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Black Lung Benefits Act
Black Lung Benefits Act.pdf
Claim for Medical Reimbursement Form
Black Lung Benefits Act
OMB: 1240-0007
OMB.report
DOL/OWCP
OMB 1240-0007
ICR 202404-1240-007
Black Lung Benefits Act
( Supplementary Document )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0007 can be found here:
2026-01-08 - No material or nonsubstantive change to a currently approved collection
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