DOL Letter to DOE Former Worker Program

 

 

Dear FWP POC Name:

 

(Survivor/Employee name) has submitted a claim for benefits under the Energy Employees Occupational Illness Compensation Program.  (Mr/Ms/ name) has claimed that he/she (his spouse/Father/Mother Full Name) participated in the {Site Name} Former Worker Screening Program.

 

The Department of Labor is requesting copies of all records you have for (employee name) to assist us in the adjudication of the claim.

 

Attached is the signed EE-3 which authorizes the FWP to release records to the Department of Labor.

 

If you have any questions regarding this request, please contact me directly at (phone number).

 

Thank you for your assistance in this matter

 

 

Sincerely,

 

 

Claims Examiner