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Get Dol Ee-2 2013
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How to fill out the DoL EE-2 online
The DoL EE-2 form is essential for filing a survivor's claim for benefits under the Energy Employees Occupational Illness Compensation Program Act. This guide will provide clear and detailed steps to help you navigate completing this form online with ease.
Follow the steps to successfully complete your DoL EE-2 form.
- Click 'Get Form' button to obtain the form and open it in the editor.
- Enter the deceased employee's information. This includes their name, sex, social security number, date of birth, and date of death. Be sure to print these details clearly.
- Indicate whether an autopsy was performed and, if applicable, list the medical facility where it took place.
- Provide survivor information, including your name, relationship to the deceased employee, sex, social security number, and date of birth.
- Fill in your address and provide your contact telephone numbers, including home and any additional numbers.
- In section 14, identify the diagnosed condition(s) that are being claimed as work-related. You should check the appropriate box and list specific diagnoses.
- Enter the date of diagnosis for the claimed condition(s) in the provided fields.
- Respond to the questions in the awards and other information section, indicating if any lawsuits or claims have been filed related to the deceased employee's condition.
- List any other potential survivors in section 22, providing their information as requested.
- Review the survivor declaration and sign the document. Ensure the date is included.
- Once completed, save your changes. You may then download, print, or share the form as needed.
Begin completing your DoL EE-2 form online today to ensure timely processing of your claim.
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Payouts under the EEOICPA can vary based on the nature of the illness and the severity of the exposure. Benefits can include lump-sum payments and ongoing medical care coverage. Connecting with resources that explain the DoL EE-2 can help clarify potential payouts and the necessary steps to access these benefits.
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