Division of Energy Employees Occupational Illness Compensation (DEEOIC)
In 2014, the DEEOIC National Office, Branch of Policy, Regulations, and Procedures (BPRP), conducted an informal audit of 119 cases that had been referred to a Contract Medical Consultant (CMC) during the period of April 1, 2014, to August 30, 2014, and 15 cases that had been referred to a Second Opinion Medical Specialist (SECOP) between January 1, 2014, and August 30, 2014. The purpose of the review was to assess the appropriateness of the CMC or SECOP referral, the quality and completeness of the Statement of Accepted Facts (SOAF), appropriateness of the questions asked by the district office, whether the physician’s written medical report was complete and responsive, and whether the responses were well-rationalized and consistent with the totality of evidence in the case under review. As a result of the audit, concerns were identified and recommendations were made to improve the Division’s performance.
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.”