Exam for Housebound Status or Permanent Need for Regular Aid and Attendance

ICR 201309-2900-013 · OMB 2900-0721 · Historical Inactive

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 2900-0721 can be found here:

Forms and Documents

Document	Type	Status	Availability
Form VA Form 21-2680 Exam for Housebound Status or Permanent Need for Regular Aid and Attendance	Form	Modified	Repair queued
2900-0721 Supporting Statement VAF 2680 9-12-13.docx	Supporting Statement A	Uploaded 2013-09-12	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
185651	Exam for Housebound Status or Permanent Need for Regular Aid and Attendance	Form	Modified

ICR Details

OMB Control No: 2900-0721	ICR Reference No: 201309-2900-013
Status: Historical Inactive	Previous ICR Reference No: 201107-2900-023
Agency/Subagency: VA	Agency Tracking No: 2900-0721 VBA-COMP-NK
Title: Exam for Housebound Status or Permanent Need for Regular Aid and Attendance
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 12/13/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/19/2013
Terms of Clearance: VA has requested withdrawal of this information collection request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2015	36 Months From Approved	05/31/2015
Responses	14,000	0	14,000
Time Burden (Hours)	7,000	0	7,000
Cost Burden (Dollars)	0	0	0

Abstract: This form will be used to gather medical information on behalf of beneficiaries or claimants who are requesting the aid and attendance or housebound benefit and who receive treatment from private doctors or physicians.

Authorizing Statute(s): US Code: 38 USC 1541(d) Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1541(e) Name of Law: Surviving spouses of veterans of a period of war
   US Code: 38 USC 1521(d) Name of Law: Veterans of a period of war
   US Code: 38 USC 1521(e) Name of Law: Veterans of a period of war
   US Code: 38 USC 1114 Name of Law: Rates of wartime disability compensation
   US Code: 38 USC 1115(1)(e) Name of Law: Additional compensation for dependents
   US Code: 38 USC 1311(d) Name of Law: Dependency and indemnity compensation to a surviving spouse

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2900-AO81	Proposed rulemaking	78 FR 211	10/31/2013

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Exam for Housebound Status or Permanent Need for Regular Aid and Attendance	VA Form 21-2680	Exam for Housebound Status Or Permanent Need For Regular Aid and Attendance

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $642,600

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Crystal Rennie 202 632-7492 [email protected]

Common Form ICR: No