DOL Seeks to Extend Black Lung Survivor Form Without Changes
Published Date: 4/10/2026
Notice
Summary
The Department of Labor wants to keep using the Survivor's Form for Black Lung Benefits and is asking for your thoughts by June 9, 2026. This form helps survivors of coal miners get the benefits they deserve, and the DOL aims to keep paperwork simple and easy. No big changes or costs are planned—just a smooth extension to keep things running.
Analyzed Economic Effects
2 provisions identified: 1 benefits, 1 costs, 0 mixed.
Survivor Application Form Extended
The Department of Labor is proposing to extend use of Form CM-912, the Survivor's Form for Benefits Under the Black Lung Benefits Act. Form CM-912 is the application survivors of deceased coal miners use to request benefits and to determine entitlement, and the form is authorized under the Black Lung Benefits Act (30 U.S.C. 901 et seq.).
Paperwork Burden and Cost Estimates
The notice reports the information-collection estimates for Form CM-912: 1,080 respondents and 1,080 responses, with 144 annual burden hours and $807 in annual respondent or recordkeeper cost. The request is for an extension without change of the currently approved collection.
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Key Dates
Department and Agencies
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