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

OMB 0920-0639

OMB 0920-0639

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.

The latest form for [NIOSH] EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8) expires 2023-01-31 and can be found here.

OMB Details

Form A: Special Exposure Cohort Petition 42 CFR 83.9

Federal Enterprise Architecture: Income Security - Survivor Compensation

Form n/aSpecial Exposure Cohort Petition - Form AFillable FileableForm and instruction

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