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Claim adjudication process for alleged presence of pneumoconiosis
OMB 1215-0090
OMB.report
DOL/ESA
OMB 1215-0090
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
All Historical Document Collections
200802-1215-002
Approved with change
Extension without change of a currently approved collection
2008-04-25
200502-1215-003
Approved without change
Revision of a currently approved collection
2005-02-04
200203-1215-001
Approved without change
Revision of a currently approved collection
2002-03-29
200201-1215-001
Withdrawn and continue
Revision of a currently approved collection
2002-01-24
199903-1215-001
Approved without change
Extension without change of a currently approved collection
1999-03-19
199601-1215-001
Approved without change
Extension without change of a currently approved collection
1996-01-26
199212-1215-002
Approved without change
Revision of a currently approved collection
1992-12-03
198911-1215-001
Approved without change
Revision of a currently approved collection
1989-11-13
198702-1215-006
Approved without change
Revision of a currently approved collection
1987-02-25
198605-1215-007
Approved without change
Revision of a currently approved collection
1986-05-29
198305-1215-002
Approved without change
Revision of a currently approved collection
1983-05-03
198106-1215-001
Approved without change
Revision of a currently approved collection
1981-06-20
198005-1215-004
Approved without change
New collection (Request for a new OMB Control Number)
1980-05-12
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