| U.S. Department of Labor | Office of Workers’ Compensation Programs Division of Energy Employees Occupational Illness Compensation Washington, DC 20210 |  |
Issue Date: April 16, 2018
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Effective Date: April 16, 2018
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Expiration Date: April 16, 2019
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Subject: Complaint Process for Licensed Medical Care Providers.
Background: This Bulletin provides guidance to all Division of Energy Employees Occupational Illness Compensation (DEEOIC) staff on how to handle complaints regarding services provided by licensed medical care providers.
References: 42 U.S.C. § 7384t, 42. U.S.C. § 7385s-8, 20 CFR Part 30.400, 20 CFR Part 30.403.
Purpose: To provide guidance on handling licensed medical care provider complaints.
Applicability: All staff.
Actions:
1. When a district office or Final Adjudication Branch (FAB) staff member receives a written complaint from an employee/claimant/authorized representative about a licensed medical care provider, the district office or FAB staff member is to complete the Licensed Medical Care Provider Complaint Form (Exhibit 1) according to the instructions provided. If the district office or FAB staff member receives the complaint during a telephone interaction, he or she is to advise the employee/claimant to document the complaint in writing and to forward it to the DOL DEEOIC Central Mail Room. Upon receipt, the district office or FAB staff member will then complete the Licensed Medical Care Provider Complaint Form, including its submission to the designated email address.
2. Upon receipt, DEEOIC Program Integrity staff will review the Licensed Medical Care Provider Complaint Form to determine whether the complaint warrants further analysis.
3. Once Program Integrity staff complete an analysis of potential violations of local/state rules/regulations/laws, guidelines or codes of conduct, regarding medical care or conduct, they will prepare a written notification to the appropriate local/state entity responsible for compliance enforcement.
Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual.
RACHEL P. LEITON
Director, Division of Energy Employees
Occupational Illness Compensation
Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, and District Office Mail and File Sections.