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GovBenefits.gov - Your Benefits Connection
GovBenefits.gov - Your Benefits Connection Group of potential benefit recipients
 
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>> Locate Federal Benefits >>

AM I ELIGIBLE: QUESTIONNAIRE


A maximum number of 6 question(s) remaining.
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Answer questions and review all benefits you may be eligible to receive.

Depending on your answers, you may be presented with additional questions. To ensure the most accurate results, you should answer all the questions listed. You may click the 'Stop and View Results' button at any time to review results based on the answers you already submitted. Your answers are used only to determine potential eligibility. GovBenefits.gov does not keep any data you enter.
Stop and view results

1.
Describe your current and past professional experiences.(check all that apply)
Agricultural producer / Farmer
Aquaculture operator
Clinical research
Coal miner
Dairy farmer
Educator (teaching, training)
Elected official
Emergency response worker
Federal employee
Firefighter
Fisherman
Health care professional
Law enforcement officer
Long shore or harbor worker
Migrant or seasonal farm worker
Military
Musician
Post-doctoral research
Practicing artist
Published writer / Poet
Railroad worker
Rancher
Translator
2.
What is your current marital status?
Divorced
Married
Remarried
Single
Widow(er)
3.
Are any of the following family members deceased (child, parent, spouse)?
Spouse
Parent(s)
None of the above
4.
Did your family member die due to a work-related injury or disease?
Yes
No
No Answer
5.
Are you suffering from a work-related injury or disease?
Yes
No
No Answer
6.
Did your deceased family member work as or at any of the following?(check all that apply)
Coal Minor
Department of Energy (or its predecessor agencies, vendors, contractors, or subcontractors)
Federal employee
Long shore or harbor worker
Answer more questions Stop and view results
 
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