Effective immediately, the Division of Coal Mine Workers’ Compensation (DCMWC), or Federal Black Lung program, will no longer use form CM-913 to collect employment history. All employment information will be collected using an updated version of the CM-911a form.

Executive Order 14058, Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government, signed in December 2021, directed agencies to examine customer service practices and make improvements. DCMWC reviewed our forms and found the information collected on form CM-913 to be the most difficult for the coal miner or third parties to complete. We determined that it would be more user friendly to combine all employment information into one form (CM-911a) to help streamline claim processing. The revised form CM-911a still collects the necessary information regarding coal mine employment and other employment, as well as the information required by our medical providers to conduct diagnostic testing.

In addition to the CM-911a, the CM-911 was recently updated. Please ensure that you are using the latest versions of all DCMWC’s forms.