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| DOL Home > Find It! By Form > DOL Form |
DOL Form CM-933
Agency: |
OWCP-DCMWC |
Title: |
CM-933, Roentgenographic Interpretation |
Form Description: |
CM-933, Roentgenographic Interpretation: The CM-933 form is used by the examining physician or radiologist to record the results of the diagnostic x-ray. The X-ray is a required diagnostic test used to determine if a claimant has pneumoconiosis. |
OMB Control Number: |
1215-0090 |