Employee:

Claimant:

Case ID:

Claimant Name

Address

Dear [Claimant Name]:

This is the third and final demand letter for payment in reference to the overpayment of compensation in your Part {B and/or E} claim filed under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA or Act).

On [date], the Division of Energy Employees Occupational Illness Compensation (DEEOIC) sent you an overpayment final decision informing you of an overpayment of compensation in the amount of [$ ] in your Part {B and/or E} claim. The decision provided a detailed explanation of the overpayment, informed you that you must repay it, and that interest began accruing on the debt at the rate of [ %] annually. Since you did not respond to the notice, the DEEOIC sent you a second demand letter on [date]. You have not returned the overpaid compensation or made arrangements to do so. Therefore, this is a delinquent debt.

When an overpayment debt remains delinquent, it must be referred to the United States Department of the Treasury for collection. This referral is authorized under the Debt Collection Act, which also authorizes the assessment of interest, administrative costs, and penalties on delinquent debts. The Department of the Treasury may recover an overpayment by garnishing the debtor’s salary; administratively offsetting any federal payments that may be due to the debtor; or referring the debt to a collection agency. Administrative costs and penalties will be added to the debt. In addition, information about the status and delinquency of the debt is reportable to credit bureaus. The information that will be provided to a credit bureau includes your name, address, social security number, the amount, status, and history of the debt, and the program under which the debt arose (Energy Employees Occupational Illness Compensation Program).

Certain rights are provided to you with respect to the referral of your debt to the Department of Treasury or credit bureaus. If you think that the determination regarding the debt is in error, you may request further information as noted below, and send your request to: DEEOIC, DOL Central Mail Room, PO Box 8306, London, KY 40742-8306.

· You may request copies of your records about this debt.

· You may request a review of our determination about the amount of your debt, its past-due status, and its legal enforceability. To exercise this right, you must state your request in writing, state your reason(s) for challenging our determinations, and sign your statement.


· If you believe that any information of record concerning your debt is not accurate, timely, relevant, or complete, you must provide information or documentation to support your belief.

To resolve this matter and avoid further collection activities and additional fees, please send your payment within 30 days to the address below. Make your check or money order in the amount of [$ ] payable to “U.S. Dept. of Labor, OWCP/DEEOIC.” Please notate the case ID number on the form of payment and indicate that it is for an overpayment refund. Send the payment to:

US DEPARTMENT OF LABOR

DEEOIC

200 Constitution Ave. NW, Room C-3320

Washington, DC 20210

If you cannot pay the full amount of the overpayment at this time, you may request that we set up an installment repayment plan. If you have any questions about this letter or wish to set up a repayment plan, you may contact me at [PA phone number] or 202-693-0081. This is the final notice before the debt is referred to the Department of the Treasury.

Sincerely,

{PA name}

Policy Analyst

Policy Unit, DEEOIC

Notice to Customers Making Payment by Check

When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment.

Privacy Act – A Privacy Act Statement required by 5 U.S.C. § 552a(e)(3) stating our authority for soliciting and collecting the information from your check, and explaining the purposes and routine uses which will be made of your check information, is available on internet site at: https://www.pccotc.gov/pccotc/index.htm , or call toll free at 1-866-945-7920 to obtain a copy by mail. Furnishing the check information is voluntary, but a decision not to do so may require you to make payment by some other method.