Division of Energy Employees Occupational Illnesses Compensation (DEEOIC) Authorization Request Forms

ICR 202404-1240-008

OMB: 1240-0060

Federal Form Document

Forms and Documents

Document Name	Status
Form EE-32 EE-32 (Home Health Care Authorization Request) Form and Instruction	Modified
Form EE-30 EE-30 (Transplant Authorization Request) Form and Instruction	Modified
Form EE-28 EE-28 (Transportation Authorization Request) Form and Instruction	Modified
Form EE-26 EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction	Modified
Form EE-24 EE-24 (Durable Medical Equipment Authorization) Form and Instruction	Modified
Form EE-22 EE-22 (General Medical Authorization Request) Form and Instruction	Modified
Supporting Statement 1240-0060_Renewal_2024_FINAL_05 2024.docx Supporting Statement A	2024-05-22
20 CFR Part 30.pdf Supplementary Document	2020-09-24
42 USC 7384 et seq.pdf Supplementary Document	2020-09-24

IC Document Collections

IC ID	Document Title	Status
243779	EE-32 (Home Health Care Authorization Request) Form and Instruction	Modified
243778	EE-30 (Transplant Authorization Request) Form and Instruction	Modified
243777	EE-28 (Transportation Authorization Request) Form and Instruction	Modified
243776	EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction	Modified
243775	EE-24 (Durable Medical Equipment Authorization) Form and Instruction	Modified
243774	EE-22 (General Medical Authorization Request) Form and Instruction	Modified