U.S. Department of Labor - Division of Coal Mine Workers' Compensation Forms
The U.S. Department of Labor - Division of Coal Mine Workers' Compensation is responsible for administering and enforcing the provisions of the Black Lung Benefits Act. This act provides compensation and benefits to coal miners who have been disabled or have died due to black lung disease, which is caused by the inhalation of coal dust. The division processes claims, determines eligibility for benefits, and ensures that qualified individuals receive their rightful compensation.
Documents:
31
PDF 
Word
This form is used for reporting any changes that could impact your black lung benefits.
This form is used for reporting any changes that may impact your Black Lung benefits.
This document is used for reporting the activities and finances of a representative payee who manages funds for someone receiving Social Security or Supplemental Security Income.
This Form is used for reporting information by representative payees for Social Security and Supplemental Security Income beneficiaries.
