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Operator Response To Notice of Claim

Form ID:

OWCP CM-2970a

Control ID:

OMB No. 1240-0033

Expiration date:

Sat, 31 Oct 2026 - 23:59

Forms

OWCP CM-2970a: Operator Response To Notice of Claim

This information is authorized by the Black Lung Benefits Act 30 U.S.C. 901 et. Seq., and the regulations of the U.S. Department of Labor governing the administration of such Act (20 CFR 725.408). Please check appropriate boxes and provide requested information. While you are not required to respond, if you fail to do so within 30 days of your receipt of the Notice of Claim you shall not be allowed to contest your liability for the payment of benefits on any of the five specific grounds set forth below in Section B. (20 CFR 725.408). You must send a copy of this response to the claimant by regular mail.