[Federal Register Volume 76, Number 73 (Friday, April 15, 2011)]
[Notices]
[Pages 21429-21430]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-9156]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-New (DBQs--Group 3)]


Proposed Information Collection (Disability Benefits 
Questionnaires--Group 3) Activity: Comment Request

AGENCY: Veterans Benefits Administration, Department of Veterans 
Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Benefits Administration (VBA), Department of 
Veterans Affairs (VA), is announcing an opportunity for public comment 
on the proposed collection of certain information by the agency. Under 
the Paperwork Reduction Act (PRA) of 1995, Federal agencies are 
required to publish notice in the Federal Register concerning each 
proposed collection of information, including each proposed new 
collection and allow 60 days for public comment in response to the 
notice. This notice solicits comments for information needed to obtain 
medical evidence to adjudicate a claim for disability benefits.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before June 14, 2011.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J. Kessinger, Veterans Benefits 
Administration (20M33), Department of Veterans Affairs, 810 Vermont 
Avenue, NW., Washington, DC 20420 or e-mail to <a href="/cdn-cgi/l/email-protection#781619161b0156131d0b0b11161f1d0a380e19561f170e"><span class="__cf_email__" data-cfemail="b5dbd4dbd6cc9bded0c6c6dcdbd2d0c7f5c3d49bd2dac3">[email protected]</span></a>. 
Please refer to ``OMB Control No. 2900-New (DBQs--Group 3)'' in any 
correspondence. During the comment period, comments may be viewed 
online through FDMS.

FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 461-9769 
or FAX (202) 275-5947.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VBA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VBA's functions, including 
whether the information will have practical utility;

[[Page 21430]]

(2) the accuracy of VBA's estimate of the burden of the proposed 
collection of information; (3) ways to enhance the quality, utility, 
and clarity of the information to be collected; and (4) ways to 
minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques or the use 
of other forms of information technology.

Titles

    a. Central Nervous System and Neuromusculo Diseases, Disability 
Benefits Questionnaire, VA Form 21-0960C-5.
    b. Headaches (Including Migraine Headaches), Disability Benefits 
Questionnaire, VA Form 21-0960C-8.
    c. Multiple Sclerosis (MS), Disability Benefits Questionnaire, VA 
Form 21-0960C-9.
    d. Esophageal Disorders (Including GERD), Disability Benefits 
Questionnaire, VA Form 21-0960G-1.
    e. Gallbladder and Pancreas Conditions, Disability Benefits 
Questionnaire, VA Form 21-0960G-2.
    f. Intestinal Disorders (Other Than Surgical or Infectious) 
(Including Irritable Bowel Syndrome, Crohn's Disease, Ulcerative 
Colitis, and Diverticulitis) Disability Benefits Questionnaire, VA Form 
21-0960G-3.
    g. Intestines Surgical and/or Infectious Intestinal Disorders 
(Bowel Resection, Colostomy, Ileostomy, Bacterial and Parasitic 
Infections) Disability Benefits Questionnaire, VA Form 21-0960G-4.
    h. Hepatitis, Cirrhosis and Other Liver Conditions, Disability 
Benefits Questionnaire, VA Form 21-0960G-5.
    i. Peritoneal Adhesions Disability Benefits Questionnaire, VA Form 
21-0960G-6.
    j. Stomach and Duodenal Conditions (Not Including GERD or 
Esophageal Disorders) Disability Benefits Questionnaire, VA Form 21-
0960G-7.
    k. Rectum and Anus Disability Benefits Questionnaire, VA Form 21-
0960H-2.
    l. Breast Conditions and Disorders Disability Benefits 
Questionnaire, VA Form 21-0960K-1.
    m. Gynecological Conditions Disability Benefits Questionnaire, VA 
Form 21-0960K-2.
    n. Sleep Apnea Disability Benefits Questionnaire, VA Form 21-0960L-
2.
    o. Arthritis Disability Benefits Questionnaire, VA Form 21-0960M-3.
    p. Osteomyelitis Disability Benefits Questionnaire, VA Form 21-
0960M-11.
    q. Ear Conditions (Including Vestibular and Infectious) Disability 
Benefits Questionnaire, VA Form 21-0960N-1.
    OMB Control Number: 2900-New (DBQs--Group 3).
    Type of Review: New collection.
    Abstract: Data collected on VA Form 21-0960 series will be used to 
obtain information from claimant's treating physician that is necessary 
to adjudicate a claim for disability benefits.
    Affected Public: Individuals or households.

Estimated Annual Burden

    a. VA Form 21-0960C-5--5,000.
    b. VA Form 21-0960C-8--3,750.
    c. VA Form 21-0960C-9--7,500.
    d. VA Form 21-0960G-1--10,000.
    e. VA Form 21-0960G-2--1,250.
    f. VA Form 21-0960G-3--1,250.
    g. VA Form 21-0960G-4--1,250.
    h. VA Form 21-0960G-5--5,000.
    i. VA Form 21-0960G-6--1,250.
    j. VA Form 21-0960G-7--2,500.
    k. VA Form 21-0960H-2--2,500.
    l. VA Form 21-0960K-1--7,500.
    m. VA Form 21-0960K-2--10,000.
    n. VA Form 21-0960L-2--1,250.
    o. VA Form 21-0960M-3--25,000.
    p. VA Form 21-0960M-11--10,000.
    q. VA Form 21-0960N-1--6,250.

Estimated Average Burden per Respondent

    a. VA Form 21-0960C-5--30 minutes.
    b. VA Form 21-0960C-8--15 minutes.
    c. VA Form 21-0960C-9--45 minutes.
    d. VA Form 21-0960G-1--15 minutes.
    e. VA Form 21-0960G-2--15 minutes.
    f. VA Form 21-0960G-3--15 minutes.
    g. VA Form 21-0960G-4--15 minutes.
    h. VA Form 21-0960G-5--30 minutes.
    i. VA Form 21-0960G-6--15 minutes.
    j. VA Form 21-0960G-7--15 minutes.
    k. VA Form 21-0960H-2--15 minutes.
    l. VA Form 21-0960K-1--15 minutes.
    m. VA Form 21-0960K-2--30 minutes.
    n. VA Form 21-0960L-2--15 minutes.
    o. VA Form 21-0960M-3--15 minutes.
    p. VA Form 21-0960M-11--15 minutes.
    q. VA Form 21-0960N-1--15 minutes.
    Frequency of Response: On occasion.

Estimated Number of Respondents

    a. VA Form 21-0960C-5--10,000.
    b. VA Form 21-0960C-8--15,000.
    c. VA Form 21-0960C-9--10,000.
    d. VA Form 21-0960G-1--40,000.
    e. VA Form 21-0960G-2--5,000.
    f. VA Form 21-0960G-3--5,000.
    g. VA Form 21-0960G-4--5,000.
    h. VA Form 21-0960G-5--10,000.
    i. VA Form 21-0960G-6--5,000.
    j. VA Form 21-0960G-7--10,000.
    k. VA Form 21-0960H-2--10,000.
    l. VA Form 21-0960K-1--30,000.
    m. VA Form 21-0960K-2--20,000.
    n. VA Form 21-0960L2--5,000.
    o. VA Form 21-0960M-3--100,000.
    p. VA Form 21-0960N-11--40,000.
    q. VA Form 21-0960N-1--25,000.

    Dated: April 8, 2011.

    By direction of the Secretary.
Denise McLamb,
Program Analyst, Enterprise Records Service.
[FR Doc. 2011-9156 Filed 4-14-11; 8:45 am]
BILLING CODE 8320-01-P


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