Division of Energy Employees Occupational Illness Compensation (DEEOIC)

The DEEOIC Medical Director conducts regular or quarterly audits of cases that have been referred to a Contract Medical Consultant (CMC) or to a Second Opinion Medical Specialist (SECOP), using the sample forms below to assist in the audit assessment of the CMC to determine whether the physician’s written medical report was complete and responsive, and whether responses were well-rationalized and consistent with the totality of evidence in the case under review.


File Review Worksheet

Impairment Evaluation Worksheet

Referee Medical Opinion Worksheet

Second Medical Opinion Worksheet

NOTE:

DEEOIC has redacted the names of the individual Contract Medical Consultant (CMC) physicians identified in the CMC audit report to protect the identities - personally identifiable information (PII) - regarding these individual physicians pursuant to Exemption 6 under the Freedom of Information Act (FOIA). Exemption 6 under FOIA permits an agency to withhold information in “personnel and medical files and similar files, the disclosure of which would constitute a clearly unwarranted invasion of personal privacy.” Additionally, the identities of individual physicians and other personnel working for medical services contractor are protected under Exemption 4 of the FOIA, which protects “trade secrets and commercial or financial information obtained from a person [that is] privileged or confidential.”

Informative