| Title |
Last Updated |
| Health Insurance Claim Form |
June 19, 2019 |
| Authorization For Release Of Medical Information (Black Lung Benefits) |
April 1, 2019 |
| Notice Of Termination Suspension Reduction Or Increase In Benefit Payments |
March 12, 2019 |
| H-1B Nonimmigrant Information Form |
November 19, 2018 |
| Certification Of Qualifying Exigency For Military Family Leave |
September 18, 2018 |
| Employer Response To Employee Request For Family Or Medical Leave |
September 14, 2018 |
| Designation Notice (Family And Medical Leave Act) |
September 14, 2018 |
| Certification Of Health Care Provider For Family Members Serious Health Condition |
September 14, 2018 |
| Certification Of Health Care Provider For Employees Serious Health Condition |
September 14, 2018 |
| Certification For Serious Injury Or Illness Of Covered Servicemember |
September 14, 2018 |
| Operator Response To Notice Of Claim |
May 16, 2017 |
| Medical Travel Refund Request |
February 27, 2017 |
| Application For Prevailing Wage Determination |
June 23, 2016 |
| H-2A Application For Temporary Employment Certification |
June 10, 2016 |
| Agricultural And Food Processing Clearance Order |
May 16, 2016 |
| Subpoena To Appear And Testify At Hearing (OALJ) |
March 30, 2016 |
| Certification Of Health Care Provider (Family And Medical Leave Act Of 1993) |
March 30, 2016 |
| Subpoena To Produce Documents Information Or Objects (OALJ) |
March 30, 2016 |
| Subpoena To Appear And Testify At A Deposition (OALJ) |
March 30, 2016 |
| Labor Condition Application For Non-Immigrant Workers (H-1B Visa Program) |
January 7, 2016 |
| Application For Authority To Employ Workers With Disabilities At Special Minimum Wages |
August 13, 2015 |
| Application For Permanent Employment Certification |
April 13, 2015 |
| Application For Alien Employment Certification Part A Offer Of Employment |
April 13, 2015 |
| Application For Alien Employment Certification Part B Statement Of Qualifications Of Alien |
April 13, 2015 |
| Form LM-10 Employer Report |
March 27, 2014 |
| Homeworker Handbook |
May 13, 2013 |
| Doctors Certificate |
August 14, 2012 |
| Application-Farm Labor Contractor-Farm Labor Contractor Employee Certificate-Registration |
August 14, 2012 |
| Report Of Earnings |
November 11, 2011 |
| 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 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 |
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