Agency:

OWCP-DCMWC

Title:

CM-988, Medical History and Examination for Coal Mine Workers' Pneumoconiosis

Form Description:

CM-988, Medical History and Examination for Coal Mine Workers' Pneumoconiosis: After a coal miner applies for black lung benefits, a complete pulmonary evaluation is authorized in order to determine if the claimant is totally disabled by pneumoconiosis. The CM-988 is completed by the physician authorized to perform the physical examination for DCMWC.

OMB Control Number:

1215-0090

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