Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child (VA Form 21P-534) |
Application for Dependency and Indemnity Compensation by a
Surviving Spouse or Child – In-Service Death (VA Form
21P-534a)
|
Application for DIC, Death Pension, and/or Accrued Benefits
|
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.
Information is requested by these forms under the authority of 38 U.S.C. 1310 through 1314 and 1532 through 1543.
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. 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. The VA Form 21P-534EZ is used for the Fully Developed Claims (FDC) program for pension claims.
The collection of information does not involve the use of automated, electronic, mechanical, or other technological collection techniques. VA does not currently have technology in place to allow for the electronic submission of this form, though VA may develop this technology in the future.
The form is available in electronically-fillable format on the benefits.va.gov website. However, the form must be printed and physically submitted.
VBA conducted program reviews to identify duplication, but found none. There is no known Department or Agency which maintains the necessary information, nor is the information available through other sources within VA.
The collection of information does not impact small business or other small entities.
If this collection is not conducted, VBA will not be able to adequately evaluate a surviving claimant’s eligibility to survivor’s benefits. The information is collected once, and cannot be collected less frequently.
There are no special circumstances which would cause this information collection to be conducted more often than quarterly, or require respondents to prepare written responses to a collection of information in fewer than 30 days after receipt of it; submit more than an original and two copies of any document; retain records, other than health, medical, government contract, grant-in-aid, or tax records for more than three years; in connection with a statistical survey that is not designed to produce valid and reliable results that can be generalized to the universe of study and require the use of a statistical data classification that has not been reviewed and approved by OMB.
The sponsor’s notice was published in the Federal Register Volume 83, Number 13, Pages 2878 and 2879, on January 19, 2018, soliciting comments on the information collection (83 FR 2878). VBA received no public comments in response to the notice.
VA did not consult with those from whom the information is to be obtained. The information is submitted once, on an ad-hoc basis. It is impossible to identify potential claimants before they claim the benefit by submitting the application.
No payments or gifts to respondents will be made under this collection of information.
The records are maintained in the appropriate Privacy Act System of Records identified as “Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28),” published at 77 FR 42593 (July 19, 2012).
There are no questions of a sensitive nature (information that, with a reasonable degree of medical certainty, is likely to have a serious adverse effect on an individual's mental or physical health if revealed to him or her), such as sexual behavior and attitudes, religious beliefs, and other matters that are commonly considered private.
VA will not disclose the information collected to any source other than what has been authorized under the Privacy Act of 1974 or Title 5, Code of Federal Regulations 1.526 for routine uses (i.e., civil or criminal law enforcement, congressional communications, epidemiological or research studies, the collection of money owed to the United States, litigation in which the United States is a party or has an interest, the administration of VA programs and delivery of VA benefits, verification of identity and status and personnel administration) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education and Vocational Rehabilitation and Employment Records - VA, published at 77 FR 42593 (July 19, 2012).
The respondent is required to provide his or her Social Security number when requested under 38 U.S.C. 5101 (c)(1). VA May disclose Social Security numbers as authorized under the Privacy Act, and specifically may disclose them for the purposes stated above. Information furnished on the information collection may be utilized in computer matching programs with other Federal or state agencies for the purpose of determining the respondent’s eligibility to receive VA benefits, as well as to collect any amount owed to the United States by virtue of the respondent’s participation in any benefit program administered by the Department of Veterans Affairs.
Number of Respondents: 150,000
VA Form 21P-534 25,635
VA Form 21P-534a 1,127
VA Form 21P-534EZ 88,238
Frequency of Response: Once
Annual Burden Hours: 69,091 hours
Estimated Completion Time: 0.6007926 hours (36.05 minutes)
VA Form 21P-534 1.25 hours (75 minutes)
VA Form 21P-534a 0.25 hours (15 Minutes)
VA Form 21P-534EZ 0.41667 Hours (25 Minutes)
The
population of respondents includes school children, working age
adults, disabled adults, and elderly adults. Therefore it is not
possible to make assumptions regarding the population of applicants,
such as the average age of applicants or their average earnings. In
order to estimate the costs to respondents, VBA used general wage
information for the population as a whole.
The Bureau of
Labor Statistics (BLS) gathers information on full-time wage and
salary workers. According to the latest available BLS data,
the median weekly earnings of full-time wage and salary workers are
$954.40. Assuming a forty (40) hour work week, the mean hourly
wage is $23.86 based on the BLS wage code – “00-0000 All
Occupations.” This information was taken from the
following website: (http://www.bls.gov/oes/current/oes_nat.htm,
May 2016).
Legally, respondents may not pay a person or
business for assistance in completing the information collection,
and a person or business may not accept payment for assisting a
respondent in completing the information collection. Therefore,
there are no expected overhead costs for completing the information
collection. VBA estimates the total cost of all respondents to be
$1,647,824.00 (69,091 burden hours x $23.85 per hour).
Median
Weekly Wage = $954.40.00/week
Median Hour Wage = $954.40/week x
40hrs/week = $23.85/hr.
Burden Hours per Response = 0.25
hrs.
Cost per Response = $23.85/hr. x 0.6007926 hrs. =
$14.328903
Total Burden Estimate = $14.328903/Response x
115,000 Responses = $1,647,824
The submission does not involve any record-keeping costs.
Estimated Costs to the Federal Government:
Grade |
Step |
Burden Time |
Fraction of Hour |
Hourly Rate |
Cost Per Response |
Total Responses |
Total |
5 |
3 |
10 Min. |
0.1667 |
$14.79 |
$2.465 |
115,000 |
$283,475.00 |
Overhead at 100% Salary |
$283,475.00 |
||||||
9 |
3 |
60 Min. |
1.0000 |
$22.42 |
$22.420 |
115,000 |
$2,578,300.00 |
|
$2,578,300.00 |
||||||
11 |
3 |
15 Min. |
0.2500 |
$27.12 |
$6.780 |
115,000 |
$779,700.00 |
Overhead at 100% Salary |
$779,700.00 |
||||||
|
|
||||||
Processing / Analyzing Costs |
$7,282,950.00 |
||||||
Printing and Production Cost |
$0.00 |
||||||
Total Cost to Government |
$7,282,950.00 |
Overhead costs are 100% of salary and are same as the wage listed above and the amounts are included in the total.
Note: The hourly wage information above is based on the hourly 2018 General Schedule (Base) Pay (https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2018/GS_h.pdf ). This rate does not include any locality adjustment as applicable.
The processing time estimates above are based on the actual amount of time employees of each grade level spend to process to completion a claim received on this form. The within-grade step (3) of each employee represents the average experience of employees within each grade.
To account for overhead costs and benefits, we factored in additional costs of 100% of employee salary. This is necessarily a rough adjustment, because methods of estimating these costs vary widely from study to study. One such study, from the Boston Business Journal (http://web.mit.edu/e-club/hadzima/pdf/how-much-does-an-employee-cost.pdf), references an estimate of overhead costs and benefits as high of 170% of employee salary. Since there is no industry standard for estimating overhead costs and benefits costs based on employee salary, we feel our estimate of 100% of employee salary is reasonable.
VBA conducted a program review and determined we receive far fewer forms under this collection than previously reported.
The time burden on the respondent has not changed. In the previously approved information collection request (ICR), VA did not evaluate the cost to respondents based on the amount of time spent completing the form. VA has included that calculation in this ICR, which is detailed in item 12 of this document.
The information collected is not for tabulation.
We are not seeking to omit the expiration date.
This submission does not include any exceptions to the certification statement.
No statistical methods are used in this data collection.
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | SUPPORTING STATEMENT FOR VA FORM 10-2065, FUNERAL ARRANGEMENTS; VA FORM 10-10, APPLICATION FOR MEDICAL BENEFITS; VA FORM 10-10I, |
Author | Preferred Customer |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |