Claim for Benefits under Energy Employees - US Department of Labor 2025

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The document is a claim form for survivor benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). It requires detailed information about the deceased employee, their diagnosed work-related conditions, and the relationship of the claimant to the deceased. The form also includes sections for additional potential survivors, declarations regarding false statements, and instructions for completing the form. It emphasizes the importance of providing accurate information and outlines privacy considerations related to personal data.

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What is the difference between EEOICPA part B and part E?

Part B only covers cancers caused by radiation. Claims for cancers caused by toxic substances will need to be pursued under Part E claims. Precancerous conditions are not covered under Part B, but may be covered under Part E.

What are the benefits of the EEOICPA part E?

In addition to an impairment award, benefits under Part E of the EEOICPA can include payment of medical expenses, wage loss benefits, and survivor benefits. The maximum compensation amount for all claims relating to one individual under Part E of the EEOICPA is $250,000.

Who is covered under the energy employees occupational illness compensation program?

Part E of the EEOICPA compensates DOE contractor and subcontractor employees, eligible survivors of such employees, and uranium miners, millers, and ore transporters as defined by RECA Section 5, for any occupational illnesses that are causally linked to toxic exposures in the DOE or mining work environment.

What is the Energy Employees Occupational Illness Compensation Program Act EEOICPA of 2000?

The Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA or the Act), as Amended, established a compensation program for the civilian men and women who, over the past 50 years, have performed duties uniquely related to the nuclear weapons production and testing programs of the Department of

What cancers are covered by the EEOICPA?

EEOICPA: The 22 Specified Cancers Leukemia; Primary or secondary cancer of the lungs; Primary or secondary bone cancer; Primary or secondary renal cancer; Primary thyroid cancer; Primary cancer; Primary esophagus cancer; Primary stomach cancer;

How do I file an EEOICPA claim?

How to File for EEOICPA Benefits Step 1: Complete the application form titled, Employee Claim for Benefits under the EEOICPA (form EE-1). Step 2: Complete the form titled, Employment History (form EE-3). Step 3: Include any copies of supporting medical and employment documentation along with your application.

What are the benefits of the Federal employees compensation Act?

The Federal Employees Compensation Act (FECA) provides compensation benefits to civilian employees for disability due to personal injury or disease sustained while in the performance of duty. The FECA also provides for payment of benefits to dependents if a work-related injury or disease causes an employees death.

What conditions are covered by the EEOICPA?

To be eligible, an employee must have: cancer, chronic silicosis, beryllium sensitivity, or. chronic beryllium disease and worked at a covered DOE facility, atomic weapons employer facility, or a beryllium vendor facility during a specified time period.

Claim for Benefits under Energy Employees - US Department of Labor 2025

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