| Title |
Last Updated |
| Homeworker Handbook |
May 13, 2013 |
| Health Insurance Claim Form |
May 13, 2013 |
| Authorization For Release Of Medical Information (Black Lung Benefits) |
May 13, 2013 |
| Application For Prevailing Wage Determination |
March 4, 2013 |
| Agricultural And Food Processing Clearance Order |
February 21, 2013 |
| Notice Of Termination Suspension Reduction Or Increase In Benefit Payments |
October 24, 2012 |
| Doctors Certificate |
August 14, 2012 |
| Application-Farm Labor Contractor-Farm Labor Contractor Employee Certificate-Registration |
August 14, 2012 |
| Work Capacity Evaluation Psychiatric-Psychological Conditions |
November 11, 2011 |
| Work Capacity Evaluation For Musculoskeletal Conditions |
November 11, 2011 |
| Work Capacity Evaluation Cardiovascular-Pulmonary Conditions |
November 11, 2011 |
| Roetgenographic Interpretation |
November 11, 2011 |
| Roentgenographic Quality Rereading |
November 11, 2011 |
| Representative Payee Report |
November 11, 2011 |
| Representative Payee Report |
November 11, 2011 |
| Report Of Ventilatory Study |
November 11, 2011 |
| Report Of Earnings |
November 11, 2011 |
| Report Of Arterial Blood Gas Study |
November 10, 2011 |
| Quarterly Mine Employment And Coal Production Report |
November 10, 2011 |
| Physicians-Medical Officers Statement |
November 10, 2011 |
| Miners Claim For Benefits Under The Black Lung Benefits Act |
November 10, 2011 |
| Medical History And Examination For Coal Mine Workers Pneumoconiosis |
November 10, 2011 |
| Employment History |
November 10, 2011 |
| Duty Status Report |
November 10, 2011 |
| Claim For Compensation |
November 10, 2011 |
| Attending Physicians Report |
November 10, 2011 |
| Mine Accident Injury And Illness Report |
October 11, 2011 |
| Report Of Changes That May Affect Your Black Lung Benefits |
September 19, 2011 |
| Report Of Changes That May Affect Your Black Lung Benefits |
September 19, 2011 |
| Rehabilitation Plan And Award |
September 19, 2011 |
| Payment Of Compensation Without Award |
September 19, 2011 |
| Application For Permanent Employment Certification |
September 19, 2011 |
| Certificate Of Training |
August 8, 2011 |
| Workers Information-Terms And Conditions Of Employment |
July 19, 2011 |
| Safety And Health Activity Certification Or Hoisting Engineer Qualification Request |
July 19, 2011 |
| Record Of Individual Exposure To Radon Daughters |
July 19, 2011 |
| Notice Of Recurrence |
July 19, 2011 |
| Claim For Continuance Of Compensation Under The Federal Employees Compensation Act |
July 19, 2011 |
| Legal Identity Report |
June 13, 2011 |
| Description Of Coal Mine Work And Other Employment |
May 23, 2011 |
| Certification Of Funeral Expenses |
May 23, 2011 |
| Application For Alien Employment Certification Part B Statement Of Qualifications Of Alien |
May 23, 2011 |
| Application For Alien Employment Certification Part A Offer Of Employment |
May 23, 2011 |
| Application For Certificate To Employ Homeworkers |
April 11, 2011 |
| Form LM-10 Employer Report |
March 29, 2011 |
| Operator Response To Schedule For Submission Of Additional Evidence |
March 29, 2011 |
| Operator Response To Notice Of Claim |
March 29, 2011 |
| Employment History For Claim Under Energy Employees Occupational Illness Compensation Program Act |
March 29, 2011 |
| Employment History Affidavit For Claim Under The Energy Employees Occupational Illness Compensation Program Act |
March 29, 2011 |
| Claim For Survivor Benefits Under Energy Employees Occupational Illness Compensation Program Act |
March 29, 2011 |
