Division of Energy Employees Occupational Illnesses Compensation (DEEOIC) Authorization Request Forms

ICR 202211-1240-001

OMB: 1240-0060

Federal Form Document

Forms and Documents

Document Name	Status
Form EE-32 EE-32 (Home Health Care Authorization Request) Form and Instruction	Unchanged
Form EE-30 EE-30 (Transplant Authorization Request) Form and Instruction	Unchanged
Form EE-28 EE-28 (Transportation Authorization Request) Form and Instruction	Unchanged
Form EE-26 EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction	Unchanged
Form EE-24 EE-24 (Durable Medical Equipment Authorization) Form and Instruction	Unchanged
Form EE-22 EE-22 (General Medical Authorization Request) Form and Instruction	Unchanged
Justification - 1240-0060 (EE-28) and (EE-32)_20221103.docx Justification for No Material/Nonsubstantive Change	2022-11-03
EE-32 (Home Health Care Authorization Request) Redlined updates.docx Supplementary Document	2022-08-05
Justification - Home Health Care Authorization (EE-32).docx Justification for No Material/Nonsubstantive Change	2022-08-05
Supporting Statement 1240-0NEW (DEEEOIC) 5.26.21 CLEAN.docx Supporting Statement A	2021-05-26
1240-0NEW 30-day FRN published.pdf Supplementary Document	2021-04-15
60-day FRN (1240-0NEW (DEEOIC)) published.pdf Supplementary Document	2021-01-19
20 CFR Part 30.pdf Supplementary Document	2020-09-24
42 USC 7384 et seq.pdf Supplementary Document	2020-09-24

IC Document Collections

IC ID	Document Title	Status
243779	EE-32 (Home Health Care Authorization Request) Form and Instruction	Unchanged
243778	EE-30 (Transplant Authorization Request) Form and Instruction	Unchanged
243777	EE-28 (Transportation Authorization Request) Form and Instruction	Unchanged
243776	EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction	Unchanged
243775	EE-24 (Durable Medical Equipment Authorization) Form and Instruction	Unchanged
243774	EE-22 (General Medical Authorization Request) Form and Instruction	Unchanged