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EE-17B Physician Certification of Medical Necessity under the E
Energy Employees Occupational Illness Compensation Program Act Forms
EE-17B
EEOICP Forms for Private Sector
OMB: 1240-0002
OMB.report
DOL/OWCP
OMB 1240-0002
ICR 202412-1240-003
IC 178683
EE-17B Physician Certification of Medical Necessity under the E
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1240-0002 can be found here:
2026-03-12 - No material or nonsubstantive change to a currently approved collection
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