Attention: This bulletin has been superseded and is inactive.
Issue Date:
________________________________________________________________
Effective Date:
________________________________________________________________
Expiration Date:
________________________________________________________________
Subject: Referrals to Dr. Lee Newman
Background: Section 78841 (8) (A) & (13) requires Claims Examiners (CEs)to adjudicate claims for Chronic Beryllium Disease (CBD) and Beryllium Sensitivity (BeS) based on certain criteria. Prior to
The National Office has established a contractual and billing agreement with Dr. Lee Newman, of the National Jewish Medical and
For tracking and budgetary purposes the National Office will manage all referrals and completed evaluations.
Reference: Energy Employees Occupational Illness Compensation Program Act of 2000, As Amended, 42 U.S.C. 7384 et seq., Section 73841(8)(A) and (13).
Purpose: To notify the District Offices of the procedures for referring a claim to Dr. Lee Newman.
Applicability: Claims Examiners, Senior Claims Examiners, All Supervisors, Technical Assistants, and mail room staff
Actions:
1. The CEs should consider consulting Dr. Newman if they are
unable to interpret medical evidence for a Beryllium Sensitivity or Chronic Beryllium Disease case, and have no success with clarification from the claimants physician. Examples of situations when a referral is needed may include:
Pre 1993 medical evidence is submitted that includes a lung biopsy report that is inconclusive, a positive LPT and x-rays that show granulomas in the lungs.
Medical tests are submitted which do not provide clear diagnosis or interpretation i.e. LPT, BAL LPT.
2. When the CE determines Dr. Newman is to be consulted, a
package should be prepared for Dr. Newman that includes:
Memo which is addressed to Dr. Newman and includes contact information for the CE and a return address for the National Office; states the reason for the referral detailing evidence being sent, and questions the CE needs answered. (See attachment for format)
Copies of Medical Records in question.
3. The CE should mail or fax the referral package to the
National Office.
Attention: Anita Brooks
ESA/OWCP, DEEOIC
Room C4511
Fax Number: (202) 693-1465 attn: Anita Brooks
4. The CE should enter the code MS (Medical Consult Sent)
under the claims status screen in ECMS with the status effective date as the date sent to the National Office.
5. The National Office will Federal Express or Fax completed
evaluations to the CE within 24 hours of receipt from Dr. Newman.
6. Upon receipt of the report from the National Office, the CE
should enter the code MR (Medical Consult Received) under the claim status screen in ECMS with the status effective date as the date received from the National Office.
7. General questions regarding Beryllium can be e-mailed
to Anita Brooks in the National Office at abrooks@esa-dol.gov who will answer or forward to Dr. Newmans staff for assistance. Examples of questions may include; What does the acronym BALLPT mean? What type of symptoms do CBD patients normally exhibit? What are the possible side effects for steroid treatment?
8. All bills are to be handled by the National Office.
Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual.
PETER M. TURCIC
Director, Division of Energy Employees
Occupational Illness Compensation
OFFICE OF WORKERS COMPENSATION PROGRAMS
DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL
ILLNESS COMPENSATION
ROOM C-4511
TELEPHONE: (202) 693-0081
Request for Medical Evidence Consultation
To: Lee S. Newman, MD., M.A., F.C.C.P. From: {Claims Examiner}
Departmental Head, Division of Environment
and Occupational Health Sciences Phone Number: {CE phone #}
National Jewish Medical and
Re: {Claimant Name}
Date:
{insert reason for referral, medical evidence submitted and questions that need to be answered}
Please return your completed evaluation and billing information to the following address:
Attention: Anita Brooks
ESA/OWCP, DEEOIC
Room C4511
Thank you for your cooperation.
Sincerely,
Claims Examiner
For DOL National use only:
Date Materials Mailed to Consultant:
Date Materials Received from Consultant:
Date Final Evaluation Mailed to CE: