Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Authorization For Release of Medical Information (Black Lung Benefits)

Form ID:

OWCP CM-936

Control ID:

OMB No. 1240-0034

Expiration date:

Mon, 31 Jan 2028 - 23:59

Forms

OWCP CM-936: Authorization For Release of Medical Information (Black Lung Benefits)