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To help determine continuing eligibility of primary beneficiaries receiving black lung benefits from the Disability Trust Fund. To verify and update on a regular basis factors that affect a beneficiary's entitlement to benefits, including income, marital status, receipt of State Worker's Compensation, and dependent status. |
Form #:
CM- 929
P
Agency:
Department of Labor
Bureau:
Employment Standards Administration
Common Name:
Report of Changes That May Affect Your Black Lung Benefits
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