OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996)

ICR 201901-2900-005 · OMB 2900-0862 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 20-0995 Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996) Form Unchanged Available
2900-0862 Supporting Statement_FINAL_1.29.19.docx Supporting Statement A Uploaded 2019-01-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
232032 Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996) Form Unchanged
ICR Details
2900-0862 201901-2900-005
Active 201807-2900-001
VA VBA-AMO-YA
Request for Higher-Level Review/Supplemental Claim Application (PL 115-55) (VA Forms 20-0995 & 20-0996)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/08/2019
Retrieve Notice of Action (NOA) 01/30/2019
  Inventory as of this Action Requested Previously Approved
02/28/2022 36 Months From Approved
115,000 0 0
28,750 0 0
0 0 0
The Veterans Appeals Improvement and Modernization Act of 2017 (Pub. L. 115-55) made substantial adjustments to VA’s benefits claims and appeals system. Among other changes, the legislation requires that claimants have access to a new three lane decision review process. As a part of the implementation of Pub. L. 115-55, VA created an entirely new higher-level review process, along with the appropriate form for requesting a higher-level review. Information is requested by this form to formalize a request for higher-level review on a decision rendered by VA. Authority is found in Pub. L. 115-55, and proposed 38 C.F.R. § 3.2601. In addition, VA created an entirely new supplemental claim process, along with the appropriate form for submitting a supplemental claim. Information is requested by this form to formalize a request for a supplemental claim on a decision rendered by VA. Authority is found in Pub. L. 115-55, and proposed 38 C.F.R. § 3.2501. In order to effectuate the new law, VBA is requesting creation of two new information collections and assignment of a new OMB Control Number for the following forms: VA Form 20-0996, Request for Higher-Level Review, and VA Form 20-0995, Supplemental Claim Application.
US Code: 38 USC 5108 Name of Law: Supplemental claims
   PL: Pub.L. 115 - 55 2 Name of Law: Veterans Appeals Improvement and Modernization Act of 2017
   US Code: 38 USC 5104B Name of Law: Higher-level review by the agency of original jurisdiction
  
None
2900-AQ26 Final or interim final rulemaking 84 FR 138 01/18/2019
Yes
  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 115,000 0 0 115,000 0 0
Annual Time Burden (Hours) 28,750 0 0 28,750 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
No
This is a new information collection and all burden hours are considered an increase.
$1,921,616
No
    Yes
    Yes
No
No
No
Uncollected
Cynthia Harvey - Pryor 202 461-5870 [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.
01/30/2019