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Division of Energy Employees Occupational Illness Compensation (DEEOIC)

Updated Claim Forms

19 EEOICPA forms have been updated for use through December 31, 2016. The 19 forms are listed below:

EE-1

EE/EN-8

EE-1 (Spanish version)

EE/EN-9

EE-2

EE/EN-10

EE-2 (Spanish version)

EE/EN-11A

EE-3

EE/EN-11B

EE-3 (Spanish version)

EE/EN-12

EE-4

EE/EN-13

EE-4 (Spanish version)

EE/EN-16

EE-7

EE/EN-20

EE-7 (Spanish version)*

Paper stock of the prior version of these forms (with the expiration date of either October 31, 2013 or December 31, 2013) should be discarded. In addition, any electronic versions of these forms should be deleted.

*Excerpt from EEOICPA BULLETIN NO. 14-02