Agency Information Collection Activities; Proposals, Submissions, and Approvals: Request for Employment Information in Connection with Claim for Disability Benefits

Agency Information Collection Activity Under OMB Review: Request for Employment Information in Connection With Claim for Disability Benefits

Dates

Comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice by clicking on the following link www.reginfo.gov/public/do/PRAMain, select "Currently under Review-Open for Public Comments", then search the list for the information collection by Title or "OMB Control No. 2900-0065."

Supplementary Information

Title: Request for Employment Information in Connection with Claim for Disability Benefits (VA Form 21-4192).

OMB Control Number: 2900-0065 https://www.reginfo.gov/public/do/PRASearch.

Type of Review: Revision of a currently approved collection.

Abstract: VA Form 21-4192 is used to gather necessary employment information from veterans' employers so VA can determine eligibility to increased disability benefits based on unemployability. Without this information, determination of entitlement would not be possible. No changes have been made to this form. The respondent burden has increased due to the estimated number of receivables averaged over the past year.

An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The Federal Register Notice with a 60-day comment period soliciting comments on this collection of information was published at 89 FR 35309, May 1, 2024.

Affected Public: Private Sector.

Estimated Annual Burden: 12,183 hours.

Estimated Average Burden per Respondent: 15 minutes.

Frequency of Response: One time.

Estimated Number of Respondents: 48,730 per year.

Authority: 44 U.S.C. 3501 et seq.