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Physician's Certification of Medical Necessity Under the Energy Employees Occupational Illness Compensation Program Act
ICR 202605-1240-003 · OMB 1240-0002 · Object 169311400.
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Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Physician's Certification of Medical Necessity Under the Energy Employees Occupational Illness Compensation Program Act |
| Subject | Form EE-17B is used to obtain a Letter of Medical Necessity (LMN) from the treating physician that describes the claimant’s Home |
| Author | US Department of Labor |
| Last Modified By | Acrobat PDFMaker 24 for Word |
| File Modified | 2024-10-24 |
| File Created | 2024-06-24 |
| Conversion State | complete |