10, 2010.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2010-14316 Filed 6-14-10; 8:45 am]
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