Attention: This bulletin has been superseded and is inactive.
Issue Date: September 6, 2002
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Expiration Date: Immediately
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Expiration Date: September 6, 2003
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Subject: ECMS Closure Codes
Background: ECMS closure codes are status claim codes that are used to indicate a claim has been closed. The number of closure codes and their descriptions were reviewed by the EMS Workgroup and it was found that the number of codes could be reduced by incorporating similar code descriptions. Closure code C2, C3, and C6 have been incorporated into closure code C3. This code should be used to close a claim when the employee dies.
Reference: ECMS FAQs (Frequently Asked Questions) on the DEEOIC shared drive.
Purpose: To clarify for the District Offices when and how ECMS closure codes should be used.
Applicability: All staff.
Actions:
1. The CE is required to input the following ECMD closure codes in the Claim Status History screen as appropriate.
C0 Closed –ADMINISTRATIVE ERROR
· Use this claim status code if a claim is created in error.
C1 Closed –CLAIM WITHDRAWN BY CLAIMANT
· Use this claim status code if the claimant withdraws an unadjudicated claim.
C3 CLOSED- EMPLOYEE DIED
· Use this claim status code when the employee dies. This code can be used on adjudicated and unadjudicated claims
· If submitted, bills on unadjudicated and denied cases will reject for payment.
· Bills on accepted cases will be paid.
C4 CLOSED-FAB AFFIRMED DO DENIAL
· Use this claim status code on a claim in which FAB affirms a recommended decision denying benefits.
· The claimant was given 30 days to appeal the final decision.
· There has been no communication between the Office and the claimant for a minimum of 30 days.
C5 CLOSED – FAB REVERSED DO RECOMMEND DECISION AND ISSUED DENIAL
· Use the claim status code on a claim in which FAB reverses a recommended decision approving benefits.
· FAB issued a final decision denying benefits.
· The claimant was given 30 days to appeal the final decision.
· There has been no communication between the Office and the claimant for a minimum of 30 days.
C7 CLOSED- SURVIVOR PAID
· Use this claim status code on a survivor claim after compensation is paid.
C8 CLOSED- SURVIOR DED PRIOR TO PAYMENT BEING MADE
· Use this claim status code on a survivor claim after if the survivor dies before compensation is paid.
C9 CLOSED-RECA CLAIM
· Use this claim status code if a claim is filed with EEOICP prior to adjudication by the Department of Justice.
CC APPEALED TO DISTRICT COURT
· Use this claim status code if the final decision issued by FAB is appealed to District Court. The process for handling those cases in which final decisions have been appealed to District Court is under review at the National Office.
2. Those claims which have already been coded C2 or C6 will not be changed to C3. Backfill will not be done.
Disposition: Retain until incorporated in the Federal (EEOICPA)Procedure Manual
PETER M. TURCIC
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, District Office Mail & File Sections, ADP Coordinators