Title:Medical Expense Report, VA Form 21-8416.
OMB Control Number:2900-0161.
Type of Review:Extension of a currently approved collection.
Abstract:VA Form 21-8416 is completed by claimants in receipt of or claiming income-based benefits to report medical expenses paid. Unreimbursed medical expenses may be excluded as countable income in determining a claimant's entitlement to income-based benefits and the rate payable.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. TheFederal RegisterNotice with a 60-day comment period soliciting comments on this collection of information was published on March 18, 2011, at page 15053.
Affected Public:Individuals or households.
Estimated Annual Burden:96,400 hours.
Estimated Average Burden per Respondent:30 minutes.
Frequency of Response:On occasion.
Estimated Number of Respondents:48,200.
Dated: May 25, 2011.
By Direction of the Secretary.
Program Analyst, Enterprise Records Service.