OMB control number

Coal Mine Operator Response to Schedule for Submission of Additional Evidence and Operator Response to Notice of Claim

OMB 1240-0033 · DOL/OWCP.

OMB 1240-0033

The OWCP, Division of Coal Mine Workers' Compensation (DCMWC) administers the Black Lung Benefits Act (30 U.S.C. 901 et seq.), which provides benefits to coal miners totally disabled due to pneumoconiosis and their surviving dependents. When the DCMWC makes a preliminary analysis of a claimant's eligibility for benefits, and if a coal mine operator has been identified as potentially liable for payment of those benefits, the responsible operator is notified of the preliminary analysis. Regulations codified at 20 CFR part 725 require that a coal mine operator be identified and notified of potential liability as early in the adjudication process as possible. Coal Mine Operator Response to Schedule for Submission of Additional Evidence (Form CM-2970) and Operator Response to Notice of Claim (Form CM-2970a) are used for claims filed after January 19, 2001, and indicate that the coal mine operator will submit additional evidence or respond to the notice of claim.

The latest form for Coal Mine Operator Response to Schedule for Submission of Additional Evidence and Operator Response to Notice of Claim expires 2026-10-31 and is listed under ICR 202401-1240-003.

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202401-1240-003 No material or nonsubstantive change to a currently approved collection 2024-01-31 Approved without change
202304-1240-007 Revision of a currently approved collection 2023-09-11 Approved without change
202002-1240-005 Revision of a currently approved collection 2020-06-16 Approved without change
201611-1240-002 Extension without change of a currently approved collection 2017-03-22 Approved without change
201309-1240-004 Revision of a currently approved collection 2014-01-30 Approved without change
201011-1240-002 Extension without change of a currently approved collection 2010-12-24 Approved without change
201003-1240-033 Revision of a currently approved collection 2010-03-12 Approved without change