Black Lung Survey- Denied Claim - Instructions Updated 8-2-2023 (002) (003)

Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)

Black Lung Survey- Denied Claim - Instructions Updated 8-2-2023 (002) (003)

OMB: 1225-0093

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Dear Claimant,


Our records indicate that you recently received a decision regarding your Federal Black Lung claim. We would like your feedback on your experience through the claim process. Your participation in the Customer Experience Survey is completely voluntary but your feedback will help us improve the claimant/customer experience. If there are any portions of the survey that you do not wish to complete, you can skip that section/question. We appreciate your assistance in helping us determine what is working and what may be improved for claimants. The following survey is confidential.



If you choose to participate in the survey, please return it using the enclosed postage paid envelope within 30 days. Thank you for your participation.




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLowe, Kenny - OWCP
File Modified0000-00-00
File Created2023-09-11

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