Information Collection Request

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

ICR 202503-1240-002 · OMB 1240-0060 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1240-0060 can be found here:

2026-02-27 - No material or nonsubstantive change to a currently approved collection

Forms and Documents

Document	Type	Status	Availability
Form EE-32 EE-32 (Home Health Care Authorization Request)	Form and Instruction	Modified	Available
Form EE-32 EE-32 (Home Health Care Authorization Request)	Form and Instruction	Modified	Missing upstream
Form EE-30 EE-30 (Transplant Authorization Request)	Form and Instruction	Unchanged	Repair queued
Form EE-30 EE-30 (Transplant Authorization Request)	Form and Instruction	Unchanged	Missing upstream
Form EE-28 EE-28 (Transportation Authorization Request)	Form and Instruction	Unchanged	Repair queued
Form EE-28 EE-28 (Transportation Authorization Request)	Form and Instruction	Unchanged	Missing upstream
Form EE-26 EE-26 (Rehabilitative Therapies Authorization Request)	Form and Instruction	Unchanged	Available
Form EE-26 EE-26 (Rehabilitative Therapies Authorization Request)	Form and Instruction	Unchanged	Repair queued
Form EE-24 EE-24 (Durable Medical Equipment Authorization)	Form and Instruction	Unchanged	Repair queued
Form EE-24 EE-24 (Durable Medical Equipment Authorization)	Form and Instruction	Unchanged	Repair queued
Form EE-22 EE-22 (General Medical Authorization Request)	Form and Instruction	Unchanged	Available
Form EE-22 EE-22 (General Medical Authorization Request)	Form and Instruction	Unchanged	Missing upstream
Justification - 1240-0060 -n DEEOIC Authorization Forms_Home Health Care Authorization Request (EE-32) ONLY.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-24	Repair queued
Justification - 1240-0060 -n DEEOIC Authorization Forms_Home Health Care Authorization Request (EE-32) ONLY.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-24	Repair queued
Supporting Statement 1240-0060_06 21_2024_FINAL_MN_clean.docx	Supporting Statement A	Uploaded 2024-06-21	Available
Supporting Statement 1240-0060_06 21_2024_FINAL_MN_clean.docx	Supporting Statement A	Uploaded 2024-06-21	Repair queued
20 CFR Part 30.pdf	Supplementary Document	Uploaded 2020-09-24	Repair queued
20 CFR Part 30.pdf	Supplementary Document	Uploaded 2020-09-24	Missing upstream
42 USC 7384 et seq.pdf	Supplementary Document	Uploaded 2020-09-24	Available
42 USC 7384 et seq.pdf	Supplementary Document	Uploaded 2020-09-24	Repair queued

IC Document Collections

IC ID	Collection	Type	Status
243779	EE-32 (Home Health Care Authorization Request)	Form and Instruction	Modified
243779	EE-32 (Home Health Care Authorization Request)	Form and Instruction	Modified
243778	EE-30 (Transplant Authorization Request)	Form and Instruction	Unchanged
243778	EE-30 (Transplant Authorization Request)	Form and Instruction	Unchanged
243777	EE-28 (Transportation Authorization Request)	Form and Instruction	Unchanged
243777	EE-28 (Transportation Authorization Request)	Form and Instruction	Unchanged
243776	EE-26 (Rehabilitative Therapies Authorization Request)	Form and Instruction	Unchanged
243776	EE-26 (Rehabilitative Therapies Authorization Request)	Form and Instruction	Unchanged
243775	EE-24 (Durable Medical Equipment Authorization)	Form and Instruction	Unchanged
243775	EE-24 (Durable Medical Equipment Authorization)	Form and Instruction	Unchanged
243774	EE-22 (General Medical Authorization Request)	Form and Instruction	Unchanged
243774	EE-22 (General Medical Authorization Request)	Form and Instruction	Unchanged

ICR Details

Status	Active
Agency/Subagency	DOL/OWCP
OMB Control No	1240-0060
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202404-1240-008
Date Submitted to OIRA	2025-03-24
Requested Expiration Date	1969-12-31