Forms

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61 - 80 of 167 results
Form name Agencies Form files Details
OWCP CM-623: Representative Payee Report OWCP
OWCP CM-623s: Representative Payee Report OWCP
OWCP CM-787: Physician's/Medical Officer's Statement OWCP
OWCP CM-893: Certificate of Medical Necessity OWCP
OWCP CM-908: Notice of Termination, Suspension, Reduction, or Increase In Benefit Payments OWCP
OWCP CM-910: Request To Be Selected As Payee OWCP
OWCP CM-911: Miner’s Claim for Benefits Under The Black Lung Benefits Act OWCP
OWCP CM-911a: Employment History OWCP
OWCP CM-912: Survivor's Form For Benefits Under The Black Lung Benefits Act OWCP
OWCP CM-913: Description Of Coal Mine Work and Other Employment OWCP
OWCP CM-921: Instructions For Completion of Form CM-921 OWCP
OWCP CM-929: Report of Changes That May Affect Your Black Lung Benefits OWCP
OWCP CM-929P: Report of Changes That May Affect Your Black Lung Benefits OWCP
OWCP CM-933: Roentgenographic Interpretation OWCP
OWCP CM-933b: Radiologic Quality Rereading OWCP
OWCP CM-936: Authorization For Release of Medical Information (Black Lung Benefits) OALJ
OWCP CM-972: Application for Approval of a Representative's Fee In a Black Lung Claim Proceeding OWCP
OWCP CM-981: Certification by School Official OWCP
OWCP CM-988: Medical History and Examination for Coal Mine Workers’ Pneumoconiosis OWCP
OWCP EE-1: Worker’s Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act OWCP