# Agency Information Collection Activity: Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s)
**AGENCY:**
Veterans Benefits Administration, Department of Veterans Affairs.
**ACTION:**
Notice.
**SUMMARY:**
Veterans Benefits Administration, 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 revision 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 February 12, 2024.
**ADDRESSES:**
Submit written comments on the collection of information through Federal Docket Management System (FDMS) at *www.Regulations.gov* or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420 or email to *[email protected].* Please refer to “OMB Control No. 2900-0659” 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), 810 Vermont Ave. NW, Washington, DC 20006, (202) 266-4688 or email *[email protected].* Please refer to “OMB Control No. 2900-0659” 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, VBA invites comments on: (1) whether the proposed collection of information is necessary for the proper performance of VBA's functions, including whether the information will have practical utility; (2) the accuracy of VBA'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:* 38 U.S.C. 5103(a), 38 U.S.C. 5107(a), Pub. L. 117-271, Pub. L. 117-303, 38 CFR 3.304(f).
*Title:* Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781).
*OMB Control Number:* 2900-0659.
*Type of Review:* Revision of a currently approved collection.
*Abstract:* VA Form 21-0781 is primarily used to gather certain information about in-service stressors, so VA may assist claimants in establishing the occurrence of the claimed stressor(s). To establish a grant of service-connected compensation, there must be evidence to support the in-service stressor(s) reported by the veteran. This form is voluntary, however, without this information, VA cannot thoroughly assist certain claimants with the research of military records and other sources of information for supporting evidence about the in-service stressor(s). The form requests information that is necessary to conduct meaningful research of evidence to help substantiate the claim.
This revision combines the two previously approved forms under this collection number into *one* form: resulting in the discontinuance of the previously approved VA Form 21-0781a, a new title, and a total reduction overall of burden on the claimant.
*Affected Public:* Individuals or Households.
*Estimated Annual Burden:* 87,436.
*Estimated Average Burden per Respondent:* 45 minutes.
*Frequency of Response:* One time.
*Estimated Number of Respondents:* 116,581.
By direction of the Secretary.
Maribel Aponte,
VA PRA Clearance Officer, Office of Enterprise and Integration/Data Governance Analytics, Department of Veterans Affairs.