OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Veteran's Application for Increased Compensation Based on Unemployability

ICR 200709-2900-012 · OMB 2900-0404 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 21-8940 Veteran's Application for Increased Compensation Based on Unemployability Form Modified Repair queued
2900-0404 justification.doc Supporting Statement A Uploaded 2008-04-09 Available
IC Document Collections
IC IDCollectionTypeStatusForm
28617 Veteran's Application for Increased Compensation Based on Unemployability Form Modified
ICR Details
2900-0404 200709-2900-012
Historical Active 200502-2900-005
VA 2900-0404
Veteran's Application for Increased Compensation Based on Unemployability
Extension without change of a currently approved collection   No
Regular
Approved without change 06/12/2008
Retrieve Notice of Action (NOA) 04/09/2008
  Inventory as of this Action Requested Previously Approved
06/30/2011 36 Months From Approved 06/30/2008
24,000 0 24,000
18,000 0 18,000
0 0 0
VA Form 21-8940 is used to gather information that is necessary to determine eligibility for increased compensation based on unemployability. Current information regarding a claimant's medical, educational, and occupational history is required in order to determine whether he/she is unable to secure or follow a substantially gainful occupation due to service-connected disabilities. Without this information, entitlement could not be determined.
US Code: 38 USC 1163 Name of Law: Trial work periods and vocational rehabilitation for certain veterans with total disability ratings.
  
None
Not associated with rulemaking
  72 FR 187 09/27/2007
72 FR 236 12/10/2007
No
  Total Approved 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 24,000 24,000 0 0 0 0
Annual Time Burden (Hours) 18,000 18,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$2,855,960
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/09/2008