Employee Benefits Security Administration (formerly PWBA) (EBSA)
Employment and Training Administration (ETA)
Mine Health and Safety Administration (MSHA)
Occupational Safety and Health Administration (OSHA)
Office of Federal Contract Compliance Programs (OFCCP)
Office of Labor-Management Standards (OLMS)
Office of Workers' Compensation Programs (OWCP)
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OWCP-1, Agreement and Undertaking
DLHWC (Longshore) & DCMWC (Black Lung)
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Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment under Section 1105 of Public Law 110-181 (Section 8102a)
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Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity
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Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity
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Carrier's Report of Issuance of Policy
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OWCP-5a, Work Capacity Evaluation For Psychiatric/Psychological Conditions
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OWCP-5b, Work Capacity Evaluation For Cardiovascular/Pulmonary Conditions
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OWCP-5c, Work Capacity Evaluation for Musculoskeletal Conditions
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OWCP-16, Rehabilitation Plan And Award
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OWCP-17, Rehabilitation Maintenance Certificate
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OWCP-44, Rehabilitation Action Report
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OWCP-957, Medical Travel Refund Request
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OWCP-1500, Health Insurance Claim Form
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Uniform Billing Form
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OWCP-915, Claim for Medical Reimbursement
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OWCP-20, Overpayment Recovery Questionnaire
Office of Workers' Compensation Programs - Energy Employees Occupational Illness Compensation Program (OWCP-EEOICP)
Office of Workers' Compensation Programs DCMWC (OWCP-DCMWC)
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OWCP-1168, Black Lung Provider Enrollment Form
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CM-929p, Report of Changes That May Affect Your Black Lung Benefits
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CM-623, Representative Payee Report
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CM-623S, Representative Payee Report
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CM-787, Physician's/Medical Officer's Statement
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CM-893, Certificate of Medical Necessity
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CM-908, Notice of Termination, Suspension, Reduction or Increase in Benefit Payments
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CM-910, Request To Be Selected As Payee
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CM-911, Miner's Claim For Benefits Under The Black Lung Benefits Act
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CM-911a, Employment History
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CM-912, Survivor's Form For Benefits Under The Black Lung Benefits Act
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CM-913, Description Of Coal Mine Work and Other Employment
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CM-921, Instructions For Completion of Form CM-921
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CM-929, Report of Changes That May Affect Your Black Lung Benefits
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CM-933, Roentgenographic Interpretation
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CM-933b, Roentgenographic Quality Rereading
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CM-936, Authorization For Release Of Medical Information (Black Lung Benefits)
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CM-972, Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The of Labor
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CM-981, Certification by School Official
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CM-988, Medical History and Examination for Coal Mine Workers' Pneumoconiosis
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CM-1159, Report of Arterial Blood Gas Study
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CM-2907, Report of Ventilatory Study
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CM-2970, Operator Response to Schedule for Submission of Additional Evidence
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CM-2970a, Operator Response to Notice of Claim
Office of Workers' Compensation Programs DFEC (OWCP-DFEC)
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DFEC CA-1, Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
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DFEC CA-2, Notice of Occupational Disease and Claim for Compensation
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DFEC CA-2a, Notice of Recurrence
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DFEC CA-5, Claim for Compensation by Widow, Widower, and/or Children
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DFEC CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren
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DFEC CA-6, Official Supervisor's Report of Employee's Death
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DFEC CA-7, Claim for Compensation
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DFEC CA-7a, Time Analysis Form
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DFEC CA-7b, Leave Buy Back (LBB) Worksheet/Certification and Election
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DFEC CA-10, What A Federal Employee Should Do When Injured At Work
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DFEC CA-12, Claim For Continuance of Compensation Under the Federal Employees' Compensation Act
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DFEC CA-17, Duty Status Report
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DFEC CA-20, Attending Physician's Report
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DFEC CA-35, Evidence Required in Support of a Claim for Occupational Disease
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DFEC CA-278, Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
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DFEC CA-721, Notice of Law Enforcement Officer's Injury Or Occupational Disease
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DFEC CA-722, Notice of Law Enforcement Officer's Death
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DFEC CA-1031, Letter to Dependants to Verify Claimant Support
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DFEC CA-1074, Letter to Parents in Death Claim Development
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DFEC CA-1108, Statement of Recovery Letter with Long Form
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DFEC CA-1122, Statement of Recovery Letter with Short Form
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DFEC CA-2231, Claim for Reimbursement Assisted Reemployment
Office of Workers' Compensation Programs DLHWC (OWCP-DLHWC)
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DLHWC (Longshore) LS-276, Application for Security Deposit Determination
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DLHWC (Longshore) LS-275ic, Agreement and Undertaking(Insurance Carrier)
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DLHWC (Longshore) LS-275si, Agreement and Undertaking (Self-Insured Employer)
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DLHWC (Longshore) LS-33, Approval of Compromise of Third Person Cause of Action
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DLHWC (Longshore) LS-426, Request for Earnings Information
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DLHWC (Longshore) LS-202, Employer's First Report of Injury or Occupational Illness
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DLHWC (Longshore) LS-205, Physician's Report on Impairment of Vision
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DLHWC (Longshore) LS-206, Payment of Compensation Without Award
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DLHWC (Longshore) LS-207, Notice of Controversion of Right to Compensation
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DLHWC (Longshore) LS-18, Pre-Hearing Statement
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DLHWC (Longshore) LS-208, Notice of Final Payment or Suspension of Compensation Payments
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DLHWC (Longshore) LS-210, Employer's Supplementary Report of Accident or Occupational Illness
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DLHWC (Longshore) LS-265, Certification of Funeral Expenses
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DLHWC (Longshore) LS-266, Application for Continuation of Death Benefit for Student
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DLHWC (Longshore) LS-267, Claimant's Statement
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DLHWC (Longshore) LS-271, Application for Self-Insurance
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DLHWC (Longshore) LS-274, Report of Injury Experience of Insurance Carrier or of Self-Insured Employer
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DLHWC (Longshore) LS-204, Attending Physician's Supplementary Report
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DLHWC (Longshore) LS-262, Claim for Death Benefits
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DLHWC (Longshore) LS-203, Employee's Claim for Compensation
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DLHWC (Longshore) LS-201, Notice of Employee's Injury or Death
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DLHWC (Longshore) LS-200, Report of Earnings
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DLHWC (Longshore) LS-1, Request for Examination and/or Treatment
Veterans Employment and Training
Service (VETS)
Wage and Hour Division (WHD)
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