Form EE-1 Worker's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

Form EE-1 Worker's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

What Is Form EE-1?

This is a legal form that was released by the U.S. Department of Labor - Office of Workers' Compensation Programs on September 1, 2021 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-1?A: Form EE-1 is the Worker's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act.

Q: What is the purpose of Form EE-1?A: The purpose of Form EE-1 is to apply for benefits under the Energy Employees Occupational Illness Compensation Program Act.

Q: Who is eligible to use Form EE-1?A: Workers who have developed illnesses or conditions due to exposure to radiation or other toxic substances while working for the Department of Energy or its contractors are eligible to use Form EE-1.

Q: What should I include when filing Form EE-1?A: When filing Form EE-1, you should include information about your employment history, medical conditions, and any supporting documentation.

Q: What benefits can I receive through the Energy Employees Occupational Illness Compensation Program?A: Through the Energy Employees Occupational Illness Compensation Program, you may be eligible for medical benefits, wage loss compensation, and impairment compensation.

Q: Is there a deadline for filing Form EE-1?A: Yes, there is a deadline for filing Form EE-1. You must file the claim within three years of the date you knew or should have known of the connection between your illness and your employment.

Q: Can I appeal if my claim is denied?A: Yes, if your claim is denied, you have the right to appeal the decision and request a hearing.

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Form Details:

  • Released on September 1, 2021;
  • 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-1 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-1 Worker's Claim for Benefits Under the Energy Employees Occupational Illness Compensation Program Act

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