[Federal Register Volume 75, Number 234 (Tuesday, December 7, 2010)]
[Notices]
[Pages 76081-76082]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-30552]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0749]
Agency Information Collection (Disability Benefits
Questionnaires) Activity Under OMB Review
AGENCY: Veterans Benefits Administration, Department of Veterans
Affairs.
ACTION: Notice.
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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 Veterans Benefits
Administration (VBA), Department of Veterans Affairs, will submit the
collection of information abstracted below to the Office of Management
and Budget (OMB) for review and comment. The PRA submission describes
the nature of the information collection and its expected cost and
burden; it includes the actual data collection instrument.
DATE: Comments must be submitted on or before January 6, 2011.
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. 2900-0749'' 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. 2900-0749.''
SUPPLEMENTAL INFORMATION:
Titles:
a. Ischemic Heart Disease (IHD) Disability Benefits Questionnaire,
VA Form 21-0960a-1.
b. Hairy Cell and Other B-Cell Leukemias Disability Benefits
Questionnaire, VA Form 21-0960b-1.
c. Parkinson's Disease Disability Benefits Questionnaire, VA Form
21-0960c-1.
OMB Control Number: 2900-0749.
Type of Review: Extension of a currently approved collection.
Abstract: VA Forms 21-0960a-1, 21-0960b-1, and 21-0960b-1 are used
to expedite claims for the following presumptive diseases based on
herbicide exposure: Hairy Cell and Other Chronic B-cell Leukemias,
Parkinson's and Ischemic Heart diseases. Veterans have the option of
providing the forms to their private physician for completion and
submission to VA in lieu of scheduling a VA medical examination. The
data collected will be used to adjudicate veterans claim for disability
benefits.
An agency may not conduct or sponsor, and a person is not required
to respond to a collection of information unless it displays a
currently valid OMB control number. The Federal Register Notice with a
60-day comment period soliciting comments on this collection of
information was published on September 29, 2010, at pages 60170-60171.
Affected Public: Individuals or households.
Estimated Annual Burden:
a. Ischemic Heart Disease (IHD) Disability Benefits Questionnaire,
VA Form 21-0960a-1--13,750.
b. Hairy Cell and Other B-Cell Leukemias Disability Benefits
Questionnaire, VA Form 21-0960b-1--500.
c. Parkinson's Disease Disability Benefits Questionnaire, VA Form
21-0960c-1--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-1--55,000.
[[Page 76082]]
b. Hairy Cell and Other B-Cell Leukemias Disability Benefits
Questionnaire, VA Form 21-0960b-1--2,000.
c. Parkinson's Disease Disability Benefits Questionnaire, VA Form
21-0960c-1--5,000.
Dated: December 1, 2010.
By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2010-30552 Filed 12-6-10; 8:45 am]
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