Form EE-2 Survivor's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form EE-2 for the current year.

Form EE-2 Survivor's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

What Is Form EE-2?

This is a legal form that was released by the U.S. Department of Labor - Office of Workers' Compensation Programs on November 1, 2016 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form EE-2?
A: Form EE-2 is a document used for filing a survivor's claim for benefits under the Energy Employees Occupational IllnessCompensation Program Act.

Q: Who can use Form EE-2?
A: Form EE-2 can be used by survivors of eligible employees who have died as a result of a covered illness or injury.

Q: What is the Energy Employees Occupational Illness Compensation Program Act?
A: The Energy Employees Occupational Illness Compensation Program Act is a federal program that provides compensation and benefits to certain employees and their survivors who have been diagnosed with specific illnesses or conditions due to their work in the nuclear weapons industry.

Q: What benefits are available under the program?
A: The program provides medical benefits, wage-loss compensation, and survivor benefits to eligible individuals.

Q: How do I file a survivor's claim using Form EE-2?
A: To file a survivor's claim, you need to complete Form EE-2 and submit it to the appropriate office as instructed on the form.

Q: Are there any eligibility requirements to use Form EE-2?
A: Yes, you must be a survivor of an eligible employee who has died as a result of a covered illness or injury to use Form EE-2.

ADVERTISEMENT

Form Details:

  • Released on November 1, 2016;
  • The latest available edition released by the U.S. Department of Labor - Office of Workers' Compensation Programs;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form EE-2 by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Office of Workers' Compensation Programs.

Download Form EE-2 Survivor's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

4.3 of 5 (23 votes)
  • Form EE-2 Survivor's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

    1

  • Form EE-2 Survivor's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act, Page 2

    2

  • Form EE-2 Survivor's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act, Page 3

    3

  • Form EE-2 Survivors Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act, Page 1
  • Form EE-2 Survivors Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act, Page 2
  • Form EE-2 Survivors Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act, Page 3
Prev 1 2 3 Next
ADVERTISEMENT