Division of Energy Employees Occupational Illness Compensation (DEEOIC)
Contract Medical Consultant (CMC) & Second Opinion Medical Specialists Quarterly Audits & Analysis -2017
The DEEOIC Medical Director conducts quarterly audits of cases referred to Contract Medical Consultants (CMC). The purpose of the audits is to assess that the appropriate medical specialists assigned to advise the Government, and that the reports provided by the medical specialists are well-rationalized, complete and responsive to the needs of the claims examiners. The DEEOIC National Office, Branch of Policy, Regulations, and Procedures (BPRP) then conducts an analysis of the audit report to determine the accuracy of audit findings and for appropriateness of the CMC or SECOP referral, the quality and completeness of the Statement of Accepted Facts (SOAF), the appropriateness of the questions asked by the district office, and whether the responses were well-rationalized and consistent with the totality of evidence in the case under review.
NOTE: DEEOIC has redacted the names of the individual Contract Medical Consultant (CMC) medical specialists and claimants identified in the CMC audit report(s) 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.”