2900-0119 justification

SUPPORTING STATEMENT

VA FORM LETTER 29-551

REPORT OF TREATMENT IN HOSPITAL

2900-0119

JUSTIFICATION:

1. The form letter is used for collecting information from hospitals to determine the insured's eligibility for disability insurance benefits. The information requested is authorized by law, 38 U.S.C. 1912, 1915, 1942 and 1948.

2. The information collected on the form letter is used by the Department of Veterans Affairs (VA) to establish the insured's eligibility for disability insurance benefits.

3. Due to privacy concerns, this form will not be made available as an electronic submission. In the future, this form will be considered as a fillable for but not as an electronic transaction due to the nature of medical records.

4. The information is not contained in any other VA records. Similar information is not available elsewhere.

5. The information does not involve any small businesses.

6. The form letter is designed for use by the insurance activity to determine the insured's eligibility for continued protection. The collection is generally conducted only once.

7. There are no special circumstances requiring that the collection be conducted in a manner inconsistent with the guidelines in 5 CFR Section 1320.6.

8. The Department notice was published in the Federal Register on May 19, 2008, Volume 73, Number 97, pages 28860-28861. There were no comments received.

9. The information collected is supplied by the respondent. No remuneration is made.

10. The information collection conforms with the Privacy Act of 1974 and is subject to the conditions of disclosure contained therein. The records are maintained in the system identified as 36VA00, "Veterans and Armed Forces Personnel United States Government Life Insurance Records - VA" as contained in the Privacy Act Issuances, 1993 Compilation.

11. There are no questions of a sensitive nature.

12. We estimate that approximately 20,277 form letters a year will be received. We also estimate that it will take approximately 12 minutes to locate, copy and mail patient records.. We arrived at this estimate by initiating a trial with a VA medical facility. The annual burden will now be 4,055 hours. The cost to the reporting public is $60,825.00 (4,055 hours x $15/hour).

13. This submission does not involve any record keeping costs.

14. Cost to Government:

$10,693.00 Estimated mailing cost (20,277 X 2 minutes per

form X $7.45/hour (average salary for station

mail personnel) plus 20,277 form letters X 27.9 cents

each (presort discount)).

$10,693.00 Estimated cost for collections (20,277 X 4 minutes

per form X $7.91/hour (average salary of station

collections personnel)).

$58,448.00 Estimated cost for processing (20,277 form letters X

15 minutes per form X $11.53/hour (Average

salary for reviewers)).

$30.00 Estimated printing costs (1,000 X $30/1,000

forms).

$79,864.00 Total cost to the Government.

15. There is no change in burden.

16. The information is collected for insurance purposes only and there are no plans for publication.

17. The collection instrument, VA Form Letter 29-551, may be reproduced and/or stocked by the respondents and veteran service organizations. This VA form letter does not display an expiration date, and if required to do so would result in unnecessary waste of existing stocks of this form letter. This form letter is submitted to OMB for approval every three years. As such, this date requirement would also result in an unnecessary burden on the respondents and would delay Department action on the benefit being sought. VA also seeks to minimize its cost to itself of collecting, processing and using the information by not displaying the expiration date. For the reasons stated, VA continues to seek an exemption that waives the displaying of the expiration date on VA Form Letter 29-551.

18. There are no exceptions to the certification statement identified in Item 19 of OMB Form 83-I.

Statistical Methods

1. This collection does not collect information employing statistical methods.