Web Survey for Soliciting Feedback for Division of Energ

EDP Web Survey

Thank you for agreeing to take our survey. Your feedback will allow us to improve our system and better serve our claimants. The OMB control number for this collection is 1225-0093 and expires on June 30, 2024. According to the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless such collection displays a valid OMB control number. Collection of this information is authorized by OMB. The obligation to respond to this collection is voluntary. We estimate it takes about 3 minutes to complete. 

1. What was the primary type of document you uploaded today? (Select one)

• Claims and Forms - All Others

• Death Records

• Employment Evidence

• Fiscal Documents

• Home Health Care Documents

• Identification of Authorized Representative

• Medical Records

• Objections to Recommended Decision Including Hearing Documents

• Occupational History Interview

• Other Documents

• Phone or Address Change

• Reconsideration Request

• Reopening Request

• Request for Copy of Case File

• Survivorship Evidence

• Telephone Records

• Waivers or Partial Waivers to Recommended Decision

• Ancillary Medical Services

2. Please rate your experience with EDP today.

• Outstanding (5)  

• Above Average (4)  

• Average (3)  

• Below Average (2)  

• Poor (1)  

3. I was able to complete the task I set out to do in EDP.

• Strongly agree (5)  

• Agree (4)  

• Neutral (3)  

• Disagree (2)  

• Strongly disagree (1)  

4. It was easy to complete my document upload in EDP.

• Strongly agree (5)  

• Agree (4)  

• Neutral (3)  

• Disagree (2)  

• Strongly disagree (1)  

5. It was easy to complete my document upload in EDP.

• Strongly agree (5)  

• Agree (4)  

• Neutral (3)  

• Disagree (2)  

• Strongly disagree (1)  

6. I understood what was being asked of me throughout the process.

• Strongly agree (5)  

• Agree (4)  

• Neutral (3)  

• Disagree (2)  

• Strongly disagree (1)  

7. This interaction increased my trust in DEEOIC. 

• Strongly agree (5)  

• Agree (4)  

• Neutral (3)  

• Disagree (2)  

• Strongly disagree (1)  

8. Do you have any additional feedback on EDP?