Request for Supplies (Chapter 31 - Vocational Rehabilitation) (VA Form 28-1905m)

ICR 202103-2900-019

OMB: 2900-0061

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2021-06-23
Supporting Statement A
2021-06-10
Supplementary Document
2021-05-04
IC Document Collections
ICR Details
2900-0061 202103-2900-019
Received in OIRA 201403-2900-023
VA VBA-VR&E-MS
Request for Supplies (Chapter 31 - Vocational Rehabilitation) (VA Form 28-1905m)
Reinstatement without change of a previously approved collection   No
Regular 06/23/2021
  Requested Previously Approved
36 Months From Approved
28,000 0
14,000 0
0 0

A claimant uses VAF 28-1905m to request supplies or equipment be provided as part of a rehabilitation program under 38 U.S.C. Chapter 31. The training facility the claimant attends, or the employer for whom the claimant works, may also need to complete the form when the facility or employer requires specific types of supplies or equipment under 38 U.S.C. 3104(a)(7). The VR&E program subsequently uses the information on this form to approve the purchase of appropriate supplies and equipment for claimants. Without the information gathered on this form, it is likely that inappropriate supplies or equipment may be provided which would negatively impact both the VA and the claimant.

US Code: 38 USC 3104(a)(7) Name of Law: Scope of services and assistance
  
None

Not associated with rulemaking

  86 FR 18376 04/08/2021
86 FR 32329 06/17/2021
No

  Total Request 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 28,000 0 0 12,000 0 16,000
Annual Time Burden (Hours) 14,000 0 0 -2,000 0 16,000
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
The VR&E program experienced an increase in rehabilitation plans developed since the last submission and VAF 28-1905m is used during the rehabilitation planning process. This increase in plans results in an increase in the use of VAF 28-1905m. The individual respondent burden decreased from one hour to 30 minutes. This decrease is associated with VAF 28-1905m only being used for the initial request of the supplies/equipment as opposed to also being used for receipt confirmation upon the supplies/equipment being delivered. A new form, VAF 28-1905r, is being developed for the purpose of verifying that the supplies/equipment have been received. Additionally, the items on VAF 28-1905m were reviewed and it was determined that the average claimant could complete the items in 30 minutes or less.

$1,492,986
No
    Yes
    Yes
No
No
No
No
Maribel Aponte 202 266-4688 maribel.aponte@va.gov

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/23/2021


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