Information Collection

DoD Referral to Integrated Disability Evaluation System (IDES) (VA Form 21-0819)

IC 181456 under ICR 201803-2900-003 · OMB 2900-0704.

Documents and Forms

Document Name Document Type
Form 21-0819 DoD Referral to Integrated Disability Evaluation System (IDES) (VA Form 21-0819) Form
21-0819 DoD Referral to Integrated Disability Evaluation System 2900-0704 VA Form 21-0819.pdf www.va.gov/vaforms Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	DoD Referral to Integrated Disability Evaluation System (IDES) (VA Form 21-0819)	Agency IC Tracking Number:	2900-0704

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 38 CFR 3.101

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	21-0819	DoD Referral to Integrated Disability Evaluation System (IDES)	2900-0704 VA Form 21-0819.pdf	www.va.gov/vaforms	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	14,000	0	14,000
Annual IC Time Burden (Hours)	3,500	-3,500	7,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.