[NIOSH] EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8)

The Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA), 42 U.S.C. 7384-7385 [1994, supp. 2001], established a compensation program to provide a lump sum payment of $150,000 and medical benefits as compensation to covered employees suffering from designated illnesses incurred as a result of their exposure to radiation, beryllium, or silica while in the performance of duty for the Department of Energy and certain of its vendors, contractors and subcontractors. NIOSH is charged with carrying out certain responsibilities under the Energy Employees Occupational Illness Compensation Program Act of 2000 on behalf of U.S. nuclear weapons workers with cancer. One of these responsibilities is to consider petitions by classes of nuclear weapons workers to be added to the Special Exposure Cohort (SEC), a cohort of workers whose claims for cancer under EEOICPA can be adjudicated without demonstrating that their cancer was “at least as likely as not” caused by radiation doses they incurred in the performance of duty. EEOICPA authorizes HHS to designate such classes of employees for addition to the Cohort when HHS lacks information to estimate the radiation doses received by these workers with sufficient accuracy. This Extension will serve to allow this information collection to continue for an additional three years.

The latest form for [NIOSH] EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8) expires 2029-01-31 and can be found here.

Form A: Special Exposure Cohort Petition 42 CFR 83.9

Federal Enterprise Architecture: Income Security - Survivor Compensation

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.