Claim adjudication process for alleged presence of pneumoconiosis

OMB 1215-0090

Latest Forms, Documents, and Supporting Material

Document Name
Form CM-988 Roentgenographic Interpretation (CM-933), Roentgenographic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of.... Form
1215-0090 Supporting Statement.doc Supporting Statement A
DOL Privacy Act systems ESA-30.pdf Supplementary Document
DOL Privacy Act systems ESA-6.pdf Supplementary Document
cm-988.pdf Supplementary Document
CM-1159 May 2008 with 50.doc Supplementary Document
cm-2907.pdf Supplementary Document
CM-933 Rev June 2008.pdf Supplementary Document
CM-933b 02-2008.pdf Supplementary Document
Roentgenographic Interpretation (CM-933), Roentgenographic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of.... Form