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

OMB 1240-0060

Latest Forms, Documents, and Supporting Material

Document Name
Form EE-32 EE-32 (Home Health Care Authorization Request) Form and Instruction
Form EE-32 EE-32 (Home Health Care Authorization Request) Form and Instruction
Form EE-30 EE-30 (Transplant Authorization Request) Form and Instruction
Form EE-30 EE-30 (Transplant Authorization Request) Form and Instruction
Form EE-28 EE-28 (Transportation Authorization Request) Form and Instruction
Form EE-28 EE-28 (Transportation Authorization Request) Form and Instruction
Form EE-26 EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction
Form EE-26 EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction
Form EE-24 EE-24 (Durable Medical Equipment Authorization) Form and Instruction
Form EE-24 EE-24 (Durable Medical Equipment Authorization) Form and Instruction
Form EE-22 EE-22 (General Medical Authorization Request) Form and Instruction
Form EE-22 EE-22 (General Medical Authorization Request) Form and Instruction
Justification - 1240-0060 -n DEEOIC Authorization Forms_Home Health Care Authorization Request (EE-32) ONLY.docx Justification for No Material/Nonsubstantive Change
Justification - 1240-0060 -n DEEOIC Authorization Forms_Home Health Care Authorization Request (EE-32) ONLY.docx Justification for No Material/Nonsubstantive Change
Supporting Statement 1240-0060_06 21_2024_FINAL_MN_clean.docx Supporting Statement A
Supporting Statement 1240-0060_06 21_2024_FINAL_MN_clean.docx Supporting Statement A
20 CFR Part 30.pdf Supplementary Document
20 CFR Part 30.pdf Supplementary Document
42 USC 7384 et seq.pdf Supplementary Document
42 USC 7384 et seq.pdf Supplementary Document
EE-32 (Home Health Care Authorization Request) Form and Instruction
EE-32 (Home Health Care Authorization Request) Form and Instruction
EE-30 (Transplant Authorization Request) Form and Instruction
EE-30 (Transplant Authorization Request) Form and Instruction
EE-28 (Transportation Authorization Request) Form and Instruction
EE-28 (Transportation Authorization Request) Form and Instruction
EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction
EE-26 (Rehabilitative Therapies Authorization Request) Form and Instruction
EE-24 (Durable Medical Equipment Authorization) Form and Instruction
EE-24 (Durable Medical Equipment Authorization) Form and Instruction
EE-22 (General Medical Authorization Request) Form and Instruction
EE-22 (General Medical Authorization Request) Form and Instruction