Agency Information Collection Activity: Camp Lejeune Family Members Program-Reimbursement of Certain Medical Expenses
| Court | Veterans Affairs Department |
| Citation | 87 FR 15492 |
| Publication Date | 18 March 2022 |
| Record Number | 2022-05662 |
Federal Register, Volume 87 Issue 53 (Friday, March 18, 2022)
[Federal Register Volume 87, Number 53 (Friday, March 18, 2022)]
[Notices]
[Pages 15492-15493]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-05662]
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DEPARTMENT OF VETERANS AFFAIRS
[OMB Control No. 2900-0822]
Agency Information Collection Activity: Camp Lejeune Family
Members Program--Reimbursement of Certain Medical Expenses
AGENCY: Veterans Health Administration, Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: Veterans Health Administration (VHA), Department of Veterans
Affairs (VA), is announcing an opportunity for public comment on the
proposed collection of certain information by the agency. Under the
Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to
publish notice in the Federal Register concerning each proposed
collection of information, including each proposed extension of a
currently approved collection, and allow 60 days for public comment in
response to the notice.
DATES: Written comments and recommendations on the proposed collection
of information should be received on or before May 17, 2022.
ADDRESSES: Submit written comments on the collection of information
through Federal Docket Management System (FDMS) at www.Regulations.gov
or to Janel Keyes, Office of Regulations, Appeals, and Policy (10BRAP),
Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC
20420 or email to [email protected]. Please refer to ``OMB Control No.
2900-0822'' in any correspondence. During the comment period, comments
may be viewed online through FDMS.
FOR FURTHER INFORMATION CONTACT: Maribel Aponte, Office of Enterprise
and Integration, Data Governance Analytics (008), 1717 H Street NW,
Washington, DC 20006, (202) 266-4688 or email [email protected].
Please refer to ``OMB Control No. 2900-0822'' in any correspondence.
SUPPLEMENTARY INFORMATION: Under the PRA of 1995, Federal agencies must
obtain approval from the Office of Management and Budget (OMB) for each
collection of information they conduct or sponsor. This request for
comment is being made pursuant to Section 3506(c)(2)(A) of the PRA.
With respect to the following collection of information, VHA
invites comments on: (1) Whether the proposed collection of information
is necessary for the proper performance of VHA's functions, including
whether the information will have practical utility; (2) the accuracy
of VHA's estimate of the burden of the proposed collection of
information; (3) ways to enhance the quality, utility, and clarity of
the information to be collected; and (4) ways to minimize the burden of
the collection of information on respondents, including through the use
of automated collection techniques or the use of other forms of
information technology.
Authority: Public Law 104-13; 44 U.S.C. 3501-3521.
Title: Camp Lejeune Family Members Program--Reimbursement of
Certain Medical Expenses, VA Forms 10-10068, 10-10068a, 10-10068b, 10-
10068c.
OMB Control Number: 2900-0822.
Type of Review: Reinstatement of a previously approved collection.
Abstract: Under 38 U.S.C. 1787, VA is required to furnish hospital
care and medical services to the family members of certain veterans who
were stationed at Camp Lejeune between 1953 and 1987 and have specified
medical conditions. In order to furnish such care, VA must collect
necessary information from the family members to ensure that they meet
the requirements of the law. The specific hospital care and medical
services that VA must provide are for a number of illnesses and
conditions connected to exposure to contaminated drinking water while
at Camp Lejeune. The forms in this
[[Page 15493]]
collection will be used to determine eligibility and reimbursement for
this medical care.
VA Form 10-10068: Application Form
Affected Public: Individuals or households.
Estimated Annual Burden: 815 hours.
Estimated Average Burden per Respondent: 30 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 1,629.
VA Form 10-10068a: Claim Form
Affected Public: Individuals or households.
Estimated Annual Burden: 4,480 hours.
Estimated Average Burden per Respondent: 15 minutes.
Frequency of Response: 11 times per year.
Estimated Number of Respondents: 1,629.
VA Form 10-10068b: Treating Physician Form
Affected Public: Individuals or households.
Estimated Annual Burden: 407 hours.
Estimated Average Burden per Respondent: 15 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 1,629.
VA Form 10-10068c: Information Update Form
Affected Public: Individuals or households.
Estimated Annual Burden: 136 hours.
Estimated Average Burden per Respondent: 15 minutes.
Frequency of Response: Once annually.
Estimated Number of Respondents: 543.
By direction of the Secretary:
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration/Data
Governance Analytics, Department of Veterans Affairs.
[FR Doc. 2022-05662 Filed 3-17-22; 8:45 am]
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