Sample Letter Participation

Attachment 9 –

Sample letter to each miner informing of the opportunity to participate in the CWHSP

JOHN Q DOE

123 MAIN STREET

MORGANTOWN, WV 26508

Dear JOHN Q DOE

The National Institute for Occupational Safety and Health (NIOSH) in Morgantown, West Virginia, administers the Coal Workers' Health Surveillance Program (CWHSP) which is a congressionally-mandated medical examination surveillance program for monitoring the health of coal miners. The CWHSP was originally authorized under the 1969 Federal Coal Mine Health and Safety Act and is currently authorized under the 1977 Federal Mine Safety and Health Act and its subsequent amendments (The Act). NIOSH recently approved a Plan filed by your employer, HIDDEN POINT MINES, to offer you a chest examination at your employer's expense. The CWHSP began in 1969, and you may have participated in this Program at some time in the past. You now have the opportunity to participate again. Free chest examinations are offered under this Program only once every 5 years and for only 6 months. The approved Plan should be posted on the mine bulletin board in a visible location, or in the case of an operator who does not have a bulletin board, such as an operator that is a contractor, they must otherwise notify you of the examination arrangements and have a copy of the Plan available for inspection. Upon request, the contractor must show NIOSH written evidence that the miner has been notified.

I am contacting you at this time to make you aware of your rights and encourage you to take advantage of this opportunity. Participation in the CWXSP is BENEFICIAL and EASY.

WHAT: FREE Chest Examination

WHEN: Between 02/15/2015 and 08/14/2015

HOW: If you are employed by the above named company/mine, complete the enclosed MINER

IDENTIFICATION DOCUMENT and take it to one of the listed facilities. This form

is required – please make it as complete as possible. For your convenience, some

of the information has already been entered. The facility will keep the form and send

it to NIOSH. If there is an urgent problem, we will call you as soon as possible, and

you should receive a written report within 60 days of our receipt of your information.

WHERE: ABC FACILITY – (999) 555-1212

XYZ CLINIC – (999) 555-1313

QWE HOSPITAL - (999) 555-1414

MORGANTOWN RADIOGRAPH FACILITY – (999) 555-1515

YOUR RIGHTS UNDER THE CWHSP

The Act and the regulations for the CWHSP guarantee that periodic chest examinations be offered:

* at no cost to you;

* at a convenient date, hour and location;

* with adequate notice to participate;

* with no report of results sent to your employer.

YOUR BENEFITS FROM PARTICIPATION

The Act established special programs and protection for you and other coal miners. Participation in the CWHSP gives you:

* An easy way of checking on your health;

* An opportunity to find out if you have evidence of coal worker's pneumoconiosis,

(CWP), commonly referred to as "black lung";

* An opportunity for detection, at an early stage, some chest problems other than "black lung".

If you are found to have radiograph evidence of CWP, you can choose:

* An option to work in a low dust area of the mine with no loss in rate of pay;

* Regular monitoring of your dust exposure levels by the Mine Safety and Health

Administration.

HELP US PROTECT YOU AND OTHER COAL MINERS!

Please complete the MINER IDENTIFICATION DOCUMENT, and take it to one of the listed facilities.

We hope you will choose to participate. The CWHSP is intended to protect your health.

If you have any questions or concerns about the Program, please contact us at the address or telephone number listed above or at our toll-free number (1-888-480-4042).

Sincerely yours,

James W. Lawson

Health Assessment Specialist

Coal Workers' Health Surveillance Program

Surveillance Branch

Respiratory Health Division