Radiologic Interpretation (CM-933), Radiologic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of....

Claim Adjudication Process for the Alleged Presence of Pneumoconiosis

OMB: 1240-0023

IC ID: 13765

Documents and Forms

Document Name Document Type
Form CM-933 Radiologic Interpretation (CM-933), Radiologic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of.... Form
Form CM-933 Radiologic Interpretation (CM-933), Radiologic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of.... Form
CM-933 Radiologic Interpretation CM-933-Form Non-Sub.docx www.dol.gov/agencies/owcp/dcmwc/regs/compliance/blforms#black Form
CM-933b Radiologic Quality Rereading CM-933b Non-Sub.docx www.dol.gov/agencies/owcp/dcmwc/regs/compliance/blforms#black Form
CM-988 Medical History and Examination for Coal Mine Workers’ Pneumoconiosis CM-988 Non-Sub.docx www.dol.gov/agencies/owcp/dcmwc/regs/compliance/blforms#black Form
CM-1159 Report of Arterial Blood Gas Study CM-1159 Non-Sub.docx www.dol.gov/agencies/owcp/dcmwc/regs/compliance/blforms#black Form
CM-2907 Report of Ventilatory Study CM-2907 Non-Sub.docx www.dol.gov/agencies/owcp/dcmwc/regs/compliance/blforms#black Form