View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
2900-0004
ICR Reference No:
201808-2900-005
Status:
Historical Active
Previous ICR Reference No:
201801-2900-002
Agency/Subagency:
VA
Agency Tracking No:
VBA-P&F-YA
Title:
Application for DIC, Death Pension, and/or Accrued Benefits; Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child; Application for Dependency and Indemnity Compensation
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
10/19/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/18/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2021
36 Months From Approved
06/30/2021
Responses
101,426
0
115,000
Time Burden (Hours)
62,857
0
69,091
Cost Burden (Dollars)
0
0
0
Abstract:
The Department of Veterans Affairs (VA), through its Veterans Benefits Administration (VBA), administers an integrated program of benefits and services, established by law, for veterans, service personnel, and their dependents and/or beneficiaries. Title 38 U.S.C. 5101(a) provides that a specific claim in the form provided by the Secretary must be filed in order for benefits to be paid to any individual under the laws administered by the Secretary. VA Forms 21P-534EZ and 21P-534 will be the prescribed forms for applications for Dependency and Indemnity Compensation (DIC), Death Pension, and/or Accrued benefits. VA Form 21P-534a will be the prescribed form for DIC when the Veteran died while in service. Information is requested by these forms under the authority of 38 U.S.C. 1310 through 1314 and 1532 through 1543. In RIN 2900-AO73, VA proposes to amend its pension regulations to maintain the integrity of its needs-based pension program. VA has authority under 38 U.S.C. 501(a) to prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by VA. VA would amend its information collections in conjunction with RIN 2900-AO73. This rulemaking is largely in response to a Government Accountability Office (GAO) report, GAO-12-50, Veterans’ Pension Benefits: Improvements Needed to Ensure Only Qualified Veterans and Survivors Receive Benefits. VA Form 21P-534EZ is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. This form is used to by claimants to apply under the Fully Developed Claim program. VA Form 21P-534 is used to gather the necessary information to determine the eligibility of surviving spouses and children for dependency and indemnity compensation (DIC), death pension, accrued benefits, and death compensation. This form is used to by claimants to apply under the Fully Developed Claim program. VA Form 21P-534a is an abbreviated application for DIC that is used only by surviving spouses and children of veterans who died while on active duty service.
Authorizing Statute(s):
US Code:
38 USC 1312
Name of Law: Benefits in certain cases of in-service or service-connected deaths
US Code:
38 USC 1313
Name of Law: Dependency and indemnity compensation to children
US Code:
38 USC 1532
Name of Law: Surviving spouses of Civil War veterans
US Code:
38 USC 1310
Name of Law: Deaths entitling survivors to dependency and indemnity compensation
US Code:
38 USC 1543
Name of Law: Net worth limitation
US Code:
38 USC 1310
Name of Law: Deaths entitling survivors to dependency and indemnity compensation
US Code:
38 USC 1314
Name of Law: Supplemental dependency and indemnity compensation to children
US Code:
38 USC 1533
Name of Law: Children of Civil War veterans
US Code:
38 USC 1534
Name of Law: Surviving spouses of Indian War veterans
US Code:
38 USC 1535
Name of Law: Children of Indian War veterans
US Code:
38 USC 1536
Name of Law: Surviving spouses of Spanish-American War veterans
US Code:
38 USC 1537
Name of Law: Children of Spanish-American War veterans
US Code:
38 USC 1311
Name of Law: Dependency and indemnity compensation to a surviving spouse
US Code:
38 USC 1542
Name of Law: Children of veterans of a period of war
US Code:
38 USC 1541
Name of Law: Surviving spouses of veterans of a period of war
US Code:
38 USC 5101
Name of Law: Claims and forms
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
2900-AO73
Final or interim final rulemaking
83 FR 47246
09/18/2018
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION BY A SURVIVING SPOUSEOR CHILD - IN SERVICE DEATH (VA FORM 21P-534a)
21P-534a
Application for Dependency and Indemnity Compensation by a Surviving Spouse or Child - In Service Death Only
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (Including Death Compensation if Applicable)
21P-534
APPLICATION FOR DEPENDENCY AND INDEMNITY COMPENSATION, SURVIVORS PENSION AND ACCRUED BENEFITS BY A SURVIVING SPOUSE OR CHILD (Including Death Compensation if Applicable)
APPLICATION FOR DIC, SURVIVORS PENSION, AND/OR ACCRUED BENEFITS
21P-534EZ
Application for DIC, Survivors Pension, and/or Accrued Benefits
ICR Summary of Burden
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
101,426
115,000
0
-13,574
0
0
Annual Time Burden (Hours)
62,857
69,091
0
-6,234
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The reduction in the number of estimated annual respondents and burden hours was published in the Notice of Proposed Rulemaking 2900-AO73 (80 FR 3839 through 386, on January 23, 2015).
Annual Cost to Federal Government:
$6,673,324
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
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:
Cynthia Harvey - Pryor 202 461-5870 cynthia.harvey-pryor@va.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
09/18/2018
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