FEDERAL (EEOICPA) PROCEDURE MANUAL Chapter 2-2000 

 Energy Case Management 

Part 2 – Claims System (ECMS)--General 

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TABLE OF CONTENTS 

Paragraph and Subject Page Date Trans. No. 

Chapter 2-2000 Energy Case Management System--General 

 

 Table of Contents. . . . . . . . i 11/09 10-06 

1 Purpose and Scope. . . . . . . . 1 11/09 10-06 

2 ECMS Components. . . . . . . . . 1 11/09 10-06 

3 Receipt of Claim in District 

 Office . . . . . . . . . . . . 2 11/09 10-06 

4 General ECMS Coding. . . . . . . 8 11/09 10-06 

5 Development of a Claim . . . . . 9 11/09 10-06 

6 Claim Status History Coding. . . 25 11/09 10-06 

7 Case Management. . . . . . . . . 55 11/09 10-06 

Exhibit 

 1 EC Code Justification Memo . . . 11/09 10-06 

 2 WS/WR Referral Form. . . . . . . 11/09 10-06 

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1. Purpose and Scope. This chapter describes in general how to 

use the Energy Case Management System (ECMS). It focuses on the 

early and developmental stages of a claim. Codes for decisions 

rendered by the District Offices (DOs), Secondary Claims 

Examiner (CE2) Unit, and the Final Adjudication Branch (FAB) are 

addressed in EEOICPA PM 2-2100. The information in this chapter 

applies to both ECMS B and ECMS E unless otherwise indicated. 

 

2. ECMS Components. 

 

a. Case Information Screen. The Case Information screen 

is used to maintain core employee-related personal 

information from Form EE-1 and Form EE-2. Also included on 

this screen are CE assignment, case and DO locations, both 

current and historical. 

 

b. Work Site Screen. The Work Site screen is accessed 

through the case screen and is used to enter and update 

data on all relevant work sites reported for an employee. 

This data is found on Form EE-3 (Employment History), and 

also includes any new worksites discovered throughout 

development of the case. 

 

c. Claim Screen. The Claim screen is used to maintain 

individual claim (including employee and/or survivor) 

relevant information for each claim filed. This includes 

filing, receipt and creation date in ECMS, as well as a 

record of actions made for a claimant during the 

adjudication process in the claim status history. The 

Special Exposure Cohort (SEC), medical conditions, and 

payee information are all accessed through this screen. 

 

d. Claim Status History Screen. The Claim Status History 

screen is used to enter codes for events taking place 

during adjudication. Claim Status History displays the 

actions that have taken place and the date of each action. 

 

e. Medical Condition Screen. The Medical Condition 

screen is used to enter medical conditions reported for 

each case/claim. All conditions are updated throughout the 

development process with relevant information, such as ICD9 codes, condition status, PoC information, medical status 

effective dates, and diagnosis dates. 

 

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2. ECMS Components. (Continued) 

f. SEC/SEC Desc Screen (ECMS B only). The SEC/SEC Desc 

screen is used to enter and update SEC data reported on 

Form EE-1, Form EE-2, and/or Form EE-3. 

If it is claimed that an employee worked at an SEC 

facility, that SEC ID is entered in this field. This field 

records that an SEC facility has been claimed, not that it 

has been verified. 

If SEC is marked on the claim form, and no SEC site is 

listed on the EE-3, use the ‘unspecified’ in the SEC 

description field. 

 

g. Payees Screen. The Payee screen is used to enter 

payee information from Forms EE-1 and EE-2. This screen is 

updated as payees become eligible or ineligible for 

compensation. Upon eligibility, updated Electronic Funds 

Transfer (EFT) or payment mailing information is added. 

3. Receipt of Claim in District Office. Case Create 

procedures are covered in EEOICPA PM 1-300. When a claim is 

received in the DO, the Case Create Clerk (CCC) enters the data 

into ECMS. The fields are completed as follows: 

 

a. General case assignment information entered by the 

CCC. 

 

(1) CE name. From the list box, the CCC selects the 

responsible CE, based on internal DO procedures. 

 

(2) Location. From the list box, the CCC selects the 

location of the Responsible CE. The location codes 

are unique for each individual in a DO and are 

assigned by the DO 

b. Form EE-1/2. The CCC enters the following fields 

directly from Form EE-1/2: 

 

(1) Employee SSN, Name, and Address. 

(2) Survivor Information (if applicable). This 

includes survivor name, sex (M-Male or F-Female), SSN, 

date of birth, relationship to the deceased, address, 

and telephone number(s). 

 

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3. Receipt of Claim in District Office. (Continued) 

(3) Employee Census Information. This includes Date 

of Birth, Date of Death (if applicable), Sex (M-Male 

or F-Female), Autopsy Indicator (if applicable), and 

Autopsy Facility ‘Y’ for Yes (if applicable). 

(4) Employee Dependents (if applicable). ‘Y’ for Yes 

or ‘N’ for No is selected for spouse, child, or other. 

(5) Employment Classification. If any field (DOE, 

Atomic, Beryllium, Uranium, Other) is checked on the 

claim form (Form EE-1/2 prior to April 2005, Form EE-3 

for April 2005 or after), then the appropriate 

field(s) must contain a ‘Y’ for Yes on this screen. 

If a field is not checked on the claim form, the 

following are acceptable: ‘-’, ‘N’. 

 

(6) Filed dt. The date the claimant sends Form EE1/2. This is the earliest of the following: postmark 

date or date stamp in the Resource Center or DO (but 

not earlier than July 31, 2001 for Part B or October 

30, 2000 for Part E). The envelope must be kept with 

the claim form and put in the case file. 

 

(7) Rcvd dt. The actual date the DO receives Form EE1/2, as shown by date stamp. 

 

(8) Signature dt. The date the claimant signed Form 

EE-1/2, but not earlier than October 30, 2000. 

 

(9) Recvd RECA ind. For the questions “Have you (or 

the deceased employee) applied for an award under 

Section 4 of the Radiation Exposure Compensation Act 

(RECA)?” and “Have you (or the deceased employee) 

applied for an award under Section 5 of the Radiation 

Exposure Compensation Act (RECA)?” the CCC selects 

‘Y’ if the “YES” box is checked on either question, or 

‘N’ if the “NO” box is checked on both questions. If 

neither box is checked, the CCC leaves the indicator 

blank. 

(10)Civil lawsuit ind. For the questions “Have you 

(or the deceased employee) filed a lawsuit seeking 

either money or medical coverage for the above claimed 

condition(s)?” and “Have you (or the deceased 

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3. Receipt of Claim in District Office. (Continued) 

employee) filed any workers’ compensation claims in 

connection with the above claimed condition(s)?” and 

“Have you or another person received a settlement or 

other award in connection with a lawsuit or workers’ 

compensation claim for the above claimed condition?” 

the CCC selects ‘Y - SWC Checked Yes on Claim’ if the 

“YES" box is checked on the claim form for either 

question, or ‘N - SWC Checked No on Claim’ if the “NO” 

box is checked. If neither box is checked, the CCC 

leaves the indicator blank. 

b. Worksite. The CCC enters all relevant worksite 

information directly from the claimant’s Form EE-3. This 

includes all potentially covered worksites and any 

contractor/subcontractor employment that either is or could 

possibly be directly related to Department of Energy (DOE) 

employment. The criterion is whether the CE must gather 

employment verification for that worksite. 

If the CCC is unsure as to whether to enter a worksite, the 

CCC references the DOE Facility List, or seeks further 

guidance from a supervisor. If the CCC determines that a 

worksite might be a contractor or subcontractor, but the 

DOE facility to which the worksite is connected is 

undetermined, that worksite is entered with the worksite ID 

‘0998 - Not specific in DOE table’, and the contractor/ 

subcontractor name listed out in the ‘Notes’ field. 

The following information for each worksite comes directly 

from Form EE-3: 

 

(1) Position Title. This field matches the ‘Position 

Title or Mine/Mill Activity’ from Form EE-3. 

 

(2) Work Start Dt. This date matches the ‘Start 

Date’ field on Form EE-3. The CCC enters the exact 

date entered on the form, unless the date is partially 

written. If the month or date is missing, the CCC 

enters ‘01/01’ as the placeholder. For example, if 

the form shows 1969, the CCC enters 01/01/1969. If the 

date is left blank on Form EE-3, the CCC leaves the 

date blank. 

 

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3. Receipt of Claim in District Office. (Continued) 

(3) Work End Dt. This date matches the ‘End Date’ 

field on Form EE-3. The CCC enters the exact date 

shown on the form, unless the date is partially 

written. If the month or date is missing, the CCC 

enters ‘12/31’ as the placeholder. For example, if 

the form shows 1969, the CCC enters 12/31/1969. If 

the date is left blank on Form EE-3, the CCC leaves 

the date blank in ECMS. 

 

(4) Note. If the CCC enters the Worksite Desc field 

with the worksite ID for ‘0998 – Not specific in DOE 

table’, then the contractor/subcontractor name is 

listed out in the ‘Notes’ field. Also, if there are 

several consecutive dates of employment at the same 

worksite with different contractors/ subcontractors, 

this can be entered under one worksite entry with the 

various dates and contractors/subcontractors listed 

out in the notes field. 

(5) Dosim Badge Ind. The CCC completes this field 

with a ‘Y’ for Yes, ‘N’ for No, or leaves it blank 

based on the answer to the question “Was a dosimetry 

badge worn while employed?” on the Form EE-3. 

 

(6) Badge No. If a badge number is provided on the 

Form EE-3, the CCC enters it in this field. 

 

c. Medical Conditions. All reported conditions on Form 

EE-1/2 must be entered. If there are multiple claimants on 

a case and they claim different illnesses, generally all 

claimed illnesses must be entered for all claimants. The 

exception to this is when an employee files and then dies 

and the survivor claims something different or if a 

survivor specifically is not claiming an illness because he 

or she may have received a state workers’ compensation or 

tort settlement. See EEOICPA PM 1-300 as to whether 

medical conditions should be entered into ECMS B, ECMS E, 

or both. The CCC looks at all the conditions claimed on 

Form EE-1 (Box 8) or Form EE-2 (Box 14) and matches each 

condition with a code from the list box in the Cond Type 

field on the Medical Condition Screen. 

 

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3. Receipt of Claim in District Office. (Continued) 

(1) If the claimant lists an occupational illness 

under Part B, each condition must be entered 

individually in the Cond Type field. 

 

CODE Covered Medical Condition Types

BD Chronic Beryllium Disease

BS Beryllium Sensitivity

CN Cancer

CS Chronic Silicosis

OL Other Lung Conditions (Covered for RECA Only)

MT Metastatic Cancer (Secondary cancers)

 

(2) For all cancer (‘CN’) and other lung (‘OL’) 

conditions, the CCC enters the specific type of cancer 

or lung condition reported on the claim form in the 

Notes text field. 

 

(3) If the case is “B Only”, and the claimant lists a 

non-covered condition, each non-covered condition must 

be entered individually in the Cond Type field in ECMS 

B. The CCC selects from the list box any conditions 

shown on the claim form. 

For example, if the illness claimed is hearing loss, 

the CCC selects ‘HL’ from the list box in the Cond 

Type field on the Medical Condition screen. No 

further explanation is required in the Notes Text 

field, since the condition type indicates the 

condition reported. 

 

(4) The CCC selects ‘99’ (Other Condition – not in 

table) from the list box if the reported condition 

does not appear in the list box. He or she also types 

the reported condition in the Note Text field as it 

appears on the claim form. 

For example, if the condition cuts/bruises is reported 

on the claim form, the CCC selects 99 from the list 

box and in the Note section types “cuts/bruises.” 

If the claimant lists multiple non-covered conditions 

which are not in the list box, the conditions can be 

listed under one ‘99’ condition type, although each 

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3. Receipt of Claim in District Office. (Continued) 

individual condition must be listed in the Note Text 

field. 

 

(5) If no condition is reported on Form EE-1/2, the 

CCC selects ‘NR’ from the list box. 

 

CODE Non-Covered Medical Condition Types for Part B

99 Other Condition - not listed in table

AN Anemia

AS Asbestosis

BK Back or Neck problems

BT Benign Tumors, Polyps, Skin Spots

BU Burns

CL CLL (Chronic Lymphocytic Leukemia)

CT Cataracts

DI Diabetes

HF Heart Failure/ Heart Attacks/Hypertension 

HL Hearing Loss

HM Other Heavy Metal Poisoning (e.g. chromium, 

cadmium, arsenic, lead, uranium, thorium, and 

plutonium)

MC Multiple Chemical Sensitivity

MP Mercury Poisoning 

NE Neurological Disorder 

NR No condition reported

OL Other Lung Conditions: Bronchitis; Asthma; 

Pulmonary Edema 

(Considered covered only for RECA claims)

PD COPD (Chronic Obstructive Pulmonary Disease); 

Emphysema

PK Parkinson’s Disease

PL Pre-Leukemia 

PP Pleural Plaques

PS Psychological Conditions

RN Renal Conditions (kidney failure, kidney 

stones)

TH Thyroid Conditions (e.g. Hypothyroidism)

 

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4. General ECMS Coding. Each development action taken 

requires a claim status code entry. It is necessary to enter 

the claim status code only in the specific system, B or E, to 

which the development action pertains. 

a. Part B Only. For these claims, all claim status 

coding is entered directly into ECMS B. 

b. Part E Only. For these claims, all claim status 

coding is entered directly into ECMS E. 

c. Part B/E Claims, Both Active. Where Part B and Part E 

are both still active (i.e., both are currently in 

development), all development actions (i.e., employment 

verification, medical or survivorship development) must be 

entered into both ECMS Part B and ECMS Part E if they apply 

to both. 

For example, upon receiving a Form EE-5 back from DOE, the 

‘ER’ code is necessary in BOTH systems. Since the case is 

B/E, the code is entered in ECMS B and ECMS E. 

Note: Some ECMS entries (coding for Document Acquisition 

Request (DAR), Former Worker Protection (FWP) requests, 

Site Exposure Matrices (SEM) usually pertain to Part E 

development and are usually entered in ECMS E only. 

However, there are circumstances where DARs, FWP requests, 

and SEM searches are completed relevant to the development 

of the Part B case, such as placing an employee on Line 1. 

In these types of circumstances these usual E only codes 

can be entered in ECMS B. 

d. Part E/B Claims, Only One Part Active. Where just one 

part is currently active (i.e., a final decision was issued 

previously in the B part of the claim, and the only part in 

development is Part E, or vice versa), development actions 

will be entered only in the system that corresponds to the 

currently active Part. 

(1) To limit the number of key strokes and ensure that 

cases are keyed to the same location and transferred 

at the same time, some information on the first screen 

is shared between ECMS B and ECMS E. Case information, 

in addition to case notes and call ups, that 

automatically transfer between the two systems 

include: 

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4. General ECMS Coding. (Continued) 

 

• CE 

• CE Assign Dt 

• Dist Office 

• Location 

• Location Assign Dt 

• Employee Name and Address fields 

• Worksite fields 

(2) However, when different medical conditions are 

claimed under Parts B and E, the development code is 

entered only in the relevant part. 

For example, if cancer is claimed under Parts B and E, 

and asbestosis only is claimed under Part E, and a 

development letter is sent to the claimant requesting 

additional medical evidence for the Asbestosis claim, 

the ‘DM’ code is entered in ECMS E only. 

5. Development of a Claim. Although the CCC enters certain 

data elements from EEOICPA forms, the CE verifies all data 

entered. The CE is also responsible for updating all data 

elements throughout the adjudication process. 

 

a. Worksite/Employment Verification. The CE confirms 

that ECMS correctly identifies all relevant worksite 

information listed on the Form EE-3, and is responsible for 

updating the employment information throughout the claims 

process. 

The CE keeps ECMS updated with the latest worksite 

information in the case file. If claimed employment dates 

are different than what is ultimately verified, the claimed 

employment dates are overwritten. Claimed employment that 

cannot be verified should be removed. If new worksites are 

verified or claimed, the CE inputs the new worksite 

information into ECMS. At the time of recommended 

decision, only verified employment should remain in the 

worksite section on the case screen. 

Upon receipt of an employment verification (DOE, Corporate 

Verifier, SSA response, Other), the CE updates the 

following fields with as much information as possible from 

the verifier. (Note: Each worksite time period could 

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5. Development of a Claim. (Continued) 

possibly be verified from multiple sources. Therefore, if 

multiple verification sources are used to verify a single 

timeframe, be sure to enter the overall employment 

timeframe that is considered verified.)

 

(1) Covered Emp Ind - This field (located on the case 

screen) must be completed by the time of the 

Recommended Decision (RD). 

If the CE determines that the employee has covered 

employment under the EEOICPA, the field must be ‘Y’ 

for Yes. 

If the CE determines that the employee does not have 

covered employment, the field must be ‘N’ for No. (As 

long as any employment is verified, this field will 

become ‘Y’ for Yes.) 

(2) Cov Emp Start Dt and Cov Emp End Dt - This field 

was created with the assumption that employment would 

be continuous, which is not always the case. 

Completion of this field is optional. 

(3) Worksite Desc - The worksite can be selected by 

clicking on the ‘worksite’ button and entering a DOE 

facility name in the ‘worksite description’ line and 

pressing the ‘Select’ button. If the exact name in 

the table is unknown, enter at least the first letter 

of the facility name, and select ‘Look Up’ to see a 

list of facilities that meet the search criteria. 

If the facility is listed, highlight the correct 

choice and select the ‘OK’ button. The worksite can 

also be added by entering the worksite description 

number, if known, directly in the blank field next to 

the ‘worksite’ button. 

 

If the CE determines that an employer might be a 

contractor or subcontractor, but it is undetermined 

where employment occurred, the worksite is entered 

with the worksite ID ‘0998 - Not specific in DOE 

table’, and the contractor/ subcontractor name listed 

out in the ‘Notes’ field. 

 

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5. Development of a Claim. (Continued) 

(4) Position Title - If the job title appears 

differently on the verification document received 

(Department of Energy (DOE), Corporate Verifier, 

Social Security Administration (SSA) response, other) 

than it was listed on Form EE-3, the CE updates the 

field to reflect the verification document. 

 

(5) Work Start Dt - The ‘Work Start Dt’ must match 

the ‘From’ or ‘Start’ date per the employer on the 

verification document received (DOE, Corporate 

Verifier, SSA response, Other). 

 

(6) Work End Dt - The ‘Work End Dt’ must match the 

‘To’ or ‘End’ date on the verification document 

received (DOE, Corporate Verifier, SSA response, 

other). If the person is currently still working at 

the facility being verified, the CE enters the date 

the verification document was signed by the certifying 

official as the ‘To Dt’. 

 

(7) Note - This field is used at the CE’s 

discretion. However, if the CE identifies that the 

employee worked for either a contractor or 

subcontractor, the CE enters the 

contractor/subcontractor name in this field. 

 

b. RECA Indicator. The RECA Indicator shows whether the 

Department of Justice (DOJ) confirmed that the claimant or 

deceased employee received benefits under the Radiation 

Exposure Compensation Act (RECA). The RECA indicator must 

be entered on all EEOICPA cases. The CCC enters ‘Y’ for 

Yes or ‘N’ for No, based on what was checked on Form EE1/2. This includes RECA and non-RECA cases in all four 

DOs. 

 

(1) The following are entered directly from Form EE1/2: 

 

(a) ‘Y’ – Yes - The claimant checked the Y 

box(es) indicating that he or she or the deceased 

employee applied for an award under Section 4 or 

5 of the RECA. 

 

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5. Development of a Claim. (Continued) 

(b) ‘N’ – No - The claimant checked the N 

box(es) indicating that he or she or the deceased 

employee did not apply for an award under Section 

4 or 5 of the RECA. 

 

(2) If the CE determines, after reviewing the claim, 

that it may be a RECA claim filed by a uranium worker 

or a survivor of a uranium worker, the CE leaves the 

RECA Indicator (Y/N) blank, or as entered by the CCC, 

until confirmation is received from DOJ. After a 

confirmation letter is received from DOJ, the CE 

inputs one of the following RECA Indicator codes: 

 

(a) ‘4’ - Used when the employee or RECA 

survivor is confirmed as a RECA Section 4 award 

recipient. 

 

(b) ‘5’ - Used when the employee or RECA 

survivor is confirmed as a RECA Section 5 award 

recipient. 

 

(c) ‘X’ - The claim is non-RECA. The CE may 

enter the X indicator at any time to confirm his 

or her determination that the case is non-RECA. 

That is, an X entry is not tied solely to receipt 

of a letter from DOJ that confirms non-RECA 

status. The X is also used if there is a 

confirmed RECA Section 4 eligibility where the 

claimant has opted not to accept the award. 

c. State Workers’ Compensation (SWC) Indicator (EMCS E 

Only). This field reflects what is currently known about 

the status of any state workers’ compensation claims. 

 

(1) The following are entered directly from Form EE-1 

or EE-2: 

(a) ‘Y - SWC Checked Yes on Claim’ - The 

claimant checked the Yes box on Form EE-1/2, 

indicating that the employee/claimant filed a 

state workers’ compensation claim. 

 

(b) ‘N - SWC Checked No on Claim’ - The claimant 

checked the No box on Form EE-1/2, indicating 

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5. Development of a Claim. (Continued) 

that the employee/claimant has not filed a state 

workers’ compensation claim. 

 

(2) During development, the CE/Hearing Representative 

(HR) updates this field to reflect the current status 

of the employee/claimant’s state workers’ compensation 

claim. The State Workers’ Compensation Indicator must 

be entered on all Part E cases, even if no SWC claim 

was filed. 

(a) ‘X – Confirmed No SWC Claim’ - Used when the 

employee/claimant is determined to have not filed 

a state workers’ compensation claim. 

 

(b) ‘R – Benefits Rec’d; Reduce Comp’ - Used 

when the employee/claimant is determined to have 

received benefits from state workers’ 

compensation for an accepted Part E medical 

condition where compensation benefits must be 

reduced. 

 

(c) ‘S – SWC; No Reduce Comp’ - Used when the 

employee/claimant is determined to have state 

workers’ compensation, but there is no reduction 

in benefits required. This code is also used in 

the case of a denied SWC claim where the employee 

received no benefits. 

 

(d) ‘P – SWC Pending’ - Used when the employee/ 

claimant is determined to have a state workers’ 

compensation claim that is currently pending. 

(3) Once the existence of a SWC claim is verified, 

the CE accesses the ‘SWC State’ drop-down box and 

selects the state in which the SWC claim was filed 

(e.g.,‘OH’ if the claim was filed in the State of 

Ohio). 

 

d. SEC Description. If the employee claims to have 

worked at an SEC worksite, the CCC or CE must identify the 

worksite in the SEC description field. As new SECs are 

added, ECMS is updated with the additional SEC facilities 

and active claims are updated accordingly. 

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5. Development of a Claim. (Continued) 

The SEC can be selected either by clicking on the ‘SEC’ 

button and selecting the SEC facility, or by entering the 

SEC description number directly in the blank field next to 

the ‘SEC’ button. This field records that an SEC facility 

has been claimed, not that it has been verified. 

 

e. Employment Classifications. As discussed in Paragraph 

3.b, if any field (DOE, Atomic, Beryllium, Uranium, Other) 

is checked on the claim form (Form EE-1/2 prior to April 

2005, Form EE-3 for April 2005 or after), then the 

appropriate field(s) must contain a ‘Y’ for Yes on this 

screen. If a field is not checked on the claim form, the 

following are acceptable: ‘-’, ‘N’. 

These fields are initially completed when the case is 

created and they are NOT tied to any employment 

verification received back from any source. 

For example, if a claimant checks "Atomic Weapons Facility" 

on the claim form, this field should be changed to ‘Y’. If 

it turns out the employee did not work at an AWE, or 

employment was not verified at an AWE, this field does not 

need to be updated to reflect that lack of employment. 

However, the CE must update these fields in certain 

circumstances to reflect something other than ‘Y’, ‘-’, or 

‘N’. These circumstances are outlined below. 

(1) Since there is no "Subcontractor" field in ECMS, 

if the CE determines that an employee could have 

worked for a subcontractor at a DOE facility, he or 

she must update the ‘DOE’ field with an ‘S’. 

 

(a) If Form EE-3 or another type of employment 

documentation (e.g., affidavit) shows that the 

employee worked for a private employer at a DOE 

facility (e.g., Joe’s Electric Company at 

Hanford), and the CE determines that a reasonable 

link exists between the employer (a 

subcontractor) and a DOE facility, the CE 

identifies the case as one with a subcontractor. 

To do this, the CE selects ‘S’ (a subcontractor 

at a DOE facility has been identified) from the 

DOE list box in the Employment Classifications 

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5. Development of a Claim. (Continued) 

Field, Case Screen. The ‘S’ code permanently 

replaces the ‘Y’ code in the DOE list box. 

 

(b) After entering the ‘S’ code, the CE 

continues to develop the employment aspect of the 

claim to determine whether employment can be 

verified with a DOE subcontractor. If the CE 

determines that the employee did not work for a 

verified subcontractor at a DOE facility, the ‘S’ 

code remains in the DOE list box (Employment 

Classifications Field, Case Screen). 

For the ‘S’ code to be used, employment with a 

subcontractor at a DOE facility need not be 

confirmed, but there must be evidence that such 

employment was claimed. 

 

(c) The CE enters the ‘S’ code only once 

regardless of whether the employee worked for one 

or multiple DOE subcontractors. 

 

(2) If the CE reviews claimed AWE employment and 

determines that the period is entirely outside of the 

weapons-related production period and either partially 

(meaning partially during the residual contamination 

period and partially after the residual contamination/ 

non-covered period) or entirely during the site’s 

period of residual radioactive contamination, the CE 

enters an ‘R’ into the AWE worksite indicator field. 

The ‘R’ represents that employment at an AWE site is 

qualifying solely on the basis of residual 

contamination. 

This code has not always been in existence and must be 

backfilled for prior claims as encountered. If 

employment at multiple AWE sites is claimed and at 

least one such site’s qualifying employment is solely 

due to residual radiation, utilize the ‘R’ code. 

 

f. Claim Status History Coding. Generally, for every 

development action taken by the CE, there is a 

corresponding claim status history code to document that 

action. And for every claim status code, there must be 

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5. Development of a Claim. (Continued) 

corresponding file documentation. See Paragraph 6 below 

for detailed instructions for claim status history coding. 

g. Coding Actions Taken by RC. Where the claim was filed 

at the RC, the RC prepares a memorandum accompanying all 

submissions of claim materials to the DO/CE2 Unit for case 

create. The memo chronologically outlines RC actions. The 

CE reviews the memo and enters the proper coding into ECMS 

to correspond with the date of occurrence in the RC. No 

coding is done at the RC. 

(1) The CE deletes the ‘UN’ code upon entry of the 

code indicating a RC action took place on a date prior 

to the case create date, since all RC actions must be 

entered into ECMS corresponding with the actual date 

upon which they took place. 

(2) The CE enters the ‘OR’ claim status code to 

correspond with the date on which the ORISE search 

took place at the RC. The ECMS status effective date 

is the date the RC searched ORISE. The code is 

entered whether the ORISE search confirms employment 

or not. 

(3) The CE enters the ‘ES’ and/or ‘CS’ claim status 

code(s) with a status effective date of the date on 

which such action(s) was taken in the RC. If the CE 

enters an ‘ES’, he or she then enters the appropriate 

reason code from the drop down menu, which includes 

the Operations Center and that Form EE-5 was sent 

[e.g., ‘AL5 – Albuquerque Operations Office (EE-5)’] 

(4) The CE enters the ‘DO’ claim status code, and 

selects the reason code ‘OH - Occupational History’ 

with a status effective date of the date on which the 

occupational history questionnaire (OHQ) was completed 

by the RC as noted on the RC memo to the DO. (This 

applies to completion of OHQs from follow-ups and 

reworks, discussed below, as well.) 

The CE should also “close out” the OHQ assignment (or 

follow-up or rework) in this manner if the RC 

attempted to complete the OHQ, but was unsuccessful 

because the claimant could not be reached or refused 

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5. Development of a Claim. (Continued) 

to complete it. The status effective date in this 

type of situation is the date of the RC memo to the 

DO/CE2 Unit explaining why the OHQ could not be 

completed. 

Note: If the OHQ is completed by an authorized rep, 

it is not valid and should not be coded as completed 

in ECMS. 

(5) The CE enters the ‘RC – Resource Center’ claim 

status code when making assignments to the RC on 

identified existing cases in ECMS that require 

occupational history development. The CE selects the 

appropriate reason code from the drop down menu to 

reflect the appropriate type of assignment to the RC: 

(a) ‘AS’ – Assignment – This reason code is 

selected when an initial assignment for an OHQ is 

made to the RC. For example, a claim is filed 

with the DO instead of the RC and the OHQ needs 

to be completed. The status effective date is the 

date of the DO memo to the RC outlining the 

assignment task. 

(b) ‘FW’ - Follow-up – This reason code is 

selected when the DO/CE2 Unit identifies a need 

for a follow-up interview because of issues that 

arise out of development. The status effective 

date is the date of the DO/CE2 Unit memo to the 

RC outlining the follow-up task. 

(c) ‘RK’ – Rework – This reason code is selected 

when an error is found in the final product from 

the RC. Reworks are not generated out of an issue 

identified by the DO as an area in need of 

additional development, but arise when the CE 

identifies a deficiency (i.e., incomplete or 

inaccurate data). 

The status effective date is the date of the 

DO/CE2 Unit’s memo to the RC outlining the rework 

task. 

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5. Development of a Claim. (Continued) 

h. Employee Medical Condition. The CCC enters 

information directly from the claimant’s Form EE-1 or EE2. The CE updates ECMS with additional medical information 

as it is received, including new, relevant medical 

conditions that are reported or discovered during 

development of the case. The CE is responsible for updating 

ECMS with the latest medical information in the case file. 

ECMS requires entry for each employee medical condition for 

each claimant. For multiple claimants, the CCC enters and 

the CE updates all medical conditions claimed for each 

claimant. [Note: the CE enters and updates any new medical 

conditions identified for data entry while in the 

development process.] 

 

(1) Reported Ind - If the claimant reported the 

medical condition on Form EE-1 or Form EE-2, this 

field will be ‘Y’, for Yes. If the CE discovers 

another medical condition that needs to be developed, 

the CE enters the new medical condition with the 

‘Reported Ind’ field as ‘N’, for No. 

 

(2) Cond type - The CE verifies the accuracy of the 

information entered by the CCC and makes changes as 

needed. Every condition claimed is entered as a 

medical condition for each claimant. Even if 

claimants claim different medical conditions, and they 

all pertain to the employee, each must be entered for 

each claim into ECMS B and/or E appropriately. 

For example, if there are two child claimants, C1 and 

C2, where C1 claims lung cancer and C2 claims prostate 

cancer, both C1 and C2’s claim screens would reflect 

both lung and prostate cancer. 

 

The CE updates the Condition Type field on the Medical 

Condition screen as new conditions are reported or 

discovered (possible work-related or covered 

conditions only, as well as all secondary cancers) 

during case development. The CE enters these updates 

as they occur. 

 

(3) Diagnosis dt - The claimant might list a 

diagnosis date on Form EE-1 or EE-2, and if so, the 

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CCC enters the date. However, this date is not always 

accurate, and the CE must confirm the date through the 

medical evidence. The diagnosis date is considered 

the earliest date of any test, pathology or doctor’s 

report evident in the case file referring to the 

diagnosis of the covered condition. 

 

(4) ICD9 - The ICD9 can be selected by either 

clicking on the ‘ICD9’ button and entering a medical 

condition (or just alpha characters) in the ‘V14 ICD9 

description’ line, and pressing select, or entering 

the ICD9 number directly in the blank field next to 

the ‘ICD9’ button. 

This field is required for all conditions where the 

case file is being sent to NIOSH, and for all 

conditions that are ‘Accepted’. An ICD9 is not 

required for non-covered conditions in ECMS B, or for 

medical conditions that are ‘Denied’ (unless the case 

was sent to NIOSH) or ‘Reported’. 

 

(5) Note - This field is used at the CE’s 

discretion. However, if the employee has a condition 

not specifically listed in the ‘cond type’ field, so 

the condition type is ‘99-Other (Not Listed)’, the CE 

enters (or assures that the CCC entered) the medical 

condition claimed in this field. 

 

(6) Cond status - This status code was previously 

based on the medical evidence known at the time of the 

RD, and it was used slightly differently in ECMS E and 

ECMS B. However, the use of this status code has 

changed. It now represents the outcome of each 

claimed medical condition at the time of the 

recommended decision. One exception to this is when 

the DO/CE2 Unit renders a decision on a consequential 

injury or inputs a prior approval for medical bill 

payments. The other exception is for employee cases 

where there is a previously accepted medical condition 

with a final decision to accept and there is a new 

recommended decision to accept an additional 

condition; these cases must have the medical condition 

status updated by FAB to avoid premature medical bill 

payment. 

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5. Development of a Claim. (Continued) 

Also, the code is used the same in ECMS B and ECMS E: 

(a) Using the ‘R’ status code: In the creation of 

a medical condition entry or in the adjudication of 

a claim, the medical cond status list box in the 

Medical Condition screen will default to an ‘R’ 

status code. The ‘R’ status code equals what is 

‘Reported’ by the claimant, usually on Form EE-1 or 

EE-2. 

The medical condition status will remain ‘R’ until 

a recommended decision is rendered on that 

condition. Essentially, ‘R’ equals pending 

adjudication. So, if a decision is issued that 

defers a decision on a medical condition, that 

condition’s medical condition status will remain at 

an ‘R’ status. 

(b) When a recommended decision is issued that 

accepts a medical condition, the medical condition 

status for that condition is changed from an ‘R’ 

(Reported) to an ‘A’ (Accept). An ‘A’ code 

indicates that medical benefits associated with 

that condition should be paid for an employee 

claimant or that a survivor is eligible for 

benefits related to the employee’s development of 

that condition. The DO/CE2 Unit can also enter ‘A’ 

to award medical benefits for consequential 

injuries or for bills to be paid on prior 

approvals. 

Note that for employee cases, use of the ‘A’ code 

alone will not create an eligibility file for 

medical benefits. All of the coding discussed in 

Paragraph 2 of Chapter 2-2100, including a final 

decision code to accept, must be completed before 

medical bills will be payable. The FAB must ensure 

the associated medical coding is correct. 

 

(c) When a recommended decision is issued that 

denies a medical condition, the medical condition 

status is changed from an ‘R’ to a ‘D’ (Deny). A 

‘D’ code is used any time a condition is being 

denied, whether the denial is for insufficient 

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5. Development of a Claim. (Continued) 

medical evidence, inability to establish causation, 

lack of covered employment, or ineligibility of the 

survivor. If the condition is not being accepted 

or a decision on that condition is not being 

deferred, it is denied. 

(d) When a claim for a condition is withdrawn, the 

associated medical condition field(s) must be 

deleted, a note entered into ECMS case notes, and 

the file documented. 

 

(e) When a case is known to be affected by a 

surplus where the employees medical bill payment 

must be suspended until the surplus is absorbed, 

the FAB representative changes the affected medical 

condition from an ‘A’ to an ‘O’ (Offset) status. 

This prevents medical bills from being paid related 

to that condition until the surplus is absorbed and 

the ‘O’ status is changed back to an ‘A’. The 

remaining medical related coding for offset cases 

is the same as outlined in this chapter. 

 

(7) Status effect dt - This field defaults to blank 

whenever a condition is entered on the medical 

condition screen. This field must be changed for all 

‘A’ or ‘Accepted’ medical conditions. The ‘status 

effect dt’ is equal to the ‘filed dt’ for all claimed 

conditions. This field is required for all employee 

and survivor claims with ‘Accepted’ conditions. 

(a) For multiple survivor claims, ECMS does not 

allow a status effective date earlier than the 

claim filing date. The CE enters each survivor’s 

own claim filing date. This field is only 

required for Accepted medical conditions. 

(b) For all medical conditions with the medical 

status condition of ‘R’ or ‘D’, no date is 

necessary. [In earlier versions, ECMS used to 

default this field to the current date. It is 

not considered an error if there is a date 

entered for conditions of the ‘R’ or ‘D’ status.] 

 

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5. Development of a Claim. (Continued) 

(8) Elig end dt - This field remains blank unless 

there is an actual end date to the eligibility of 

medical benefits. The Elig end dt must be filled in 

when a condition is ‘A’ or ‘Accepted’ and the case 

file has a recommended or final decision to accept, 

and the CE is aware of an end date for medical 

benefits. This happens when an employee files a claim 

for benefits and then dies during or after 

adjudication, and some medical bills will be covered 

prior to death, or a consequential illness is only 

acceptable over a period of time, or for prior 

approvals that should be paid for a specific day or 

period of time. Otherwise, the field remains blank. 

 

(9) PoC (Probability of Causation) - After the CE 

runs the National Institute for Occupational Safety 

and Health (NIOSH) Interactive RadioEpidemiological 

Program (IREP), the results of the ‘PoC’ are entered. 

[If the case is a B/E case, the PoC (and date and 

version of IREP) is entered into ECMS B and ECMS E.] 

For a single cancer, the total from the ‘99th 

Percentile’ line is entered in this field. For 

multiple cancers, the CE runs each primary cancer 

‘Probability of Causation for Multiple Primary 

Cancers’. The grand total, under ‘Result: Total PC’, 

is entered for PoC for each cancer included. 

For every cancer included on the NIOSH Referral 

Summary Document (including any Amended NRSD), a PoC 

is required in that medical condition’s PoC field, 

even if an IREP is not run for that particular cancer. 

For example, if three primary cancers are sent to 

NIOSH, and the dose reconstruction includes an IREP 

for only one cancer since the PoC is already over 50%, 

the total result is entered for all cancers sent to 

NIOSH. 

If there are additional metastatic cancers that are 

not sent to NIOSH, the PoC result is not entered in 

ECMS for these cancers. The med cond status, however, 

must be updated to ‘A’ or ‘D’ based on the result of 

the dose reconstruction. 

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5. Development of a Claim. (Continued) 

(10) PoC dt - The PoC date is the date the NIOSH-IREP 

is run in the DO/CE2 Unit, as reflected on the NIOSH 

IREP Probability of Causation Results printout. 

 

(11) IREP version - The CE takes the NIOSH-IREP 

version directly from the CDC/NIOSH website. For 

example, the IREP heading states, ‘Interactive 

RadioEpidemiological Program, NIOSH-IREP v5.2’. The 

actual IREP version is ‘5.2’. The CE enters 5.2 in 

this field. The version is also listed on the NIOSH 

IREP Probability of Causation Results printout. For 

CLL cancer-only, where no IREP is run, the CE enters 

‘N/A’ in this field. 

 

i. Medical Exceptions for ECMS Coding. There are two 

exceptions to the above coding requirements. One occurs 

when an employee files a claim and dies prior to an 

acceptance, and the other occurs when the CE must set up 

payment options for medical appointments, consultants and 

records before the case is accepted. 

 

(1) Since ECMS was set up to download medical 

information from employee claims to the eligibility 

file that is used by the bill processing contractor, 

the employee’s claim needs to be updated with certain 

data to allow for payment of medical bills between the 

employee’s filing date and date of death. 

When an employee dies prior to the adjudication of the 

claim, additional claimant(s) file, and ultimately 

medical conditions are accepted for the new 

claimant(s), the deceased employee’s claim must 

reflect the accepted medical conditions. To ensure 

that data is downloaded for medical benefits, the CE 

must: 

 

(a) Enter the employee’s date of death on the 

case screen. 

 

(b) Enter the ‘C3’ claim status code, with a 

status effective date of the date when the 

Resource Center, DO/CE2 Unit, or FAB was notified 

of the death (i.e., phone call, letter), 

whichever is earlier. 

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5. Development of a Claim. (Continued) 

(c) For ALL accepted medical conditions on the 

case, the CE enters or updates the following 

information for the employee claim: 

 

(i) Correct medical condition type. 

 

(ii) Correct ICD-9 of the condition. 

 

(iii)Med cond status of ‘A’ (for accepted). 

 

(iv) Status effective date, which is the 

employee’s claim filing date. 

 

(v) Eligibility end date, which is the 

employee’s actual date of death. 

 

(d) Other than the ‘C3’ claim status code, and 

accepted medical condition coding, no additional 

coding is generally entered for the employee 

claim after his or her death. 

However, an exception to this rule occurs if an 

employee dies prior to a final decision, but 

EEOICP is unaware of the death until after the 

final decision was issued. If there is/are 

surviving claimant(s), the employee’s final 

decision may need to be vacated and appropriate 

claim status coding (see Paragraph 12 in Ch 2-

2100) would follow the ‘C3’code. 

 

(2) When a case is referred to a District Medical 

Consultant (DMC), sent out for a second opinion, or 

approved for payment of fees for the release of 

medical records to DOL, the CE uses ECMS to set up the 

‘prior approval’ process through the medical bill 

processing contractor. The CE enters the prior 

approval as if entering a new medical condition. The 

following fields are required: 

 

(a) cond type – Select ‘PA’, for prior approval 

(b) ICD-9 code – See chapter 2-0800 for the 

appropriate ICD-9 code to enter in different 

situations. 

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5. Development of a Claim. (Continued) 

(c) status effective date - Enter the date of 

the medical exam for second opinions, or the date 

of referral for DMC or authorization for medical 

records. 

 

(d) eligibility end date - Enter the date of the 

medical exam for second opinions, or the date the 

DMC’s response or medical records are datestamped as received in the DO. 

(e) medical condition status – Change the medical 

condition status to ‘A’. 

 

j. Payee Information. The CCC enters information 

directly from the claimant’s Form EE-1 or EE-2. 

 

(1) Change of Address and/or Phone Number - If 

address changes are documented, the CE forwards that 

information to the PCA (Payee Change Assistant) to 

update ECMS. The CE updates ECMS with any changes to 

the claimant’s telephone number. 

 

(2) Eligibility Ind – This field identifies whether 

or not a claimant is eligible for compensation, either 

in the form of a lump sum payment or medical benefits. 

This field defaults to ‘N’, for No, and the CE updates 

the Eligibility Ind only if a case is in posture for a 

Recommended Accept decision. The Eligibility Ind is 

then changed to ‘Y’, for Yes. During adjudication, 

and if the case is in posture for a Recommended Denial 

decision, the indicator remains ‘N’, for No. 

 

6. Claim Status History Coding. Generally, for every 

development action the CE takes, there is a corresponding claim 

status history code to document that action. And, for every 

claim status code, there must be corresponding file 

documentation. 

Only development actions taken on that particular claim are to 

be entered for a claimant. For example, any employment action 

codes to DOE, Corporate Verifiers, or SSA are related to all 

claims in the case, and are entered for each claimant. However, 

if individual development actions are related to a particular 

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6. Claim Status History Coding. (Continued) 

claimant(s) only, then the claim status codes are entered for 

the applicable claimant(s) only. 

Note: Telephone calls recorded in the Telephone Management 

System (TMS) do not qualify as actions that require a claim 

status code (except for telephone calls to a corporate verifier, 

see ‘DE’ and ‘CS’ coding, discussed in this chapter). 

If, for example, the CE telephones the claimant and asks for 

medical documentation, that is not considered the development 

action. The CE follows up in writing for any requested 

information sought over the telephone. For the letter 

documenting the requested information, the CE enters the 

appropriate claim status coding. The following are the current 

claim status codes, organized by action type: 

 

a. Development Action Codes. When selecting which code 

to enter, the development code is to be as specific as 

possible to the corresponding action. If there are 

multiple issues included in one letter, select the 

development code that best fits the overall content. 

For example, if a single letter requests both medical ‘DM’ 

and survivor ‘DO’ information, the CE would select ‘DO’ 

because it represents the contents of the letter better 

than ‘DM’, which would exclude the survivorship 

development. Only one code is to be entered, since the 

development was done in one letter. 

 

Since every development action requires a development code, 

if two actions are taken on the same date, such as 

requesting medical information from the claimant and 

sending a NIOSH smoking history questionnaire, these are 

different actions. The development letter is coded ‘DM’, 

while the NIOSH smoking history questionnaire is coded 

‘DO.’ Even though they might be mailed in the same 

envelope, they are still considered separate actions. 

Only development actions pertinent to the adjudication of 

the claim require a code. Items such as acknowledgement 

letters do not require a code. 

 

(1) DB - ‘Developing Both Medical and Employment’- For 

development that includes both medical and employment, 

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6. Claim Status History Coding. (Continued) 

the CE enters the ‘DB’ code. This could be either one 

development action that includes both medical and 

employment, or two separate actions, one for medical 

and one for employment, but completed on the same 

date. 

This should not include initial employment 

verification requests or follow-up on employment 

verification to DOE, SSA, CPWR, or a corporate 

verifier. [All initial requests require use of the 

‘ES’, ‘CS’, ‘SS’, or ‘US’ code with the appropriate 

reason code, and follow-up to the various employment 

verification sources requires use of the ‘DE’ code 

with the appropriate reason code.] 

The status effective date is the date of the letter. 

 

(2) DE - ‘Developing Employment’ - When developing 

initial or follow-up employment directly with the 

claimant, searching the subcontractor database, or as 

a follow-up to DOE (for DARs or EE-5s), a corporate 

verifier, CPWR, or the Social Security Administration 

(SSA), the CE enters the ‘DE’ (Developing Employment) 

claim status code. 

The status effective date of the ‘DE’ code is either 

the date of the letter to the claimant, the date the 

subcontractor database is searched, or the date of the 

follow-up action to the employment verifier. ‘DE’ is 

not used for initial development to employment 

verifiers (except for the CPWR database search), only 

follow-up. 

 

Certain corporate verifiers have asked to be contacted 

by telephone. For those verifiers, the printout of the 

telephone call will serve to document the development 

action. The CE enters the ‘DE’ with the status 

effective date of the telephone call. Verification 

will still need to be in writing though. 

Upon entry of the ‘DE’ code, the CE selects a specific 

reason code from the ‘reason cd’ field. This field is 

a drop-down box that corresponds with the ‘DE’ claim 

status code. Included in the reason cd field are both 

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6. Claim Status History Coding. (Continued) 

the full reason for the ‘DE’ code and a two-character 

code representing each option. The reason codes 

available for the ‘DE’ claim status code are: 

 

(a) Follow-up Letter to Claimant/Other(s)- ‘LE’ - 

Used for initial or follow-up letters mailed 

directly to the claimant or other entity (for 

miscellaneous employment issues, such as 

affidavits or subcontractor issues) when asking 

for employment clarification or information. 

 

(b) Follow-up to DOE- ‘DE’ - Used exclusively for 

follow-up to the DOE for employment verification 

(EE-5). 

 

(c) Follow-up to Corporate Verifier-‘CS’ - Used 

exclusively for follow-up to a Corporate 

Verifier. 

 

(d) Follow-up to CPWR – ‘US’ - Used exclusively 

for follow-up to CPWR. 

 

(e) Follow-up to SSA – ‘SS’ - Used exclusively 

for follow-up to the SSA. 

 

(f) Document Acquisition Request – ‘DAR’ – Used 

for DAR second requests. 

(g) CPWR Subcontractor Database Searched – ‘CD’ 

– Used when the CPWR subcontractor database is 

searched. 

 

(3) DJ - ‘Developing Department of Justice’ – 

Deactivated. This code was used when a letter was 

sent to the DOJ requesting Section 5 award status, but 

it has been deactivated. 

 

(4) DM - ‘Developing Medical’ - For any medical 

development the CE enters the ‘DM’ code, whether or 

not there is a claimed covered condition. If the CE 

sends a letter to the claimant stating that no covered 

condition was claimed, or if a covered condition is 

claimed and more medical evidence is sought, either 

from the claimant or a physician/hospital, the ‘DM’ 

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6. Claim Status History Coding. (Continued) 

code is used. This includes any initial development 

and/or follow-up. 

The status effective date is the date of the 

development action. Upon entry of the ‘DM’ code, the 

CE has the option to select a reason code. 

A reason code is not required for general medical 

development as listed above. However, there are two 

types of specific medical development letters that do 

require a reason code. The reason codes available for 

the ‘DM’ claim status code are as follows: 

(a) DMB - Deny Specific Medical Benefits on 

Accepted Conditions – This reason code must be 

selected when an initial letter is sent to deny a 

specifically requested medical benefit (that is 

not currently being paid) on an accepted 

condition. 

For example, a claimant requests a vehicle 

modification, but it is deemed “not medically 

necessary,” and the request is denied. If the 

claimant challenges the decision, a more formal 

decision is required (see the decision coding 

section in Chapter 2-2100.) 

(b) RMB – Reduce Medical Benefits on Accepted 

Condition – This reason code must be selected 

when an decision is made to reduce a medical 

benefit that is currently being paid for an 

accepted condition. 

For example, an employee was receiving home 

health care, but upon further evaluation, it is 

determined that the in-home health care is 

unnecessary and will no longer be a covered 

medical expense. If the claimant challenges the 

decision, a more formal decision is required (see 

the decision coding section in Chapter 2-2100.) 

(5) DO - ‘Developing Other’- When sending an initial 

or follow-up letter that does not solely address 

medical or employment issues, but includes some other 

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development action (e.g., survivorship), or when 

sending initial or follow-up NIOSH questionnaires, the 

CE enters the ‘DO’ code with no associated reason 

code. 

The status effective date is the date of the 

development letter. More specific development actions 

can be captured by selecting one of the following from 

the corresponding reason code drop down menu: 

 

(a) OH – ‘Occupational History’ (E only) - 

Selected to reflect that an OHQ was completed or 

attempted. 

(b) IM – ‘Impairment’ (E only) - Selected when 

letter developing impairment is sent. 

 

(c) TD – ‘Toxic Exposure Development’ (E only) – 

Selected when a letter developing toxic exposure 

is sent. 

 

(d) WL – ‘Wage Loss’ (E only) - Selected when a 

letter developing wage loss is sent. 

 

(e) WI – ‘Wage Loss and Impairment’ (E only) – 

Selected when a letter developing wage loss and 

impairment is sent. 

 

(f) EHP – ‘Email to Health Physicist’ – Selected 

when an e-mail/documentation regarding a case is 

sent to the health physicist for review. 

(g) EIH – ‘Email to Industrial Hygienist’ (E 

only) – Selected when an e-mail/documentation 

regarding a case is sent to the industrial 

hygienist for review. 

(h) ETX – ‘Email to Toxicologist’ (E only) – 

Selected when an e-mail/documentation regarding a 

case is sent to the toxicologist for review. 

(6) ‘SM’ – Site Exposure Matrix Searched – The CE 

enters this code into the claim status history when 

searching SEM for the first time. No coding is 

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6. Claim Status History Coding. (Continued) 

required for additional SEM searches unless SEM is 

consulted to develop causation for another claimed 

condition at another time. 

Regardless of the outcome of the SEM search, the CE 

places the search results in the case file to show 

that the search was conducted. The status effective 

date of the code is the date of the search, as 

reflected on the bottom right hand corner of the SEM 

printout. 

b. Medical Action Codes. 

 

(1) MS - ‘Sent to Medical Consultant’ - When a CE 

identifies a case for referral to a District Medical 

Consultant (DMC) or medical expert, the Medical 

Scheduler prepares the file for mailing. If the 

Medical Scheduler has claim status coding capability, 

he or she must enter the ‘MS’ code into ECMS. 

Otherwise, the Medical Scheduler must notify the CE 

once the package is mailed to the medical specialist 

so the CE can enter the ‘MS’ code. 

The status effective date for the ‘MS’ code is the 

date of the cover letter of the referral package to 

the DMC. When entering the ‘MS’ code, the CE must 

select the appropriate reason code that describes the 

subject matter of the request. 

The reason codes available are: 

 

(a) Impairment (E only)- ‘IM’ - Used for a 

referral related to an impairment evaluation. 

 

(b) Causation (E only)- ‘CA’ - Used for a 

referral related to establishing causation. 

 

(c) Medical Condition Referral - ‘MC’ - Used for 

a referral related to establishing a claimed 

illness. 

 

(d) Wage Loss (E only) – ‘WL’ – Used for a 

referral related to establishing wage loss. 

 

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6. Claim Status History Coding. (Continued) 

(e) Other/Referred for Multiple Issues – ‘OT’ – 

Used for a referral encompassing several 

different reasons or any reason not listed above. 

 

(2) MR - ‘Received Back from Medical Consultant’ - 

Upon completion of the review, the DMC returns the 

narrative report and the completed HCFA-1500 to the CE 

within 30 days. Upon receipt of the narrative report 

and the bill, the CE enters the code ‘MR’. 

The status effective date for the ‘MR’ code is the 

date the report from the DMC is stamped “received” by 

the DO. If the report received is insufficient, the 

CE should not code the MR code until a corrected 

report is received. When entering the ‘MR’ code, the 

CE must select the appropriate reason code that 

describes the subject matter of the response. The 

reason codes available are: 

 

(a) Impairment (E only)- ‘IM’ - Used for a 

response related to an impairment evaluation. 

 

(b) Causation (E only)- ‘CA’ - Used for a 

response related to establishing causation. 

 

(c) Medical Condition Referral - ‘MC’ - Used for 

a response related to establishing a claimed 

illness. 

 

(d) Wage Loss (E only) – ‘WL’ – Used for a 

response related to establishing wage loss. 

 

(e) Other/Referred for Multiple Issues – ‘OT’ – 

Used for a response encompassing several 

different referral reasons or any reason not 

listed above. 

 

(3) 2S - ‘Sent for 2nd Opinion’- When a CE identifies 

a case requiring a medical second opinion, the Medical 

Scheduler prepares the documentation for mailing. If 

the Medical Scheduler has claim status coding 

capability, he or she must enter the ‘2S’ code into 

ECMS. Otherwise, the Medical Scheduler must notify 

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the CE once the package is mailed to the medical 

specialist so the CE can enter the ‘2S’ code. 

The status effective date for the ‘2S’ code is the 

date of the cover letter of the referral package. 

When coding the ‘2S’ code, the CE must select the 

reason code that describes the subject matter of the 

request. The reason codes available are listed below 

(a) Impairment (E only)- ‘IM’ - Used for a second 

opinion examination in support of impairment. 

 

(b) Causation (E only)- ‘CA’ - Used for a second 

opinion examination in support of causation. 

 

(c) Medical Condition Referral - ‘MC’ - Used for 

a second opinion examination in support of 

establishing a claimed illness. 

 

(d) Wage Loss (E only) – ‘WL’ – Used for a second 

opinion examination in support of establishing 

wage loss. 

 

(e) Other/Referred for Multiple Issues – ‘OT’ – 

Used for a second opinion examination 

encompassing several different referral reasons 

or any reason not listed above. 

 

(4) 2R - ‘Received 2nd Opinion’ - Once the CE receives 

the medical narrative from the second opinion 

specialist and determines that it adequately addresses 

the CE’s questions, the CE enters the ‘2R’ code. 

The status effective date for the ‘2R’ is the date the 

medical narrative is date-stamped in the DO. When 

entering the ‘2R’ code, the CE must select the reason 

code that describes the subject matter of the 

response. The reason codes available are: 

 

(a) Impairment (E only)- ‘IM’ - Used for a 

response related to a second opinion examination 

in support of impairment. 

 

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6. Claim Status History Coding. (Continued) 

(b) Causation (E only)- ‘CA’ - Used for a 

response related to a second opinion examination 

in support of causation. 

 

(c) Medical Condition Referral - ‘MC’ - Used for 

a response related to a second opinion 

examination in support of establishing a claimed 

illness. 

 

(c) Wage Loss (E only) – ‘WL’ – Used for a 

response related to a second opinion examination 

in support of establishing wage loss. 

 

(e) Other/Referred for Multiple Issues - ‘OT’ – 

Used for a response related to a second opinion 

examination encompassing several different 

referral reasons or any reason not listed above. 

 

c. Employment Action Codes. 

 

(1) CS - ‘Employment Verification Request Sent to a 

Corporate Verifier’ - When an initial employment 

verification request is sent to a corporate verifier, 

the CE enters the ‘CS’ code. A ‘CS’ code is entered 

for each initial request. If the CE sends requests to 

two different corporate verifiers, then the CE enters 

two ‘CS’ codes. 

The status effective date is the date of the letter to 

the corporate verifier. If the request is faxed, it 

is the date the fax was sent. (When the CE follows up 

on the initial request, no ‘CS’ claim status code is 

entered; rather, the CE enters the ‘DE’ claim status 

code with the ‘CS’ reason code.) 

 

Certain corporate verifiers have asked to be contacted 

by telephone. For those verifiers, the printout of 

the telephone call serves to document the development 

action. The CE enters the ‘CS’ with the status 

effective date of the telephone call. 

 

(2) CR - ‘Complete Employment Verification Received 

from a Corporate Verifier’ - The CE uses the ‘CR’ code 

only when the response from the corporate verifier is 

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6. Claim Status History Coding. (Continued) 

sufficient to establish that all information available 

has been provided. Such a response may address all of 

the claimed employment, or it may address some or none 

of the employment, if the corporate verifier notes 

that no other information is available. Such a 

response may also state that the corporate verifier 

has no employment records for the individual. 

The status effective date of the ‘CR’ code is the date 

the DO/CE2 Unit received the response, i.e., the date 

the written response is received. 

The ‘CR’ code is NOT used when a follow-up to the 

corporate verifier is required because the response is 

returned blank, the information provided is confusing 

or incomplete, or the response does not indicate which 

period of employment is or is not verified. 

 

(3) EC - ‘Employment Verification Process Complete’ - 

When multiple "sent" codes (‘ES’,‘CS’) exist, and the 

CE receives a single response that confirms all 

outstanding employment dates, the claim is coded 

‘EC’. The ‘EC’ code signifies that a response has 

been received that fully addresses the employment 

issue and that further employment development is 

unnecessary. 

The CE also uses the ‘EC’ code when issuing RDs to 

deny benefits if he or she determines that further 

development of the employment verification issue is 

unnecessary, since other evidence (or lack thereof) 

will result in a recommended denial. Only one ‘EC’ 

code is used no matter how many outstanding "sent" 

codes are in ECMS. 

 

Whenever an ‘EC’ code is entered into ECMS, the CE 

completes the EC Code Justification Memo (Exhibit 1) 

for the case file. The status effective date of the 

‘EC’ code is the date of the EC Code Justification 

Memo. 

 

(4) ES - ‘Employment Verification Sent to DOE’- This 

code is used when a Form EE-5 is sent to the DOE, when 

a Document Acquisition Request (DAR) is made, or when 

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6. Claim Status History Coding. (Continued) 

the initial contact letter is sent to DOJ requesting 

employment verification/RECA award status. 

When an employment information request is sent to the 

DOE or DOJ, the CE enters the ‘ES’ code. An ‘ES’ code 

is entered for each initial request sent to a DOE 

Operations Center or DOJ. If the request is sent to 

two different Operations Centers, then the CE enters 

two ‘ES’ codes. 

The status effective date is the date the request is 

made. (When the CE follows up on the initial request, 

no ‘ES’ claim status code is entered; rather, the CE 

enters the ‘DE’ claim status code with the appropriate 

reason code. For follow-up to DOJ if no response has 

been received, the CE enters a DO code with 

corresponding case note). 

(a) For EE-5 (or DOJ) employment verification 

requests, the CE selects the DOE Operations 

Center and notes the sending of a Form EE-5 from 

the reason cd field that corresponds with the 

‘ES’ claim status code being recorded. The 

three-character code and the DOE Operations 

Center to which the Form EE-5 is sent are 

included on the same line, so only one selection 

will be made from the drop-down box. 

For example, if Form EE-5 is sent to the Chicago 

Operations Center, the CE selects ‘CH5 – Chicago 

Operations Center (EE-5)’ from the reason cd 

drop-down menu. For the initial contact letter 

sent to DOJ requesting employment verification/ 

RECA award status, the CE selects ‘RE5 - RECA 

employment (EE-5)’ from the reason cd drop-down 

menu. 

 

Note: If a CE sends one Form EE-5 to one 

Operations Center, and that Operations Center 

sends a copy of Form EE-5 to more than one 

facility for response, the CE enters one ‘ES’ 

code for the appropriate Operations Center. 

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6. Claim Status History Coding. (Continued) 

(b) For DARs, the CE selects the appropriate 

reason code from the drop down menu that reflects 

that a DAR was sent, as well as where it was sent 

(e.g., ‘ALD – Albuquerque Operations Office 

(DAR]’). The ES code is equipped with drop down 

boxes that include a breakdown of DOE Operations 

Centers for DAR submissions sent to DOE. The CE 

selects the proper DOE Operations Center from the 

drop down box when submitting the DAR package. 

The ECMS status effective date of the code is the 

date reflected on the DAR request form. 

DARs can also be made to the DOJ on RECA cases. 

In these types of cases, the CE will select the 

reason code ‘RED – RECA Employment (DAR)’. 

 

(5) ER - ‘Employment Verification Received from the 

DOE’ - The CE uses the ‘ER’ code when the DAR response 

is received, when the DOJ response is received, or 

when Form EE-5 from DOE is sufficient to establish 

that all the information available has been provided 

(i.e., the response addresses all of the claimed 

employment; addresses some, or none, of the 

employment, if DOE notes that they have no other 

information; or states that DOE has no employment 

records for that individual.) 

The ‘ER’ date is the date the response is date-stamped 

in the DO. The ‘ER’ code is NOT used if Form EE-5 is 

returned blank, or the information provided is 

confusing or incomplete, or the response does not 

indicate which period of employment is or is not 

verified. 

(a) For EE-5 (or DOJ employment/award) responses, 

the CE selects the DOE Operations Center from 

which a Form EE-5 was received from the reason cd 

field that corresponds with the ‘ER’ claim status 

code being recorded. The three-character code 

and the DOE Operations Center from which Form EE5 is returned included on the same line, so only 

one selection will be made from the drop-down 

box. 

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6. Claim Status History Coding. (Continued) 

Example 1: If Form EE-5 is returned from the 

Chicago Operations Center, the CE selects ‘CH5 – 

Chicago Operations Center (EE-5)’ from the reason 

cd drop-down menu. The CE enters an ‘ER’ for 

each Form EE-5 received from the Operations 

Center(s). 

Example 2: If the CE receives one Form EE-5 from 

the Richland Operations Office and another from 

the Ohio Field Office, the CE enters the ‘ER’ 

code with reason code ‘RI5-Richland Operations 

Office (EE-5)’ for Richland, and a separate ‘ER’ 

code with reason code ‘OF5-Ohio Field Office (EE5)’ for the Ohio Field Office. 

 

If a CE sends one Form EE-5 to one Operations 

Center, and that Operations Center sends a copy 

of Form EE-5 to more than one facility for 

response, the CE enters one ‘ES’ code for the 

appropriate Operations Center. 

Where DOE notifies the CE as to how many copies 

the Operations Center sent to the facilities 

(oftentimes Oak Ridge Operations Office), or when 

the CE is aware that multiple Forms EE-5 are 

expected from that original inquiry, the CE 

enters the corresponding ‘ER’ code only after all 

anticipated EE-5 forms are returned. 

 

Note: If an unsolicited Form EE-5 is received 

after a documented Form EE-5 was already received 

and for which an ‘ER’ was previously entered, the 

additional Form EE-5 must also be documented in 

ECMS as a new ‘ER’ if Form EE-5 contains 

additional/new information. This means that 

entries of ‘ES’, ‘ER’, ‘ER’ may potentially 

appear in ECMS. This is acceptable since DOE may 

send out follow-up Form EE-5 documents which 

could further clarify employment verification. 

When the DOJ response regarding employment 

verification/RECA award status is received, the 

CE selects ‘RE5 - RECA employment (EE-5)’ from 

the ‘reason cd’ drop-down menu. 

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6. Claim Status History Coding. (Continued) 

(b) For DAR responses, the CE selects the 

appropriate reason code from the drop down menu 

(described above), [e.g., ‘ALD – Albuquerque 

Operations Office (DAR)’] to show that the DAR 

response was received and to denote which DOE 

Operations Center responded. For DAR responses 

from the DOJ, the CE will select the reason code 

‘RED – RECA Employment (DAR)’. 

 

(6) OR - ‘ORISE Employment Evidence Received’ - When 

a claim is initially reviewed, if it is determined 

that a request for employment verification is 

appropriate, and the employee worked at one of the 

facilities on the ORISE list, the CE searches the 

ORISE database. 

Regardless of whether the information from the ORISE 

database addresses all, part or none of the employment 

data, the CE enters the ‘OR’ status code, with the 

status effective date as the date on the printout of 

the results of the ORISE database search. 

(7) SS - ‘Employment Verification Request Sent to 

Social Security’ - When an employment verification 

request(Form SSA-581) is sent to the Social Security 

Administration (SSA), the CE enters the ‘SS’ claim 

status code in ECMS. 

The status effective date is the date the SSA-581 form 

is sent to SSA. The CE date stamps the form at the 

time the form is sent to SSA and a copy is kept for 

the case file. (When the CE follows up on the initial 

request, no ‘SS’ claim status code is entered. 

Instead, the CE enters the ‘DE’ claim status code with 

the ‘SS’ reason code.) 

 

(8) SR - ‘Employment Verification Received from 

Social Security’ - When employment verification is 

received from the Social Security Administration (Form 

SSA-L460, the end product of Form SSA-581), regardless 

of whether the response addresses all, part or none of 

the employment data, the CE enters the ‘SR’ code. 

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6. Claim Status History Coding. (Continued) 

The status effective date is the date the response is 

date-stamped in the DO. (Note: The SR code is not 

entered if the SSA records are received from the 

claimant or another source.) 

 

(9) US - ‘Union Sent’ - When an employment 

verification request is sent to the Center for 

Construction Research and Training (CPWR), the CE or 

Point of Contact (POC) enters the ‘US’ code. The 

status effective date is the date of the referral 

mailing. The ‘US’ code signifies that all actions 

pertaining to a CPWR mailing, including release of a 

completed referral package and mailing of a cover 

letter to the claimant(s), are complete. 

Upon entry of the ‘US’ code, the CE must select the 

number of CP-2s that are sent to CPWR from the 

corresponding drop-down box. The drop-down menu will 

allow the CE to select only a number between one and 

twenty. In the rare occurrence that more than twenty 

CP-2s are sent to CPWR, the CE will enter an 

additional ‘US’ code and select the remaining number 

of CP-2s (greater than twenty) that are being mailed. 

For example, if twenty-five CP-2s are being sent to 

CPWR, the CE will have to enter one ‘US’ code and 

select ‘20’ from the drop-down menu. Then the CE will 

have to enter a second ‘US’ code and select ‘5’ from 

the drop down menu. 

 

After entering the ‘US’ code, a note must be entered 

in the ‘Worksite Desc’ field on the main case screen. 

For each facility where employment is claimed and for 

which CPWR is assisting in collection of employment 

evidence, the CE or POC must enter the following note 

using the first 13 characters of the ‘Worksite Desc’ 

field for outstanding CPWR referrals: ‘CPWR pending’. 

This note is not to replace any existing entry 

pertaining to the site. 

 

The CE also enters a 40-day call-up effective the date 

of referral to notify the POC of the overdue request 

if needed. The POC is to input a claim status code of 

‘DE’ with the reason code ‘US’ in the claim status 

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6. Claim Status History Coding. (Continued) 

history screen effective the date contact is made with 

CPWR concerning an overdue response. 

 

Notes of all phone calls or e-mails are to be recorded 

in the case file. The POC has three working days to 

report all overdue referrals to CPWR. Also, he or she 

must update the status of the referral in the CPWR 

tracking program. 

(10) UR - ‘Union Received’- Upon receipt of a CPWR 

response, the CE or POC enters the claim status code 

‘UR’ (Received from Union) in the claim status history 

screen . The status effective date is the date the DO 

received the referral, according to the date-stamp. 

Upon entering the ‘UR’ code, the CE must select a ‘VNVerified None’, ‘VS-Verified Some’, or ‘VA-Verified 

All’ from the corresponding drop-down box. 

 

(a) ‘VN - Verified None’ - Selected when none of 

the data requested from CPWR was used to verify 

the claimed covered employment. 

 

(b) ‘VS - Verified Some’ - Selected when some 

portion of the data requested from CPWR was used 

to verify the claimed covered employment. 

 

(c) ‘VA - Verified All’ - Selected when all of 

the data requested from CPWR was used to verify 

the claimed covered employment. 

(l1) SF – ‘Records Request Sent to Former Worker 

Program’ - When a records request is made to the 

Former Worker Program (FWP), the CE enters the claim 

status code ‘SF’ into the claim status history screen 

with a status effective date equal to the date of the 

cover letter/memo to the FWP. 

(12) RF – ‘Response Received From Former Worker 

Program’ - Upon receipt of records from the FWP, the 

CE enters the claim status code ‘RF’ into the claim 

status history screen. The status effective date is 

the date the response was received in the DO/CE2 Unit, 

according to the date stamp. 

 

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6. Claim Status History Coding. (Continued) 

d. NIOSH Action Codes. 

 

(1) NI - ‘Sent to NIOSH for Dose Reconstruction’ - 

While the NI code is used in both ECMS B and ECMS E, 

the use of the code varies on B only cases versus BE 

cases: 

(a) For B Cases – the ‘NI’ claim status code is 

entered for each individual claimant within a 

case sent to NIOSH for dose reconstruction. When 

a case is sent to NIOSH, the CE prepares the 

NIOSH Referral Summary Document (NRSD), which 

includes a listing of all of the claimants. When 

this form is signed by the Senior or Supervisory 

CE, the ‘NI’ is coded for each claimant included 

on the NRSD. The status effective date is the 

date of the Senior or Supervisory CE’s signature 

on the NRSD. 

If the case is already at NIOSH and the DO/CE2 

Unit receives a claim from a new claimant, the CE 

prepares an Amended NIOSH Referral Summary 

Document, which includes all additional claimants 

since the original NRSD. (Note: All claimants 

on the case should be forwarded to NIOSH, 

regardless of survivorship eligibility at the 

time of the referral.) When this form is signed 

by the Senior or Supervisory CE, the ‘NI’ is 

coded for each new claimant included on the 

Amended NRSD. The status effective date is the 

date of the Senior or Supervisory CE signature on 

the Amended NRSD. 

If the case is already at NIOSH and the DO/CE2 

Unit receives notice of a new claimed cancer, the 

CE prepares an Amended NIOSH Referral Summary 

Document, which includes all additional cancers 

since the original NRSD. When this Amended NIOSH 

Referral Summary Document is sent to NIOSH, no 

additional NI code is needed. 

(b) For B/E cases - When a non-SEC cancer claim 

is referred to NIOSH, or was originally referred 

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6. Claim Status History Coding. (Continued) 

to NIOSH as a Part B claim and a new Part E claim 

now exists, the CE does not input the ‘NI’ (SENT 

TO NIOSH) code into ECMS E to show that the claim 

is pending dose reconstruction at NIOSH. The 

‘NI’ code is input into ECMS B only (unless the 

case is a RECA Section 5 case with claim for 

cancer other than lung cancer). The CE must 

concurrently develop for exposure to toxic 

substances. 

When toxic exposure development is complete and 

the CE cannot accept causation, the CE creates a 

memorandum to file stating that the toxic 

exposure development is complete and then codes 

‘NI’ into ECMS E. The status effective date is 

the date of the memorandum. 

(c) PEP – ‘Rework Based on Program Evaluation 

Plan’ – This reason code is available for 

selection for Part B or B/E cases in association 

with the ‘NI’ claim status code. When it is 

determined a case needs a rework based on a 

program evaluation plan/report (PEP/PER), an 

amended NIOSH referral summary document (ANRSD) 

is prepared and submitted to NIOSH. The ‘NI’ 

code is entered with a ‘PEP’ reason code to 

indicate the case is being referred to NIOSH for 

a rework based on a program evaluation 

plan/report. The status effective date of the 

‘NI’ code with ‘PEP’ reason code is the date of 

the ANRSD. 

 

Again, the ‘NI’ status code with ‘PEP’ reason 

code should only be entered in ECMS E after toxic 

exposure development is complete and the CE has 

placed a memo the file stating that toxic 

exposure development is complete. The CE then 

enters status code ‘NI-PEP’ into ECMS E with the 

date of the memorandum as the status effective 

date. 

If the NI code had been entered into ECMS E prior 

to the rework and there are no new claimed 

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conditions, the ‘NI-PEP’ should be coded into 

ECMS E with a status effective date of the ANRSD, 

just as in ECMS B, and no new memo is required.

 

Since this is considered a new dose 

reconstruction, the CE should not change the 

existing NR/DR status code to NR/RW as typically 

done for rework cases. Furthermore, if a PoC 

value is already entered into ECMS, the CE should 

not delete the PoC. The new PoC will simply be 

updated into both ECMS B and E once it is 

calculated. 

 

(2) NO - ‘NIOSH, Administrative Closure’ - For cases 

at NIOSH, Form OCAS-1 is provided to the claimant 

after completion of the dose reconstruction report. 

The claimant is required to sign and return the form 

to NIOSH before NIOSH can return the case to DOL. 

If none of the claimants sign the OCAS-1 form or 

submit comments within 60 days, NIOSH will close the 

case administratively and send a letter/e-mail to DOL 

addressing the closure. The CE enters the ‘NO’ claim 

status code in ECMS B, with a status effective date of 

the receipt of the letter/e-mail from NIOSH. (If the 

district office cannot obtain an OCAS-1 from any claim 

on the case, the case will also need to be 

administratively closed with DOL by entering a ‘C2’ 

code on the claims.) 

If the case is a B/E case where toxic exposure 

development is complete and the ‘NI’ code has already 

been entered into ECMS E, the CE enters the ‘NO’ code 

into ECMS E as well. If toxic exposure development 

has not yet been completed and the ‘NI’ code has not 

yet been coded into ECMS E, the CE does not enter the 

‘NO’ code into ECMS E. 

 

(3) NR - ‘NIOSH Dose Reconstruction Received’ - When 

a case is returned from NIOSH with a dose 

reconstruction, or it is returned from NIOSH because a 

dose reconstruction could not be performed, the CE 

enters the ‘NR’ (Received from NIOSH) claim status 

code into ECMS B. If the case is a B/E case where 

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toxic exposure development is complete and the ‘NI’ 

has already been coded in ECMS E, the ‘NR’ code is 

entered into ECMS E as well. The status effective 

date is the date the DO received the dose 

reconstruction (according to the date-stamp). 

The PoC and IREP information must be entered into ECMS 

B and E on B/E cases regardless of whether an NI was 

previously entered into ECMS E. 

Upon entry of the ‘NR’ code, the CE selects a specific 

reason code from the ‘reason cd’ field. This field is 

a drop-down box that corresponds with the ‘NR’ claim 

status code. Included in the reason cd field are both 

the full reason for the ‘NR’ code and a two-character 

code representing each option. The reason codes 

available for the ‘NR’ claim status code are: 

 

(a) Dose Reconstruction Received, POC-‘DR’ - Used 

when the DO receives a routine dose 

reconstruction (not fitting one of the other 

specific reason codes listed below). 

(Even though the CE might not yet have had an 

opportunity to review the dose reconstruction 

report, this is the appropriate reason code to 

use at this time. If it is determined after 

review that the reason code needs to be changed, 

e.g., for a rework, the CE updates the reason 

code.) 

 

(b) Reworks of Dose Reconstruction, no POC-‘RW’ - 

Used exclusively if it is determined that the 

received dose reconstruction is not to be used, 

based on the review by the Health Physicist at 

National Office (NO). Once the Health Physicist 

determines the case must be returned to NIOSH for 

a rework, the CE changes the reason code for the 

‘NR’ claim status code from ‘DR’ to ‘RW.’ If a 

PoC was entered into ECMS, it should be removed. 

(Note: A new ‘NR’ claim status code is not to be 

entered. Only the reason code for the existing 

‘NR’ code is to be updated with the new reason 

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6. Claim Status History Coding. (Continued) 

code of ‘R’. However, the date of the original 

claim status code is not changed or updated. 

This is because the ‘NR’ code documents the 

receipt date of the dose reconstruction disc.) 

Once the CE prepares the rework and a new Amended 

NIOSH Referral Summary Document (ANRSD) is ready 

to be sent back to NIOSH, a new ‘NI’ claim status 

code is entered, with a status effective date of 

the ANRSD. 

 

(c) CLL only, no POC- ‘CL’ - In Part B cases when 

after full medical development the only claimed 

primary cancer is CLL, the CE enters the ‘NR’ 

claim status code in ECMS, even though there will 

not be an ‘NI’ code. On these cases, the status 

effective date of the ‘NR’ code with the ‘CL’ 

reason code is the date of the RD to deny based 

on CLL (0% PoC). The CE should not bother 

entering the ‘NR’ code with the ‘CL’ reason code 

in ECMS E because of the presumption of a 0% PoC 

with regards to radiation exposure, only toxic 

exposure development would be pursued under Part 

E. 

 

(d) No Dose Reconstruction Possible, SEC – ‘ND’ - 

Used for non-SEC cancers claimed at an SEC 

facility where NIOSH determines that no dose 

reconstruction is possible. Note: Denials based 

on this situation are coded D7/F9. 

 

(e) Partial Dose Reconstruction, SEC – ‘PD’ - 

Used for non-SEC cancers claimed at an SEC 

facility where NIOSH can only perform a partial 

dose reconstruction, such as occupational medical 

x-ray doses only or external dose only. The dose 

reconstruction report must be carefully reviewed 

to determine if a partial dose reconstruction was 

performed. 

(4) NW - ‘NIOSH, Returned without a Dose 

Reconstruction’ - When withdrawing a case from NIOSH 

for any reason (e.g., the CE realizes there was no 

covered employment and the case should not have been 

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6. Claim Status History Coding. (Continued) 

sent to NIOSH), and the DO will not be sending the case 

back to NIOSH, the CE requests the return of the case 

from NIOSH without a dose reconstruction and enters 

the ‘NW’ code in ECMS B. The CE only enters the ‘NW’ 

code into ECMS E on BE cases where the toxic exposure 

development was completed and the ‘NI’ code had been 

entered into ECMS E. The CE notifies NIOSH that the 

dose reconstruction is no longer needed for the case. 

The status effective date is the date of the 

notification to NIOSH. 

There are also instances when NIOSH requests that DOL 

withdraws a case that is currently at NIOSH (e.g., 

during NIOSH interview claimant claims additional 

cancer or employment period which requires development, 

claimant passes away). In these types of situations, 

the file must be documented with the TMS record of the 

NIOSH call requesting withdrawal and the CE codes an 

‘NW’ with a status effective date of the NIOSH email. 

Please note, the ‘NW’ code is not applicable in 

instances where NIOSH advises DOL that the case is 

pended at NIOSH. Cases pended at NIOSH do not required 

ECMS coding. 

Please note that an administrative closure of a claim 

in ECMS does not “close out” a pending NIOSH case. For 

example, if an employee dies while his or her case is 

at NIOSH, an ‘NW’ code and a ‘C3’ code must be entered. 

The ‘C3’ code alone is not sufficient. 

 

(5) NAR – ‘No Additional Review Needed’ with Reason 

Code NRC – ‘NIOSH Returned Case’ – This code indicates 

that all processing is completed on a case that was 

returned from NIOSH with an ‘NR’ or ‘NW’ code and no 

further processing is necessary. Typically a case 

should be returned or withdrawn from NIOSH (‘NR’/‘NW’) 

before a recommended and/or final decision is issued, 

but there are some rare instances that the case is 

returned or withdrawn after a recommended and/or final 

decision is rendered and there is no additional 

development required on the case. Another circumstance 

where this code combination would be used is when the 

claim is withdrawn from NIOSH after a claim has been 

closed. 

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6. Claim Status History Coding. (Continued) 

When a decision is issued or a claim is closed on a 

case that is currently at NIOSH and the dose 

reconstruction is received or the claim is withdrawn 

after the fact, the ‘NAR’ claim status code with ‘NRC’ 

reason code is entered. Otherwise, reports would show 

that a decision or closure were pending, which would be 

inaccurate. 

The ‘NAR’ claim status with ‘NRC’ reason code must be 

approved by the District Director, Assistant District 

Director, FAB Manager, and/or designated person. Once 

the CE/HR determines that the ‘NAR/NRC’ code is 

applicable, he/she prepares a memo to the file 

explaining the context in which the ‘NAR/NRC’ code is 

needed and the applicable ECMS system (Part B, E or 

both) for the claim. The designated person then 

approves and signs off on the memo and codes the 

‘NAR/NRC’ code in ECMS accordingly, with a status 

effective date of the date of the approved memo. 

(6) LNS – ‘Letter Sent to NIOSH’ - This code is used 

when a letter is sent to NIOSH inquiring as to the 

applicability of a Program Evaluation Report (PER) on 

a case’s previous dose reconstruction. The status 

effective date is the date the letter is sent to 

NIOSH. This is a B/E code, but is only entered into 

ECMS E if the ‘NI’ had previously been entered, 

indicating the toxic exposure development was 

complete. 

(7) LNR – ‘Letter Received from NIOSH’ - This code 

was initially created to document NIOSH’s response to 

our request (LNS). However, the use of LNR is now used 

to document the receipt of an Individual Case 

Evaluation/Individual PER from NIOSH indicating that 

the case was evaluated against a PER and any other 

changes that may affect the dose reconstruction. The 

status effective date is the date stamp received into 

the DO. This is a B/E code, but is only entered into 

ECMS E if the ‘NI’ had previously been entered, 

indicating the toxic exposure development was 

complete. 

 

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6. Claim Status History Coding. (Continued) 

The LNR code has several associated reason codes. The 

reason codes represent the EEOICPA Bulletin that 

addresses a particular PER or possibly multiple PERs. 

The applicable reason code must be selected from the 

reason code drop down list (i.e. ‘824’ – PER/ICE 

addressed in Bulletin 08-24). New reason codes are 

added as new PERs are released. 

e. Additional Action Codes. 

 

(1) 15 - ‘EE-15 Form Sent’ - Deactivated. The ‘15’ 

code was previously used when the CE mailed Form EE-15 

(which was required with older versions of Form EE1/2) with a status effective date of the date the form 

was mailed. However, the EE-15 is no longer used. 

When a CE requests information similar to what was on 

Form EE-15, such as tort suit information, the CE will 

enter the ‘DO’ code, instead of a ‘15’. 

 

(2) RD - ‘Development Resumed’ - The ‘RD’ code is 

used to resume development on claims two ways in 

ECMS. The first use is when a case has a Final 

Decision, and a current claimant on the case submits a 

subsequent claim form for a new medical condition. 

The status effective date of the ‘RD’ in this case is 

equal to the new filing date (postmark date, if 

available, or received date) for the new claim form. 

The second use is when a claim has been closed prior 

to adjudication, and the claimant (or DOJ, in the case 

of a pending RECA claim) writes a letter asking to 

resume development on the claim. The CE then enters 

the ‘RD’ code and resumes development. 

The status effective date of the ‘RD’ in this case is 

equal to the date-stamp of the letter requesting 

development be resumed. This code can be used in 

conjunction with the following closure codes: 

‘C0’,‘C1’,‘C2’,‘C9’, or‘C10’ where the claimant was 

not at MMI, since none of these closure codes refer to 

the death of a claimant (Note: This code is not to be 

used for the Reopening of Claims due to Director’s 

Orders.) 

 

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6. Claim Status History Coding. (Continued) 

(3) UN - ‘Unadjudicated’ - The ‘UN’ code is a default 

claim status code created when a new claim is entered 

in ECMS. This code is generated by the system when a 

claim is created, and the CE does not use it as a 

development code. If Resource Center development predates the ‘UN’ code, the ‘UN’ code should be deleted 

when the development actions are entered. 

 

(4) SE - ‘Confirmed SEC Claim’ - When a CE determines 

a claim meets the SEC criteria, the CE enters the ‘SE’ 

code into ECMS B. The status effective date is equal 

to the date of the recommended decision awarding SEC 

benefits. If FAB is the first to become aware of the 

SEC criteria being met, they should code it the date 

of their decision (reverse to accept or remand if 

further development is required.) This code is 

required for all accepted SEC claims. 

This code must also be entered into ECMS E if the 

basis for the Part E decision is the Part B/SEC 

acceptance. The status effective date is the date of 

the Part E recommended decision. 

 

(5) WS - ‘Washington, DC: Sent to’ - When the CE or 

HR identifies a policy or procedural issue that 

requires NO attention, other than a technical issue 

regarding health physicist, toxicologist, and/or 

industrial hygienist review, the CE prepares the WS/WR 

Referral/Response Form (Please see exhibit 2). After 

the Supervisory CE and District Director (DD) or FAB 

Manager reviews the case file and the referral form 

and agrees to send the issue to NO, the DD or FAB 

Manager (or designate) enters the ‘WS’ code. The 

status effective date is the date the DD or FAB 

manager signs and dates the WS/WR Referral/Response 

Form. 

On these types of reviews, the use of the ‘WS’ code is 

restricted to the DD and FAB Manager, to ensure that 

he or she agrees with the CE’s rationale for the 

referral to NO and also agrees that the CE cannot 

continue working on the case until the outstanding 

issue is resolved. Included in the ‘reason cd’ field 

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6. Claim Status History Coding. (Continued) 

are both the full reason for the ‘WS’ code and a twodigit code for each option. The reason codes that 

should be selected for these types of reviews is PR – 

‘Policy Review’ - Used for referral to NO for general 

policy review (not including review by Health 

Physicist or Medical Director). 

For cases that require technical review by the Health 

Physicist, Toxicologist, and/or Industrial Hygienist, 

the CE will select the ‘DO’ reason code with the EHP, 

EIH, or ETX reason code. If the scientist reviewing 

the file determines the issue is complex and will 

require a significant time to review (30 days or 

more), they will notify the DD via email and enter the 

‘WS’ code into ECMS. If the scientist has the case 

file, they will print a copy of this email to 

associate with the case file. If the DO still has the 

case file, DD will print a copy of this email for the 

file. The date of the ‘WS’ code will be the date of 

the email. Depending on who is conducting the review, 

the appropriate reason code is selected:

 

(a) ‘HP’ – ‘Health Physicist Review’ - Used for a 

referral to NO for review by the Health Physicist. 

(b) IH – ‘Industrial Hygienist Review’ (E only) - 

Used for referrals to the Industrial Hygienist. 

(c) TX – ‘Toxicologist Review’ (E only) – Used for 

referrals to the Toxicologist. 

(d) OP – ‘Overpayment Review’ – Used for referrals 

to NO because either for review of a potential 

overpayment or for overpayment 

processing/handling. 

(e) FR – ‘Facility Review’ – Used for referrals to 

NO for a determination on whether a facility 

should be covered or for expansion of dates of a 

covered facility. 

(f) RDR – ‘RECA Dose Reconstruction’ – This code 

was used to identify those claims that were held 

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6. Claim Status History Coding. (Continued) 

in the DO until it was determined how NIOSH was 

to perform dose reconstructions on RECA cancers. 

 

(6) TL – ‘Terminal Claimant Designated by DD/FAB 

Manager’ - This code is used when a determination has 

been made that the claimant is in a terminal 

condition. Use of this code is restricted to the DD 

or FAB Manager or their designee. If the case is a 

B/E case, the TL code must be coded into both ECMS B 

and ECMS E. The status effective date of the code is 

equal to the date the DD or FAB Manager determines the 

claim is in need of expedited processing due to a 

terminal illness, such as the date of a phone call 

(with corresponding TMS message printout), email, or 

other communication. 

(7) WR - ‘Washington, DC: Received Back From’ - When 

NO resolves a pending ‘WS’ issue, the Branch of 

Policy, Regulations and Procedures will return the 

WS/WR-Referral/Response Form to the District Office. 

The ‘WR’ response for technical reviews could also be 

an email or memo. The District Director enters the 

‘WR’ in ECMS, with an effective date of the receipt of 

the WS/WR-Referral/Response Form/memo/email. 

(8) IC – ‘Impairment Claimed’ (E only) - Used when 

the claimant informs DEEOIC in writing of intent to 

pursue an impairment claim. The status effective date 

is the postmark date of the letter, if available, or 

the date the letter is received in the DO/RC. If 

impairment is claimed multiple times, the IC code 

needs to be entered only once (unless it is claimed 

again after the final decision or when withdrawn ‘C10’ 

– ‘NM’). 

Also, if the claimant does not submit a written claim 

for impairment, but submits an impairment rating, this 

is treated as a claim for impairment and the IC code 

is entered. 

(9) WC – ‘Wage Loss Claimed’ (E Only) - Used when the 

claimant informs the DEEOIC in writing of intent to 

pursue a wage-loss claim. The status effective date 

is the postmark date of the letter, if available, or 

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6. Claim Status History Coding. (Continued) 

the date the DO/RC receives the letter. If wage loss 

is claimed multiple times, the WC code needs to be 

entered only once (with the initial claim for wage 

loss) until a decision is rendered (unless it is 

claimed after the final decision or when withdrawn 

‘C10’ – ‘WLW’). 

(10) NIM – ‘Not Claiming Impairment’ (E Only) - This 

code is used when the claimant informs the DEEOIC in 

writing that he or she is not claiming impairment 

(even though it was never actually claimed) or after 

the appropriate development for an impairment claim 

has been completed and the claimant has been 

unresponsive. The status effective date is the date 

the letter is received in the DO from the claimant 

stating they do not wish to claim impairment or the 

date on a letter sent to the claimant confirming an 

impairment claim will not be pursued at this time 

because of the lack of response. 

NIM has an optional reason code that must be selected 

in circumstances where the maximum payable benefit has 

already been paid, so a claim for impairment is not 

being solicited. This reason code is ‘MBM - Maximum 

Payable Benefits Met’. This code is not to be used if 

impairment has been claimed. In those circumstances, 

the claim must be withdrawn by the claimant or 

adjudicated. 

(11) NWL – ‘Not Claiming Wage Loss’ (E Only) - This 

code is used when the claimant informs the DEEOIC in 

writing that he or she is not claiming wage loss (even 

though it was never actually claimed) or after 

appropriate development for a wage loss claim has 

taken place and the claimant has been unresponsive. 

The status effective date is the date the letter is 

received in the DO from the claimant stating they do 

not wish to claim wage loss or the date on a letter 

sent to the claimant confirming a wage loss claim will 

not be pursued at this time because of the lack of 

response. 

NWL has an optional reason code that must be selected 

in circumstances where the maximum payable benefit has 

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6. Claim Status History Coding. (Continued) 

already been paid, so a claim for wage loss is not 

being solicited. This reason code is ‘MBM - Maximum 

Payable Benefits Met’. This code is not to be used if 

wage loss has been claimed. In those circumstances, 

the claim must be withdrawn by the claimant or 

adjudicated. 

(l2) NA – ‘No Action Necessary – SEC/PEP/PER’ – This 

code has several associated reason codes. Each reason 

code is generally specific to a Bulletin number 

regarding a new SEC or PEP/PER (B only). On occasion 

the reason codes are associated with a special project 

(B or E). Use of the ‘NA’ code and its associated 

reason code indicates that a claim was reviewed under 

the pertinent instructions and no action is necessary 

at this time. New reason codes are added as new 

SEC/PEP/PERs (or special projects) are released. 

(13) ISL – ‘Initial SEC Screening, Likely SEC’ (B 

only) – This code is used when the CE screens a case 

and determines that it is likely to meet the criteria 

for inclusion into an SEC class, as per a Bulletin. 

The status effective date of the ‘ISL’ code is to 

correspond with the completion date of the screening 

worksheet. 

(14) ISU – ‘Initial SEC Screening, Unlikely SEC’ (B 

only) – This code is used when the CE screens a case 

and determines that it is unlikely to meet the 

criteria for inclusion into an SEC class, as per a 

Bulletin. The status effective date of the ‘ISL’ code 

is to correspond with the completion date of the 

screening worksheet. 

(15) ISD – ‘Initial SEC Screening, Development Needed’ 

(B only) – This code is used when the CE screens a 

case and determines that development may be needed in 

order to reach a determination on SEC class inclusion, 

as per a Bulletin. The status effective date of the 

‘ISL’ code is to correspond with the completion date 

of the screening worksheet. 

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7. Case Management. ECMS contains ‘Notes’ and ‘Call-Ups’ 

sections, as well as a Telephone Management System (TMS), to 

assist the claims staff with managing cases, 

 

a. Notes and Call-Ups. The ‘Notes and Call-ups’ are 

intended primarily as a tool for CEs, Senior CEs, HRs, and 

Supervisory CEs in managing their caseloads. Each call-up 

is a note with an associated ‘action date’ used to display 

pending actions by date and type. 

 

(1) Each ECMS note consists of up to 255 characters 

of text, note type, code claim type associated with 

note, DO Code, call-up date priority, public flag, 

update, current owner id, and date created 

by/transferred to current owner. (See below for 

detailed information about these date elements), 

 

(2) Each note is Public, and visible to all 

authorized ECMS users. Notes are included in the case 

file for any FOIA requests. ECMS no longer allows for 

the saving of private notes. 

(3) Assigning a priority is strictly at the 

discretion of the owner of the note (1 = highest 

priority, 5 = lowest priority). A user can sort notes 

and call-ups by selecting the Manage Call-ups/Notes 

under the ‘Inquiry’ menu option based on priority, but 

this is not required. The default is ‘1’. 

(4) A ‘call-up date’ can be entered in the notes 

screen to serve as a “tickler” system for the CE. 

ECMS will then prompt the assigned CE to read the 

associated note when the call-up date is reached. It 

will continue to prompt the CE until the ‘task 

completed’ field is changed from ‘N’ to a ‘Y’ (or the 

call-up date is changed to a future date). 

b. Telephone Management System (TMS). The TMS was 

established to document each incoming call received and 

outgoing call placed, particularly calls related to 

existing case files. There is no single “TMS” Screen in 

ECMS. Rather, TMS refers to a combination of screens and 

functions related to on-line telephone message tracking and 

management. For example, the phone message screen is 

accessed by clicking the red phone icon, and phone message 

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7. Case Management. (Continued) 

reports are accessed through the ‘Inquiry’ menu in ECMS or 

through clicking the ECMS Reports icon. 

An automated telephone record must be created for every 

telephone call received or initiated by DOL, regardless of 

whether the caller is a DEEOIC claimant or a representative 

or other interested party to a DEEOIC claim (including 

NIOSH, DOE, and DOJ). For example, calls taken by contact 

representatives, workers’ compensation assistants, and 

supervisors must be entered into the system and, if needed, 

assigned to specific individuals for return calls. 

 

(1) Entering phone calls into ECMS. 

 

(a) Incoming phone calls: All incoming calls 

from DEEOIC claimants, survivors, attorneys, 

Congressional Offices and/or any other parties to 

a DEEOIC claim (including NIOSH, DOE, and DOJ) 

must be recorded in TMS, whether or not a return 

call is required, under the case number in ECMS. 

 

Calls from medical representatives, members of 

interest groups, or elected officials (or their 

staff members) must be documented. Also, calls 

that result in sending informational packets or 

application forms related to the EEOICPA to 

potential claimants or any other persons must be 

recorded in TMS, under each office’s “dummy SSN”, 

with a description in the text field of what was 

sent, to whom, and when. 

If the person receiving an incoming telephone 

call answers it completely (i.e., no return call 

is needed), he or she immediately enters the call 

into the system as an incoming call and the call 

will be marked ‘Y’ in the Call Completed field. 

(b) Outgoing phone calls - A call initiated by 

claims personnel, to a claimant or a party to the 

claim, must be entered as a phone message into 

TMS. After entering all appropriate data to 

record, the call will be marked ‘Y’ in the Call 

Completed field, and ensure that the phone 

message is closed. 

 

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7. Case Management. (Continued) 

If an outgoing call generates the need for a 

call-up, the person making the call first must 

document the call in the phone message screen, 

then open the Notes and Call-ups screen to enter 

a call-up note and date. 

 

(2) Fields to be completed - When a call requiring 

TMS entry is taken, the required data that must be 

entered into TMS are: 

 

(a) Call Reason - Select from list; use ‘other’ 

if none apply. 

 

(b) Claim Type - Select from list; ‘other’ 

values are available for calls unrelated to 

existing claims. 

 

(c) Note - The individual taking the call enters 

a note - up to 2000 characters - describing the 

substance of the inquiry. This note is known as 

the Primary Phone Message. 

 

(d) Caller Name - Enter name of caller. 

 

(e) Call For - Enter name and/or title/position 

of person to whom the caller asked to speak; use 

‘N/A’ if specific person was not requested. 

 

(f) Relation - Select from list - caller’s 

relationship to the claimant identified in Claim 

Type field. 

 

(g) Received by - System will default to loggedin user id. 

 

(h) Call Type - Select from list: 

‘D-Direct Call’ when an incoming phone call 

is received and completed without requiring 

a return call. 

‘O-Outgoing Call’ when the CE or other DOL 

employee initiates a phone call to any 

source and completes it, as long as the call 

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7. Case Management. (Continued) 

is not a return call as part of a previously 

opened return call. 

‘R-Return Call’ when returning a phone call 

that could not be completed at the time of 

the incoming or outgoing phone call, and 

required the DOL employee to return the 

telephone call. 

 

(i) Receive date - System will default to 

current date. 

 

(j) Callback No. - Enter caller’s phone number, 

if provided by caller. 

 

(k) Assign to - Select from list - any user in 

DO. The user name entered in the Assign to field 

becomes the ‘owner’ of the telephone note. 

 

(l) Call Completed – ‘Y’ or ‘N’ - phone call 

will remain open and pending until ‘Y’ is entered 

and saved to this field. The CE must ensure that 

the date corresponds with the call return. Return 

calls are the only call type that do not 

automatically have a call completed status of 

‘Y’. 

 

(m) Returned by - Select from list; the user ID 

of the person who returned the phone call. 

 

(3) Calls Requiring a Return Call. The owner (user 

name appearing in the Assign to field) of the phone 

call is responsible for returning it and closing out 

the TMS phone message. After returning an open or 

pending call, he or she must take two actions to close 

out the pending call in TMS: 

 

(a) Return/completed call messages must be 

entered on a supplemental message screen 

(Callback/Addendum Notes) accessed via the bottom 

portion of the phone message screen. (The TMS 

user moves the cursor into one of the rows in the 

grid and then depresses the <INSERT> key to add a 

new callback/addendum note.) 

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7. Case Management. (Continued) 

A blank callback/addendum note will appear on the 

screen - the user enters the details of the 

return call here. A callback note must 

comprehensively describe the reply to the 

caller’s inquiry. TMS will allow up to 1000 

characters. 

After this addendum note is saved, it appears as 

a new row in the grid view at the bottom of the 

Phone Message Screen. Double-clicking on the 

specific row for a Callback/Addendum note 

displays the full text of the note. 

 

(b) After the addendum note is entered and 

saved, the CE or other user must return to the 

telephone message Add/Update screen and click the 

‘Y’ in the Callback Completed box, and ensure 

that the (Callback Completed On) date reflects 

the actual return call date. 

If ‘Y’ is selected, the call will no longer 

appear on the pending phone messages list. If 

‘N’ is selected, the TMS system will not close 

out the call and the call will appear on the 

owner’s pending phone message list. 

 

(4) General Information about TMS. 

 

(a) Any return telephone call entered into TMS 

will remain an open call until closed out in TMS. 

 

(b) The note field of the primary phone message 

must not be modified or updated, except in two 

instances: 

 

(i) By the creator of the message, and then 

only to correct or clarify the text entered 

on the date of call creation. 

 

(ii) By the owner of the message (or 

supervisory personnel), to explain why he or 

she is reassigning the message to another 

user. 

 

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7. Case Management. (Continued) 

(c) When a user logs into ECMS, TMS displays a 

message identifying the number of pending phone 

messages which have been logged (that is, 

assigned to, or owned by) for that user. By 

selecting the ‘Open Phone Msgs’ option, TMS 

displays all the outstanding return calls that do 

not contain a completed call date. 

 

(d) Once a phone call is assigned to a person, 

it is owned by that person. TMS permits only the 

person who owns a call, or supervisory personnel, 

to reassign a phone call. TMS permits 

reassignment of an individual phone message from 

within that message screen - the current owner 

simply selects the new owner of the message from 

among the list of users in the Assign To box. 

When reassignment occurs in this manner, the 

owner must type his or her user ID and the date 

within the ‘Notes’ portion of the primary 

message, along with a brief reason for the 

reassignment. 

The owner will reassign a phone call only when he 

or she does not actually speak to the caller. 

The call will not be closed out until a return 

call is made. 

For example, a customer service representative 

answers a call and refers it to CE-1. CE-1 

receives the referral and becomes the owner; 

however the case is actually managed by CE-2. 

CE-1 does not return the call, and reassigns the 

case to CE-2. CE-2 then becomes responsible for 

returning the call timely. 

 

(e) While in any one of the telephone screens, 

the user may go into another ECMS screen to check 

the status of the case. All claim-related 

telephone call messages must be printed and 

spindled down in the case file, but only after 

the phone call record is closed, i.e., for calls 

requiring a response, after the response is 

recorded in the Callback/Addendum Note. 

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 7. Case Management. (Continued) 

(f) Documentation of all calls not related to a 

specific case must be printed and kept in a 

central location in the office for reference and 

tracking purposes. 

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________________________________________________________________

EC CODE JUSTIFICATION MEMO 

Employee Name: _______________ SSN: _______________ 

Claimant Name(s)(if other than employee: ______________ 

Response to employment verification requests are no longer 

required based on the following criteria: 

______ ORISE verification received 

______ DOE employment verification received 

______ Corporate verification received 

______ Social Security verification received 

______ Rec. Decision–Deny – 

______ Medical evidence insufficient 

______ Employment evidence insufficient 

______ Survivor evidence insufficient 

______ Other: ______________________________________ 

_______________________________________ 

 

Claims Examiner: ___________________ Date: _________ 

 

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________________________________________________________________

WS/WR - REFERRAL/RESPONSE FORM 

Employee Name: ________________ Case #: ___________ District Office: _______ 

Claimant’s Name (if other than employee): ____________ Relationship: _______ 

Manner of Referral: Case File: ______ Copies of Documents: ____ E-Mail:_____ 

Type of Issue(s): Policy: _____ Procedure: ___ 

 Medical _____ Employment _____ Survivorship _____ Other: _______ 

DO: Issue(s) 

CE’s Signature: __________________________ Date: _________________

SCE’s Signature: _________________________ Date: _________________ 

DD’s Signature: _________________________ Date: _________________ 

BPRP: Response 

 Signature: _________________________________ Date: _______________ 

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TABLE OF CONTENTS 

Paragraph and Subject Page Date Trans. No. 

Chapter 2-2100 Energy Case Management System--Decisions 

 

 Table of Contents. . . . . . . . . i 11/09 10-06 

1 Purpose and Scope. . . . . . . . . 1 11/09 10-06 

2 Required Coding for Approvals. . . 1 11/09 10-06 

3 Required Coding for Recommended 

Denials . . . . . . . . . . . 2 11/09 10-06 

4 General Decision Coding. . . . . . 2 

5 Recommended Decision Codes . . . . 11 11/09 10-06 

6 Between Recommended and 

 Final Decisions . . . . . . . 25 11/09 10-06 

7 FAB Decision Codes . . . . . . . 30 11/09 10-06 

8 Alternative Filing Codes . . . . . 50 11/09 10-06 

9 Reconsideration Codes. . . . . . . 50 11/09 10-06 

10 Closure Codes. . . . . . . . . . . 52 11/09 10-06 

11 New Claims for New Medical 

 Conditions . . . . . . . . . . . 57 11/09 10-06 

12 Director’s Orders. . . . . . . . . 59 11/09 10-06 

 

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1. Purpose and Scope. This chapter describes how to use the 

Energy Case Management System (ECMS) with respect to decisions 

rendered by the District Offices (DOs), Secondary Claims 

Examiner (CE2) Unit, and the Final Adjudication Branch (FAB). 

It also addresses ECMS coding procedures as it relates to 

alternative filings, reconsiderations, closure of claims, and 

claims filed for new conditions after a final decision. EEOICPA 

PM 2-2000 addresses ECMS coding in general, focusing on the 

early and developmental stages of a claim. The information in 

this chapter applies to both ECMS B and ECMS E, unless otherwise 

indicated. 

Decisions specify which benefits are awarded/accepted, denied, 

or under development, and under which Part of the Act (B or E or 

both). Recommended Decisions and Final Decisions are reflected 

in ECMS by decision code/reason code combinations that relate to 

the Part B portion in ECMS B, and to the Part E portion in ECMS 

E. This is necessary to ensure accurate statistics about 

decisions made under Parts B and E. 

2. Required Coding for Approvals. All approved claims must 

contain at least one medical condition with a medical condition 

type, an ICD-9 code, a diagnosis date, and an “A” for Accepted 

in the cond status field. [For Part B cases, the medical 

condition type must be equal to BD, BS, CN, CS, MT, OL (for 

RECA), or PD (for RECA). 

The medical status effective date must be equal to the claim 

filing date. If the case is a B/E case with different filing 

dates under Part B and E, then ECMS B and E will reflect 

different filing dates and status effective dates. The earliest 

of the two status effective dates for a Part B/E condition will 

be transmitted to central bill pay for medical eligibility 

processing. 

Any verified worksite data must be updated with information from 

the verification(s) received, and the Covered Employment Ind 

field (case screen) and the Payee Eligibility field (located on 

the payee screen) must be “Y,” for “Yes." 

 

A recommended decision code to fully or partially accept (A0, 

A1, A2, A8) must be entered in the Claim Status History with an 

appropriate reason code. See Paragraphs 4 and 5 below for an 

in-depth discussion of recommended decision coding. 

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3. Required Coding for Recommended Denials. A recommended 

denial claim status code (D1, D3, D4, D5, D7) and associated 

reason code (for D5 and D7 only) are required in the Claim 

Status History. See Paragraphs 4 and 5 below for an in-depth 

discussion of recommended decision coding. 

The recommended denial code must correspond with the primary 

reason for recommendation of denial under that Part of the Act 

(B or E). That means that the claim status code should match 

with the most reasonable basis for the denial. Therefore, only 

one claim status code is entered per claimant (per part – B or 

E). The hierarchy is as follows: 

 

a. ‘D3’ Code. If a claimant files who is an ineligible 

survivor, the claim should be denied on the basis of being 

an ineligible survivor, regardless of any lack in medical 

or employment evidence. 

b. ‘D4’ Code (B only). If a claimant files only for a 

non-covered condition, the CE develops for a covered 

occupational illness. Until a covered condition is found, 

employment is not developed. If a covered occupational 

illness is never claimed, the claim should be denied on the 

basis of a non-covered condition (‘D4’). 

 

c. ‘D7’ Code. If a claimant files for a covered 

occupational illness, and employment is developed, but 

after development there is not enough medical evidence to 

support the covered condition, the claim is denied because 

of insufficient medical evidence to support a covered 

condition (‘D7’). This is true whether or not employment 

verification has been completed and regardless of whether 

employment is covered. 

 

d. ‘D1’ Code. If a claimant files for a covered 

occupational illness and enough medical evidence is 

received to accept the medical portion of the claim, but 

the employment requirements are not met after development, 

the claim is denied due to lack of covered employment 

(‘D1’). 

 

4. General Decision Coding. When a recommended or final 

decision is issued, the Claims Examiner (CE), Senior Claims 

Examiner (SrCE), or Hearing Representative (HR) enters the 

appropriate claim status code(s) into ECMS. The coding must 

match the wording in the decision. There are three possible 

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4. General Decision Coding. (Continued) 

outcomes for each claimed element: accept, deny, or defer. 

Deferring a decision means that a decision is not being made on 

that element at this time because further development is needed, 

essentially holding the decision in abeyance. 

It is important that decisions do not state that a decision on 

additional elements is being deferred unless additional elements 

have actually been claimed. For example, a decision should not 

state, “A decision regarding impairment and wage loss benefits 

is being deferred pending further development” if those items 

have never been claimed. These types of statements in decisions 

lead the claimant to believe they will be receiving decisions on 

those items, which they will not, unless claimed. If matching 

deferral coding is input into ECMS, it will cause reporting 

problems. 

a. Primary Decision Codes. All decisions require at 

least one ‘primary’ decision code. If the decision 

addresses Part B benefits only, a primary decision code is 

entered into ECMS B. If the decision addresses Part E 

benefits only, a primary decision code is entered into ECMS 

E only. If the decision addresses Part B and Part E 

benefits, there is a primary decision code entered into 

ECMS B and a separate primary decision code in ECMS E. 

Generally, there is no more than one primary decision code 

in either ECMS B or ECMS E, per decision. Exceptions will 

be listed in this chapter. The status effective date for 

the decision codes is the date of the decision. 

When selecting a primary decision code, the CE/SrCE/HR must 

look at what is happening overall on the decision for Part 

B or Part E, separately. For example, if a decision is 

accepting lung cancer under Part B and denying it under 

Part E because the survivor is ineligible, the coding must 

reflect a primary decision code in ECMS B that only 

reflects an acceptance (A0/F0), while ECMS E must only 

reflect a denial (D3/F3). It is not coded as a partial 

accept/partial deny (A8/F9) in both systems. 

Some primary decision codes also have reason codes 

associated with them that give more detail as to what is 

being accepted or denied. Primary recommended decision 

codes and their associated reason codes are discussed in 

detail in Paragraph 5. Primary final decision codes and 

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4. General Decision Coding. (Continued) 

their associated reason codes are discussed in detail in 

Paragraph 7. 

b. Secondary Decision Codes. On Part E decisions that 

are more than straight acceptances or denials, it is 

necessary to enter a second claim status code that gives 

additional information on what is being denied or deferred 

in the decision. This additional claim status code is 

called a ‘secondary’ decision code. 

A secondary decision status code must be used in ECMS E 

only and must be used in conjunction with a ‘primary’ 

decision status code entered with the same status effective 

date of the primary decision status code. There should 

never be more than one of each of the secondary decision 

status codes per decision. Secondary decision status codes 

(and their reason codes) are listed and described below. 

(1) The ‘PD’ [Partial Deny] secondary decision status 

code must never be used without tandem entry in ECMS E 

of a primary decision status code describing a partial 

Part E acceptance or denial. That is, ‘PD’ must never 

be entered without first entering, with the same 

status effective date, one of the following ‘primary’ 

decision status codes in ECMS E: A2/G2 (Partial 

Accept/Partial Develop/Partial Deny), A8/F8 (Partial 

Accept/Partial Deny), D5/F5 (Deny-cancer not work 

related), D7/F9 (Non-cancer causation/insufficient 

medical denial), or F6 (FAB Reversed to Accept). 

The ‘PD’ status code can be used in conjunction with 

the D5/F5 or D7/F9 denial code to address multiple 

types of denials, such as insufficient medical in 

addition to a non-cancer causation denials or to a 

cancer not work related denial (See example 4 below). 

The ‘PD’ status code can be used in conjunction with 

the ‘F6’ (FAB Reversed to Accept) code if at least one 

portion of the recommended decision is reversed from a 

denial to an acceptance, and there is still another 

element being denied in the final decision. The 

reason code associated with F6 would encompass 

whatever is being accepted and the reason code under 

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4. General Decision Coding. (Continued) 

the ‘PD’ status code would reflect what is being 

denied. 

Once the ‘PD’ status code is entered, the CE/SrCE/HR 

selects the reason code from the drop-down menu that 

corresponds with the element(s) being denied. Both 

the DO/CE2 Unit and FAB use this code when issuing 

decisions that require partial denial coding. 

(a) IN – ‘Insufficient Medical to Establish 

Claimed Illness’ - Used when a covered illness is 

claimed under E but medical evidence is 

insufficient to establish the illness. 

(b) CAU – ‘Causation’ - Used when a covered 

illness is claimed under E, but causation cannot 

be established. 

(c) WAG – ‘Wage Loss’ - Used when claimed wage 

loss is being denied. 

(d) CAW – ‘Causation and Wage Loss’ - Used when 

a covered illness is claimed under Part E, but 

causation cannot be established and claimed wage 

loss must also be denied. 

(e) IM0 – ‘Impairment – 0%’ - Used when the 

claim for impairment is being denied because the 

impairment rating is 0% based upon the AMA Guides 

or because a claim for impairment was filed, but 

the claimant failed to provide the necessary 

medical documentation. 

(f) IMN – ‘Impairment – Not Ratable’ - Used when 

the claim for impairment is being denied because 

the claimed impairment is non-ratable, such as 

certain psychiatric conditions. 

(g) IMR – ‘Impairment – Resolved’ - Used when 

the claim for impairment is being denied because 

the claimed impairment was resolved (i.e., does 

not exist anymore) prior to the issuance of the 

decision. 

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4. General Decision Coding. (Continued) 

(h) I0W – ‘Impairment (0%) and Wage Loss’ - Used 

when wage loss and impairment are both the only 

portions being denied. The claim for impairment 

is denied because it has a 0% rating based upon 

the AMA Guides or because a claim for impairment 

was filed, but the claimant failed to provide the 

necessary medical documentation. 

(i) INW – ‘Impairment (Not Ratable) and Wage 

Loss’ -Used when wage loss and impairment are 

being denied. Impairment is denied because the 

condition being claimed is not ratable for 

impairment, such as certain psychiatric 

conditions. 

(j) IRW – ‘Impairment (Resolved) and Wage Loss’ 

- Used when wage loss and impairment are both 

being denied. The claim for impairment is being 

denied because the impairment was resolved (i.e., 

does not exist anymore) prior to the issuance of 

the decision. 

(k) C0W – ‘Causation, Impairment (0%) and Wage 

Loss’ - Used when claims for causation, 

impairment, and wage loss are being denied 

simultaneously. The impairment is denied because 

the impairment rating is 0% based upon the AMA 

Guides or because a claim for impairment was 

filed, but the claimant failed to provide the 

necessary medical documentation. 

(l) CNW – ‘Deny Causation, Wage Loss, & 

Impairment (Not Ratable)’ - Used when claims are 

made for causation, wage loss, and impairment, 

all of which are being denied. The impairment is 

being denied because it is for a non-ratable 

condition, such as certain psychiatric 

conditions. 

(m) CRW – ‘Causation, Impairment (Resolved), and 

Wage Loss’ - Used when claims for causation, 

impairment and wage loss are being denied 

simultaneously as portions of the claim as a 

whole. The impairment claim is being denied 

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4. General Decision Coding. (Continued) 

because the impairment was resolved (i.e., does 

not exist anymore) prior to the issuance of the 

decision. 

(n) CA0 – ‘Causation and Impairment (0%)’ - Used 

when causation and 0% impairment based upon the 

AMA Guides are being denied simultaneously or 

because a claim for impairment was filed, but the 

claimant failed to provide the necessary medical 

documentation. 

(o) CAN – ‘Causation and Impairment (Not 

Ratable)’ - Used when causation and a non-ratable 

impairment are being denied simultaneously. 

(p) CAR – ‘Causation and Impairment (Resolved)’ 

- Used when causation and impairment, that is 

resolved prior to the issuance of the decision, 

are being denied simultaneously. 

(q) MBM – Maximum Payable Benefit Met’ – Used 

when the maximum payable benefit is already paid 

and a decision is required for an impairment 

and/or wage loss claim. 

(2) The ‘DV’ [Partial Develop] secondary decision 

status code is used exclusively in ECMS E to record 

findings in a decision that describe a partial 

deferral for a claimed element under Part E. The ‘DV’ 

status code is entered in conjunction with a primary 

decision status code. Both the primary and secondary 

decision codes have the same status effective date 

(the date the decision is issued). 

 

The ‘DV’ status code must be used in conjunction with 

one of the following ‘primary’ decision status codes 

in ECMS E: A2/G2 (Partial Accept/Partial 

Develop/Partial Deny) or A1/G1 (Partial Accept/Partial 

Develop); and can be used with D5/F5 (Deny-cancer not 

work related), D7/F9 (Non-cancer causation/ 

insufficient medical denial), or F6 (FAB Reversed to 

Accept). 

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4. General Decision Coding. (Continued) 

The ‘DV’ status code can be used in conjunction with 

the D5/F5 or D7/F9 denial codes to address partial 

deny/partial develop decisions. The reason code 

associated with D5/F5 or D7/F9 would encompass 

whatever is being denied and the reason code under the 

‘DV’ status code would reflect what is being deferred. 

The ‘DV’ status code can also be used in conjunction 

with the ‘F6’ (FAB Reversed to Accept) code if at 

least one portion of the recommended decision is 

reversed from a denial to an acceptance and there is 

still a decision on another element being deferred in 

the final decision. The reason code associated with 

F6 would encompass whatever is being accepted and the 

reason code under the ‘DV’ status code would reflect 

what is being deferred. 

The associated primary decision code could also be in 

ECMS B if the decision only addresses Part B benefits 

and completely defers the adjudication of any pending 

Part E element(s). (See example 1 below). 

Once the ‘DV’ status code is entered, the CE/SrCE/HR 

selects the reason code from the drop-down menu that 

corresponds with the element(s) being held in abeyance 

for further development. Both the DO/CE2 Unit and the 

FAB use this code when issuing decisions that require 

partial development or deferral codes. 

(a) CAU – ‘Causation’ - Causation for another 

claimed condition requires further development. 

(b) CAW – ‘Causation and Wage Loss’ - Causation 

for another claimed condition and wage loss 

require further development. 

(c) CAI – ‘Causation and Impairment’ - Causation 

for another claimed condition and impairment 

require further development. 

(d) IMP – ‘Impairment’ - Claimed impairment 

requires further development. 

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4. General Decision Coding. (Continued) 

(e) WAG – ‘Wage Loss’ - Claimed wage loss 

requires further development. 

(f) IMW – ‘Impairment and Wage Loss’ - Claimed 

impairment and claimed wage loss require further 

development. 

(g) CIW – ‘Causation, Impairment, and Wage Loss’ 

- Causation for another claimed condition, 

claimed impairment and claimed wage loss require 

further development. 

c. Examples. A decision that accepts a claimed condition 

under E and denies a second claimed condition under B is 

not considered a ‘partial’ decision outcome for coding 

purposes. Instead, the ‘A0’ acceptance status code in ECMS 

E and the appropriate ‘D_’ denial status code in ECMS B 

should be used. It is incorrect to consider the ECMS E 

outcome as ‘A8’ [Partial Accept/Partial Deny] because the 

partial deny outcome does not apply to Part E. The 

following examples further illustrate these rules. 

Example 1: If there is a recommended decision to deny 

cancer for Probability of Causation (PoC) under Part B, and 

the Part E case has yet to be developed for causation based 

on toxic exposure, so that the Part E decision is deferred, 

the coding would be: ’D5’ [Recommended Deny - Cancer not 

work related/PoC<50%], with Reason Code ‘B’ [Part B] in 

ECMS B, and ‘DV’ [Partial Develop] with no primary 

recommended decision status code in ECMS E (the tandem 

primary code is in ECMS B). 

The final decision code, if upheld by FAB, would be: ‘F5’ 

[Final Deny - Cancer not work related/PoC<50%] in ECMS B, 

with Reason Code ‘B’ [Part B] and ‘DV’ [Partial Develop] 

with no primary final decision status code in ECMS E 

(assuming the Part E claim is still under development). 

Example 2: If there is a recommended decision to accept 

CBD for both Parts B and E, but the claims for wage loss 

and impairment are being deferred under Part E, the coding 

would be: ‘A0’ [Recommended Accept] in ECMS B, with Reason 

Code ‘B’ [Part B] (since all of the medical conditions are 

accepted and completed in Part B), and ‘A1’ [Recommended 

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4. General Decision Coding. (Continued) 

Partial Accept/Partial Develop] in ECMS E, with Reason Code 

‘CAU’, since the CBD is being partially accepted (for 

causation). 

 

To record in ECMS E that the claims for wage loss and 

impairment are being deferred (the case is only deferred if 

there is an actual claim for wage loss/impairment in the 

case file), status code ‘DV’ [Partial Develop], with Reason 

Code ‘IMW’ [Impairment and Wage Loss], would be entered. 

The final decision coding, if upheld by FAB, would be: ‘F0’ 

[Final Accept] in ECMS B, with Reason Code ‘B’ [Part B] and 

‘G1’ [Final Partial Accept/Partial Develop] in ECMS E, with 

Reason Code ‘CAU.’ To record in ECMS E that the claims for 

wage loss and impairment are being deferred, status code 

‘DV’ [Partial Develop], with Reason Code ‘IMW’ [Impairment 

and Wage Loss], would be entered. 

 

Example 3: If there is a recommended decision to accept 

Asbestosis in Part E, and defer wage loss and impairment, 

and also to deny cancer in both Parts B and E (because the 

claimant did not prove he or she had cancer), the coding 

would be: ‘D7’ [Recommended Deny - medical information 

insufficient to support claim/non-cancer causation denial], 

with Reason Code ‘B’ [Part B] in ECMS B (since the cancer 

was denied for insufficient medical evidence), and ‘A2’

[Recommended Partial Accept/Partial Deny/Partial Develop] 

in ECMS E, with Reason Code ‘CAU’ (for accepting Asbestosis 

for causation). 

To record in ECMS E that the claims for wage loss and 

impairment related to Asbestosis are being deferred, status 

code ‘DV’ [Partial Develop], with Reason Code ‘IMW’ 

[Impairment and Wage Loss], would be entered. To record in 

ECMS E that the claim for cancer is being denied, status 

code ‘PD’ [Partial Deny], with Reason Code ‘IN’ 

[Insufficient Medical to establish claimed illness], would 

be entered. 

The final decision coding, if upheld by FAB, would be 

nearly identical to the recommended decision coding: Status 

Code ‘F9’ [Final Deny - medical information insufficient to 

support claim/non-cancer causation denial] with Reason Code 

‘B’ in ECMS B and ‘G2’ [Final Partial Accept/Partial 

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Deny/Partial Develop] with Reason Code ‘CAU’ in ECMS E, 

along with status codes ‘DV’, with Reason Code ‘IMW’; and 

‘PD’, with Reason Code ‘IN’. 

Example 4: If there is a recommended decision to deny 

cancer and asbestosis in Part E because causation could not 

be established and peripheral neuropathy is denied because 

medical evidence was not provided to support a diagnosis of 

the claimed illness and wage loss is also being denied, the 

coding would be ‘D5’[Recommended Deny – Cancer not work 

related] with Reason Code ‘CAW’ [to encompass the cancer 

and asbestosis causation denials and wage loss denial] 

followed by ‘PD’ [Partial Denial], with Reason Code ‘IN’, 

to capture the denial of peripheral neuropathy because of 

the lack of evidence of a diagnosis. 

The final decision coding, if upheld by FAB, would be 

nearly identical to the recommended decision coding: 

‘F5’[FAB Affirmed Deny – Cancer not work related] with 

Reason Code ‘CAW’ [to encompass the cancer and asbestosis 

causation denials and wage loss denial] followed by ‘PD’ 

[Partial Denial], with Reason Code ‘IN’, to capture the 

denial of peripheral neuropathy because of the lack of 

evidence of a diagnosis. 

5. Recommended Decision Codes. The CE/SrCE must enter the 

appropriate recommended decision code when issuing a recommended 

decision. The status effective date of the code equals the 

recommended decision issuance date. 

a. A0 - ‘Recommended Accept – Sent to FAB’. When the 

CE/SrCE renders a recommended decision on a claim for 

approval for benefits, where there are no other pending 

elements on the claim (including additional medical 

conditions, wage loss, or impairment), the DO/CE2 Unit 

enters the ‘A0’ code. The status effective date is the 

date of the recommended decision. 

Upon entering the ‘A0’ code, the CE/SrCE must select a 

specific reason code from the “reason cd” field, which is a 

drop-down box corresponding to the ‘A0’ claim status code. 

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5. Recommended Decision Codes. (Continued) 

To record any accepted Part B component of the decision, 

the CE must select reason code ‘B’ [Part B] for entry in 

ECMS B. 

To record any accepted Part E component of the decision, 

the CE must select one of the following reason codes from 

the drop-down menu to record all claimed elements 

(causation, wage loss, and/or impairment) being accepted in 

the current decision. These drop-down codes are required 

exclusively for Part E ECMS. 

(1) CAU – ‘Causation Accepted’ - Used when causation 

is established under Part E, which results in medical 

benefits for an employee or death benefit for an 

eligible survivor. 

(2) CAW – ‘Causation and Wage Loss Accepted’ - Used 

when causation and wage loss are being accepted 

simultaneously under Part E. 

 

(3) CAI – ‘Causation and Impairment Accepted’ - Used 

when causation and impairment are being accepted 

simultaneously under Part E. 

 

(4) IMP – ‘Impairment Only Accepted (Causation 

Previously Accepted)’ - Used when causation was 

established on a previous decision and impairment is 

all that is being accepted in this decision under Part 

E. 

 

(5) WAG – ‘Wage Loss Only Accepted’ - Used when 

causation was established on a previous decision and 

wage loss is all that is being accepted in this 

decision under Part E. 

 

(6) IMW – ‘Impairment and Wage Loss Accepted’ - Used 

when causation was established in a previous decision 

and the current decision accepts for wage loss and 

impairment. 

(7) CIW – ‘Causation, Impairment, and Wage Loss 

Accepted’ - Used when causation, impairment, and wage 

loss are all being accepted in the current Part E 

decision. 

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5. Recommended Decision Codes. (Continued) 

(8) DEF – ‘Decision Deferred’ - Deactivated. This 

code was only to be entered by the FAB in certain rare 

circumstances where a decision to accept was made 

without the DO/CE2 Unit having issued a recommended 

decision. This code has been deactivated with the 

potential to be reactivated if the need arises.

b. A1 - ‘Recommended Partial Accept/Partial Develop’. 

When the CE/SrCE renders a recommended decision where part 

of the claim is approved for benefits, while another part 

of the claim needs further development (including 

additional medical conditions, wage loss, or impairment), 

the DO/CE2 Unit enters the ‘A1’ code. The status effective 

date is equal to the date of the recommended decision. 

This code allows benefit disbursement, if FAB upholds the 

decision, while other development continues. 

For Part B cases only, the CE/SrCE should use status code 

‘A1’ with reason code ‘B’ [Part B] for Recommended 

decisions that describe a partial acceptance for at least 

one claimed condition under Part B and partial development 

for one or more other conditions under Part B. 

For Part E cases only, the CE/SrCE must select the 

appropriate reason code from the drop-down menu for input 

into ECMS E. The reason code for the decision explains 

only what is being accepted in the current decision. These 

are the Part E reason codes available in the drop down 

menu: 

(1) CAU – ‘Causation’ - Used when causation for a 

claimed condition is accepted for benefits and 

additional development of another claimed element is 

required. 

(2) CAW – ‘Causation and Wage Loss’ - Used when 

causation and wage loss are being accepted and 

additional development of another claimed element is 

required. 

(3) CAI – ‘Causation and Impairment’ - Used when 

causation and impairment are being accepted and 

additional development of another claimed element is 

required. 

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5. Recommended Decision Codes. (Continued) 

(4) IMP – ‘Impairment’ - Used when causation has been 

previously accepted and impairment alone is being 

accepted and the additional development of another 

claimed element is required. 

(5) WAG – ‘Wage Loss’ - Used when causation has been 

previously accepted and wage loss alone is being 

accepted and additional development of another claimed 

element is required. 

(6) IMW – ‘Impairment and Wage Loss’ - Used when 

causation has been previously accepted, impairment and 

wage loss are both currently being accepted, and 

additional development of another claimed element is 

required (e.g., a cancer that is undergoing dose 

reconstruction at the National Institute of 

Occupational Safety and Health (NIOSH). 

(7) CIW – ‘Causation, Impairment, and Wage Loss’ - 

Used when causation is accepted along with both 

impairment and wage loss and additional development of 

another claimed element is required (e.g., a cancer 

that is undergoing dose reconstruction at NIOSH). 

The portion(s) of the claim being held in abeyance for 

additional development is/are identified by the secondary 

decision status code ‘DV’ [Partial Develop] and 

corresponding reason code set out in Paragraph 4 above. 

c. A2 - ‘Recommended Partial Accept/Partial Deny/Partial 

Develop’. When the CE/SrCE renders a recommended decision 

where part of the claim is approved for benefits, while 

another part of the claim is denied, and yet another part 

of the claim needs further development (including 

additional medical conditions, wage loss, or impairment), 

the DO/CE2 Unit enters the ‘A2’ code . The status 

effective date is the date of the recommended decision. 

This code allows for benefits to be administered, if FAB 

upholds the decision, while other development continues. 

For Part B cases only, status code ‘A2’ is used with reason 

code ‘B’ [Part B] in ECMS B for recommended decisions that 

describe a partial acceptance for at least one claimed 

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5. Recommended Decision Codes. (Continued) 

condition under Part B and partial denial and partial 

development for one or more other conditions under B. 

For Part E cases only, the CE/SrCE must select the 

appropriate reason code from the drop-down menu in ECMS E. 

The reason code for the decision explains only what is 

being accepted in the current decision. These are the Part 

E reason codes available in the drop down menu: 

(1) CAU – ‘Causation’ - Used when causation for a 

claimed condition is accepted for benefits, a portion 

of the claim is being denied, and a portion of the 

claim requires additional development. 

(2) CAW – ‘Causation and Wage Loss’ - Used when 

causation and wage loss are being accepted, a portion 

of the claim is being denied, and a portion of the 

claim requires additional development. 

(3) CAI – ‘Causation and Impairment’ - Used when 

causation and impairment are being accepted, a portion 

of the claim is being denied, and a portion of the 

claim requires additional development. 

(4) IMP – ‘Impairment’ - Used when causation has been 

previously accepted, impairment alone is being 

accepted, a portion of the claim is being denied, and 

a portion of the claim requires additional 

development. 

(5) WAG – ‘Wage Loss’ - Used when causation has been 

previously accepted, wage loss alone is being 

accepted, a portion of the claim is being denied, and 

a portion of the claim requires additional 

development. 

(6) IMW – ‘Impairment and Wage Loss’ - Used when 

causation has been previously accepted, impairment and 

wage loss are both currently being accepted, a portion 

of the claim is being denied, and a portion of the 

claim requires additional development. 

(7) CIW – ‘Causation, Impairment, and Wage Loss’ - 

Used when causation is accepted along with impairment 

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5. Recommended Decision Codes. (Continued) 

and wage loss, a portion of the claim is being denied, 

and a portion of the claim requires additional 

development (e.g., a cancer is undergoing dose 

reconstruction at NIOSH). 

The portion(s) of the claim being denied or held in 

abeyance for additional development are identified by the 

secondary decision status codes ‘PD’ [Partial Denial] and 

‘DV’ [Partial Develop] and corresponding reason codes set 

out in Paragraph 4 above. 

d. A8 - ‘Recommended Partial Accept/Partial Deny’. When 

the CE/SrCE renders a recommended decision where part of 

the claim is going to be approved for benefits, while 

another part of the claim is going to be denied, the DO/CE2 

Unit enters the ‘A8’ code in ECMS. The status effective 

date is equal to the date of the recommended decision. 

This code allows for benefit administration, if FAB upholds 

the decision, while development continues. 

For Part B cases only, the CE/SrCE should use status code 

‘A8’ with reason code ‘B’ [Part B] in ECMS B for 

recommended decisions that describe a partial acceptance 

for at least one claimed condition under Part B and partial 

denial for one or more other conditions under B. 

For Part E cases only, the CE/SrCE must select the 

appropriate reason code from the drop-down menu. The 

reason code for the decision explains only what is being 

accepted in the current decision. These are the Part E 

reason codes available in the drop down menu: 

(1) CAU – ‘Causation’ - Used when causation for a 

claimed condition is accepted for benefits and a 

portion of the claim is being denied. 

(2) CAW – ‘Causation and Wage Loss’ - Used when 

causation and wage loss are being accepted and a 

portion of the claim is being denied. 

(3) CAI – ‘Causation and Impairment’ - Used when 

causation and claimed impairment are being accepted 

and a portion of the claim is being denied. 

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5. Recommended Decision Codes. (Continued) 

(4) IMP – ‘Impairment’ - Used when causation has been 

previously accepted, claimed impairment alone is 

currently being accepted, and a portion of the claim 

is being denied. 

(5) WAG – ‘Wage Loss’ - Used when causation has been 

previously accepted, wage loss alone is currently 

being accepted, and a portion of the claim is being 

denied. 

(6) IMW – ‘Impairment and Wage Loss’ - Used when 

causation has been previously accepted, impairment and 

wage loss are both currently being accepted, and a 

portion of the claim is being denied. 

(7) CIW – ‘Causation, Impairment, and Wage Loss’ - 

Used when causation is accepted along with impairment 

and wage loss, and a portion of the claim is being 

denied (another claimed medical condition). 

The portion(s) of the claim being denied is identified by 

the secondary decision status code ‘PD’ [Partial Deny] and 

corresponding reason code set out in Paragraph 4 above. 

e. D1 - ‘Recommended Deny – Non-Covered Employment’. 

When the CE/SrCE renders a recommended decision to deny 

benefits due to employment that is not covered, the CE/SrCE 

enters the ‘D1’ code. The status effective date is equal 

to the date of the recommended decision. There are no 

associated reason codes. 

f. D3 - ‘Recommended Deny - Survivor Not Eligible’. When 

the CE/SrCE renders a recommended decision to deny benefits 

because the claimed survivor is not eligible, the DO/CE2 

Unit enters the ‘D3’ code. The status effective date is 

equal to the date of the recommended decision. There are no 

associated reason codes. 

g. D4 – ‘Recommended Deny – Condition Not Covered’(B 

only). When the CE/SrCE renders a decision to deny Part B 

benefits because the condition is not covered under Part B, 

the DO/CE2 Unit enters a ‘D4’ code. The status effective 

date is equal to the date of the recommended decision. 

There are no associated reason codes. 

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5. Recommended Decision Codes. (Continued) 

h. D5 - ‘Recommended Deny - Cancer Not Work Related 

(PoC)’. When the CE/SrCE renders a recommended decision to 

deny benefits based wholly or in part on the PoC result 

from NIOSH being less than 50%, the DO/CE2 Unit enters the 

‘D5’ code. The status effective date is equal to the date 

of the recommended decision. This means if more than one 

condition is being denied, but at least one of them is a 

cancer case that went to NIOSH, the ‘D5’ primary decision 

code must be selected. This is also the only decision 

status code approved for use when denying a cancer claim 

based upon the PoC being less than 50% under both B and E. 

This code is also to be used in cases of CLL-cancer only, 

wherein the PoC is presumed to be zero. 

Upon entry of the ‘D5’ code, the CE/SrCE selects a specific 

reason code from the "reason cd" field, which is a dropdown box that corresponds with the ‘D5’ claim status code. 

The only reason code allowable for ECMS B is ‘B’ [Part B]. 

The remaining reason codes available for the ‘D5’ claim 

status code are to be used in ECMS E. 

Note 1: In ECMS E, the ‘D5’ code can also be used in 

conjunction with the ‘DV’ code to capture partial 

deny/partial develop decisions, for which there isn’t a 

single, unique primary decision status code. The CE/SrCE 

enters the ‘D5’ code with a reason code denoting what is 

being denied. The CE/SrCE then enters the ‘DV’ status code 

and appropriate associated reason code listed in Paragraph 

4 above to identify which benefits are being held for 

further development. The status effective date of both 

codes is the date of the decision. 

Note 2: If there is also a finding in the Part E decision 

to deny one or more claimed conditions because medical 

evidence was not provided to support diagnosis of the 

claimed condition, in addition to the cancer(s) 

specifically included in the NIOSH PoC determination 

(described by using the ‘D5’ code), it is appropriate to 

enter, in tandem with the ‘D5’ entry, status code ‘PD’ 

[Partial Deny] with ‘IN’ reason code to describe/record the 

additional denial. Essentially, the coding would be 

deny/partial deny. This captures one or more conditions 

were denied because causation could not be established and 

at least one other condition had insufficient medical to 

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5. Recommended Decision Codes. (Continued) 

establish the diagnosis of the claimed illness. Additional 

elements being denied, such as impairment, wage loss, and 

other causation denials can be captured in the reason code 

for ‘D5’, unless specifically requested in relation to the 

condition(s) being denied under ‘PD’. 

For example, if prostate cancer and wage loss are denied 

for lack of causation (PoC and toxic exposure) and 

asbestosis is denied because medical evidence was not 

provided, the Part E case would be coded ‘D5/F5-CAW’ and 

‘PD-IN’. 

The reason codes associated with the ‘D5’ code are: 

(1) B – ‘Part B’ (B only) - Used when cancer is 

claimed under Part B, but is being denied based on the 

NIOSH PoC. 

(2) CAU – ‘Causation’ (E only) - Used when cancer is 

claimed under Part E, but causation cannot be 

established (through dose reconstruction or toxic 

exposure development). 

(3) WAG – ‘Wage Loss’ (E only) - Used in the rare 

circumstance when a wage loss claim is received and 

adjudicated after a cancer denial. 

 

(4) CAW – ‘Causation and Wage Loss’ (E only) - Used 

when cancer and wage loss are claimed under Part E, 

but causation cannot be established (through dose 

reconstruction or toxic exposure development) and wage 

loss must also be denied. 

(5) IM0 – ‘Impairment – 0%’ (E only) - Used in the 

rare circumstance when an impairment claim is received 

and adjudicated after a cancer denial. The impairment 

rating may not have been completed because causation 

was not established or if one was provided with a 0% 

impairment rating. 

(6) IMN – ‘Impairment – Not Ratable’ (E only) - Used 

in the rare circumstance when an impairment claim is 

received and adjudicated after a cancer denial and 

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the claim for impairment is for a non-ratable 

condition, such as certain psychiatric conditions. 

(7) IMR – ‘Impairment – Resolved’ (E only) - Used in 

the rare circumstance when an impairment claim is 

received and adjudicated after a cancer denial and the 

claimed impairment was resolved (i.e., does not exist 

anymore) prior to the issuance of the decision. 

(8) I0W – ‘Impairment (0%) and Wage Loss’ (E only) -

Used when wage loss and impairment related to a 

previously denied cancer are both being denied. The 

claim for impairment is denied because it has a 0% 

rating or because an impairment rating was not 

completed due to lack of causation. 

 

(9) INW – ‘Impairment (Not Ratable) and Wage Loss’ (E 

only) - Used when wage loss and impairment are both 

being denied related to a previously denied cancer. 

The claim for impairment is denied because the 

condition being claimed is not ratable for impairment, 

such as certain psychiatric conditions. 

(10) IRW – ‘Impairment (Resolved) and Wage Loss’ (E 

only) - Used when wage loss and impairment are both 

being denied related to a previously denied cancer. 

The claim for impairment is being denied because the 

impairment was resolved (i.e., does not exist anymore) 

prior to the issuance of the decision. 

(11) C0W – ‘Causation, Impairment (0%) and Wage Loss’ 

(E only) - Used when claims for causation, impairment, 

and wage loss are denied simultaneously. Impairment 

is denied because the impairment rating is 0% or 

because the claimant failed to provide the necessary 

medical documentation or because the impairment rating 

was not performed because causation could not be 

established. 

(12) CNW – ‘Causation, Impairment (Not Ratable), and 

Wage Loss’ (E only) - Used when a claim is made for 

causation, wage loss, and impairment, all of which are 

being denied simultaneously. The impairment claim is 

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being denied because it is for a non-ratable 

condition. 

(13) CRW – ‘Causation, Impairment (Resolved), and 

Wage Loss’ (E only) - Used when claims for causation, 

impairment, and wage loss are being denied 

simultaneously. The impairment claim is denied 

because the impairment was resolved (i.e., does not 

exist anymore) prior to issuance of the decision. 

(14) CA0 – ‘Causation and Impairment (0%)’ (E only) -

Used when causation and 0% impairment are being denied 

simultaneously. Impairment is denied because the 

impairment rating is 0% or because the claimant failed 

to provide the necessary medical documentation or 

because the impairment rating was not performed 

because causation could not be established. 

(15) CAN – ‘Causation and Impairment (not ratable)’ (E 

only) - Used when causation and an impairment for a 

non-ratable condition, such as certain psychiatric 

conditions, are being denied simultaneously. 

(16) CAR – ‘Causation and Impairment (Resolved)’ (E 

only) - Used when causation and an impairment that is 

resolved (i.e., does not exist anymore) prior to the 

issuance of the decision are being denied 

simultaneously. 

h. D7 - ‘Recommended Deny – Medical Information 

Insufficient to Support Claim/Non-Cancer Causation Denial’. 

This code is used when the CE/SrCE renders a recommended 

decision to deny benefits because, after developing the 

claimed covered condition(s), there is insufficient medical 

evidence to support an acceptance; the decision is for a 

non-cancer causation denial; the maximum payable benefit is 

met; or the decision solely addresses impairment and/or 

wage loss claims where the related condition was not 

previously denied under D5. 

The status effective date is the date of the recommended 

decision. Upon entry in ECMS of the ‘D7’ code, the CE/SrCE 

selects a specific reason code from the "reason cd" field, 

which is a drop-down box that corresponds with the ‘D7’ 

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5. Recommended Decision Codes. (Continued) 

claim status code. The reason codes available for the ‘D7’ 

claim status code are listed below. The reason code ‘B’ 

[Part B] is only to be used in ECMS B. 

Note 1: In ECMS E, the ‘D7’ code can also be used in 

conjunction with the ‘DV’ code to capture partial 

deny/partial develop decisions, for which there isn’t a 

single, unique primary decision status code. The CE/SrCE 

enters the ‘D7’ code with a reason code denoting what is 

being denied. The CE then enters the ‘DV’ status code and 

appropriate associated reason code listed in Paragraph 4 

above to identify which benefits are being held for further 

development. The status effective date of both codes is 

the date of the decision. 

Note 2: If the decision contains findings to deny multiple 

claimed conditions, and one denial is for insufficient 

medical evidence to establish the claimed illness and 

another denial is for inability to establish causation, 

impairment or wage loss, the CE/SrCE should enter ‘D7’ with 

the reason code describing the causation/impairment/wage 

loss denial. In tandem with the ‘D7’ entry, the CE/SrCE 

should enter ‘PD’ [Partial Deny] with reason code ‘IN’ to 

record the denial for insufficient medical to establish 

illness. 

(1) B – ‘Part B’(B only) - Used when a condition is 

denied in ECMS B. 

(2) DMB – ‘Deny Specific Medical Benefits on Accepted 

Condition’ (B and/or E) - Used when a specific medical 

benefit is being denied on an accepted condition in a 

formal decision (not just a letter). (See EEOICPA PM 

3-0300.) 

(3) RMB – ‘Reduce Medical Benefits on Accepted 

Condition’ (B and/or E) - Used when a medical benefit 

on a previously paid item for a covered condition is 

reduced in a formal decision (not just a letter). 

(See EEOICPA PM 3-0300.) 

 

(4) IN – ‘Insufficient Medical to Establish Claimed 

Illness’(E only) - Used when a covered illness is 

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claimed under Part E but medical evidence is 

insufficient to establish the illness. 

 

(5) R4C – ‘RECA 4 Cancer’(E only) - Used when a Part E 

cancer case is denied because the claimant had 

received benefits under RECA Section 4. 

(6) CAU – ‘Causation’ (E only) - Used when a covered 

illness is claimed under Part E, but causation cannot 

be established. 

(7) WAG – ‘Wage Loss’ (E only) - Used when the claim 

for wage loss is being denied due to lack of medical 

evidence to support the claimed period of wage-loss is 

causally related to the covered illness. 

(8) CAW – ‘Causation and Wage Loss’ (E only) - Used 

when a covered illness is claimed under Part E, but 

causation cannot be established and claimed wage loss 

must also be denied. 

(9) IM0 – ‘Impairment – 0%’ (E only) - Used when the 

claim for impairment is being denied because the 

impairment rating is 0% under the AMA Guides or 

because a claim for impairment was filed, but the 

claimant failed to provide the necessary medical 

documentation. 

(10) IMN – ‘Impairment – Not Ratable’ (E only) - Used 

when the claim for impairment is being denied because 

the claimed impairment is non-ratable, such as certain 

psychiatric conditions. 

(11) IMR – ‘Impairment – Resolved’ (E only) - Used 

when the claim for impairment is being denied because 

the claimed impairment was resolved (i.e., does not 

exist anymore) prior to the issuance of the decision. 

(l2) I0W – ‘Impairment (0%) and Wage Loss’ (E only) - 

Used when wage loss and impairment are both being 

denied. The claim for impairment is denied because it 

has a 0% rating or because a claim for impairment was 

filed, but the claimant failed to provide the 

necessary medical documentation. 

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5. Recommended Decision Codes. (Continued) 

(13) INW – ‘Impairment (Not Ratable) and Wage Loss’ 

(E only) - Used when wage loss and impairment are both 

being denied. The claim for impairment is denied 

because the condition being claimed is not ratable for 

impairment, such as certain psychiatric conditions. 

(14) IRW – ‘Impairment (Resolved) and Wage Loss’ (E 

only) - Used when wage loss and impairment are both 

being denied. The claim for impairment is being 

denied because the impairment was resolved (i.e., does 

not exist anymore) prior to the issuance of the 

decision. 

(15) C0W – Causation, Impairment (0%) and Wage Loss’ 

(E only) - Used when claims for causation, impairment, 

and wage loss are denied simultaneously. Impairment 

is denied because the impairment rating is 0% or 

because a claim for impairment was filed, but the 

claimant failed to provide the necessary medical 

documentation. 

(16) CNW – ‘Causation, Impairment (Not Ratable), and 

Wage Loss’ (E only) - Used when a claim is made based 

on causation, wage loss, and impairment, all of which 

are being denied. The impairment is being denied 

because it is for a non-ratable condition. 

(17) CRW – ‘Causation, Impairment (Resolved), and Wage 

Loss’ (E only) - Used when claims for causation, 

impairment, and wage loss are being denied 

simultaneously. The impairment claim is being denied 

because the impairment was resolved (i.e., does not 

exist anymore) prior to the issuance of the decision. 

(18) CA0 – ‘Causation and Impairment (0%)’ (E only) - 

Used when causation and impairment are being denied 

simultaneously. Impairment is denied because the 

impairment rating is 0% or because a claim for 

impairment was filed, but the claimant failed to 

provide the necessary medical documentation. 

(19) CAN – ‘Causation and Impairment (Not Ratable)’ (E 

only) - Used when causation and an impairment that is 

not ratable are being denied simultaneously. 

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5. Recommended Decision Codes. (Continued) 

(20) CAR – ‘Causation and Impairment (Resolved)’ (E 

only) - Used when causation and an impairment that is 

resolved prior to the issuance of the decision are 

being denied simultaneously. 

 

(21) MBM – ‘Maximum Payable Benefit Met’ (E only) – 

Used when the maximum payable benefit is already met 

and a formal decision is required for an impairment 

and/or wage loss claim. 

6. Between Recommended and Final Decisions. When the FAB 

receives a case from the DO, the case is transferred in ECMS 

using the codes discussed in EEOICPA PM 1-0700, Exhibit 2. The 

date the file is “transferred in” is the date the transfer sheet 

is date stamped in. 

When the case is transferred in, the ‘FD’ (FAB Received RD) code 

is entered into the Claim Status History for each active 

claimant with a status effective date of the date FAB received 

the case. 

At this time, ECMS automatically generates a docket number for 

each claim, viewable at the top of the ECMS claim screen and 

payee screen. This number is generated the first time the case 

goes to FAB. Subsequent decisions that go to the FAB for review 

are not given new docket numbers. This number is referenced on 

decisions issued by the FAB and is used on published decisions. 

 

a. ‘FN’ – FAB Initial Review Complete. After the case is 

transferred into FAB and coded ‘FD’/”docketed”, it is 

assigned to the appropriate CE or Hearing Representative 

(HR). The CE/HR completes an initial review of the case, 

assigns a CE2 if necessary, and enters an ‘FN’ (FAB Initial 

Review Complete). The status effective date of the ‘FN’ 

code is the date the CE/HR completes the initial review. 

 

b. ‘FJ’ – FAB Received Waiver of Objections. When FAB 

receives a waiver of objections, a ‘FJ’ code is entered 

into the claim status history for the claimant who provided 

the completed waiver. 

The status effective date of the ‘FJ’ code is the date that 

the waiver is received and date stamped into any FAB office 

only (not the DO, National Office, or a Resource Center). 

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6. Between Recommended and Final Decisions. (Continued) 

ECMS requires the selection of a reason code from the 

associated drop-down box. The reason codes available for 

the ‘FJ’ status code are: 

 

(1) ‘PW’- Partial Waiver – Used when a bifurcated 

waiver is received, waiving the right to object to a 

portion of the decision and reserving the right to 

object to another. 

 

(2) ‘WF’ - Full Waiver – Used when a waiver is 

received waiving the right to object to all findings 

and conclusions in the recommended decision. 

When choosing between a full waiver and a partial waiver, 

the CE/HR must look at what is being done in Parts B and E 

separately (as with the decisions). Here are some sample 

scenarios illustrating the use of this code: 

Example 1: If a decision grants benefits under Part E and 

denies under Part B, and a partial waiver is received 

(waiving the Part E decision and reserving the right to 

object to the Part B decision), the CE/HR would enter an 

‘FJ-WF’ (full waiver) in ECMS E and nothing in ECMS B. 

Essentially there is a full waiver on the Part E decision 

and no waiver on the Part B decision. 

Example 2: If the Part B decision is an acceptance and the 

Part E decision is a partial accept/partial deny, and a 

bifurcated (partial) waiver is received, the CE/HR would 

enter a ‘FJ-WF’ (full waiver) into ECMS B and an ‘FJ-PW’ 

(partial waiver) into ECMS E. Please note that if a 

bifurcated waiver is received for a recommended decision 

pertaining to one part of the Act and the final decision to 

accept is issued prior to the final decision to deny 

because the claimant has reserved his or her right to 

object to the denial, that decision must be coded as a 

“partial develop” because a portion of the decision has 

been deferred. In this particular example the Part B 

decision would be coded ‘F0-B’ and the first Part E 

decision would be coded ‘G1’ (partial accept/partial 

develop) with an appropriate reason code + ‘DV’ (partial 

develop) with an appropriate reason code. The second Part 

E decision that would be issued after the objection period 

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6. Between Recommended and Final Decisions. (Continued) 

expired, would be coded as a denial (assuming nothing 

changed from the recommended decision). 

 

c. Coding Objections. If the claimant submits an 

objection, it must be coded into ECMS. While every 

claimant is affected by an objection, the objection only 

needs to be coded for the claimant who submits it. 

However, based on the portion of the decision (Part B or 

Part E) to which the claimant is objecting; it is coded 

only into ECMS B or ECMS E. If it is unknown whether the 

objection pertains to Part B or E, or the claimant 

specifies both, the objection will be coded into both ECMS 

B and ECMS E. 

A claimant who objects may request either a review of the 

written record or an oral hearing. In either case, the 

Appeals screen must be completed. To access the appeals 

screen, the CE/HR clicks on the “Appeals/Recons” button on 

the claim screen. The CE/HR then goes to the section 

marked appeals, selects an area in that field and clicks 

“Insert”. This will take the CE/HR to the appeals screen, 

for which completion is discussed below. These fields are 

completed as the appropriate information becomes available: 

 

(1) Rec Decision – This field will be populated with 

the recommended decision code entered by the DO/CE2 

Unit. If multiple recommended decisions have been 

issued, select the one referenced in the objection 

from the drop-down menu. 

 

(2) Auth Rep – This field is completed with the name 

of the claimant’s authorized representative, if any. 

If there is no authorized representative, this field 

is left blank. 

 

(3) FAB Rep – This field is completed with the ID of 

the FAB employee assigned to the case by using the 

drop-down menu. 

 

(4) Appeal Rcpt Dt – This field is completed with the 

date that the objection was received in any FAB office 

only (not the DO, National Office, or a Resource 

Center). 

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6. Between Recommended and Final Decisions. (Continued) 

(5) Dist Office – This field is automatically 

populated with the office location of the FAB 

representative. 

(6) Ext Thru – This is an optional field used for the 

CE/HR’s information if an extension is granted. If 

time allows, the CE/HR can grant one extension, at the 

claimant’s request, for submission of additional 

evidence.

 

(7) Appeal Type – This field is used to indicate how 

the objection is being addressed. The following 

reasons are available via the drop-down menu: 

 

(a) ‘FQ – Hearing’ – Selected when the claimant 

has requested an oral hearing. 

 

(b) ‘FT – Hearing Teleconference’ – Selected when 

the claimant requests a telephonic hearing. 

 

(c) ‘FW – Review of the Written Record’ – 

Selected when the claimant requests a review of 

the written record or if the claimant objects and 

fails to specify that a hearing is desired. 

 

(8) Objection – This field is used to specify the 

main reason that the claimant is objecting. There is 

a drop-down box that describes several types of 

objections, such as more evidence available, secondary 

exposure, general, etc. The CE/HR selects the one 

that best applies to the claimant’s objection. 

 

(9) Date to FAB Rep – This field is completed with 

the date the objection is assigned to the CE/HR. 

 

(10) AckReq Dt – This field is completed with the 

date FAB sends a letter to the claimant acknowledging 

that the objection has been received. 

 

(11) Hearing Scheduled Dt – This field is completed 

only for hearing requests, using the date the hearing 

arrangements were made. 

 

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6. Between Recommended and Final Decisions. (Continued) 

(12) Notice Sent Dt – This field is completed only for 

hearing requests, using the date the hearing 

notification letter was sent to the claimant. 

 

(13) Hearing Dt – This field is completed only for 

hearing requests, using the date of the hearing. 

 

(14) Date RWR – This field is completed only for 

reviews of the written record (RWR), using the date 

the RWR is completed/the date of the final decision. 

 

(15) Location and State – These fields are completed 

only for oral hearing requests, using the city where 

the hearing is to take place. The state where the 

hearing is to occur can then be selected from the 

drop-down menu associated with the state field. 

 

(16) Appeal Status and Appeal Status Date – The CE/HR 

selects the current status of the objection process 

(such as “Hearing Convened” or “Appeal Request 

Untimely”) along with completing the date of the 

current status in the appeal status date field. 

 

(17) Notes – This is an optional field where any notes 

regarding the objections can be listed. For example, 

if the received date for an appeal appears untimely 

because the appeal receipt date is more than 60 days 

after the recommended decision, but the postmark date 

is within 60 days, the timely postmark date would be 

mentioned in the notes section. 

 

(18) Final Decision – This field is completed when the 

final decision is issued. On cases where objections 

have been filed and an oral hearing or RWR was 

performed, the Final Decision Code is entered through 

the appeals screen. To enter the final decision code 

in these circumstances, the CE/HR selects the button 

next to the final decision field on the appeals screen 

and enters the appropriate final decision code (see 

Paragraph 7 below). 

 

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7. FAB Decision Codes. The FAB CE/HR must ensure that all 

coding throughout the claim file is correct when a FAB decision 

is issued. If FAB must enter missing codes on behalf of the 

DO/CE2 Unit, the FAB CE/HR must select the appropriate office’s 

“dist office cd” on the claim status code (update) screen to 

reflect the office that actually took the action. The FAB CE/HR 

must ensure that the status effective date of any added or 

updated codes have the correct status effective date. 

When issuing final decisions, the appropriate final decision 

code (see list below) is entered into ECMS. The status 

effective date of the code will be the date the final decision 

was issued. 

 

Currently there are two systems for ECMS separately tracking 

Part B and Part E activity. The final decision coding is entered 

with a decision code/reason code combination that relates to the 

‘Part B’ portion in ECMS B, and a decision code/reason code 

combination that relates to the ‘Part E’ portion in ECMS E. This 

is necessary to ensure accurate statistics about what decisions 

were made in relation to the ‘Part B’ and ‘Part E’ portions of 

the case. For example, if a decision is issued that accepts 

Part B and denies Part E, it would not be coded as a partial 

accept/partial deny in both systems. It would be coded as an 

acceptance in ECMS B and a denial in ECMS E. 

Under Part E, “causation” for employee claimants means that the 

claimed covered illness was caused by exposure to a toxic 

substance at a covered Part E facility or site. “Causation” for 

a survivor claimant means that exposure to a toxic substance at 

a covered Part E facility or site was a significant factor in 

aggravating, contributing to, or causing the death of the 

employee. 

 

a. F0 - ‘Final Accept’. When the CE/HR renders a final 

decision on an approved claim for benefits, where there are 

no other pending elements on the claim (including 

additional medical conditions, wage loss, or impairment), 

the CE/HR enters the ‘F0’ code. The status effective date 

is the date of the final decision. 

Upon entering the ‘F0’ code, the CE/HR must select a 

specific reason code from the “reason cd” field, which is a 

drop-down box corresponding to the ‘F0’ claim status code. 

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7. FAB Decision Codes. (Continued) 

To record any accepted Part B component of the decision, 

the CE/HR must select reason code ‘B’ [Part B] for entry in 

ECMS B. 

To record any accepted Part E component of the decision, 

the CE/HR must select one of the following reason codes 

from the drop-down menu to record all of the claimed 

elements being accepted in the current decision. These 

reason codes are to be entered exclusively in ECMS E: 

(1) CAU – ‘Causation Accepted’ - Used when causation 

is established under Part E, which results in medical 

benefits for an employee or death benefit for an 

eligible survivor. 

(2) CAW – ‘Causation and Wage Loss Accepted’ - Used 

when causation and wage loss are being accepted 

simultaneously under Part E. 

 

(3) CAI – ‘Causation and Impairment Accepted’ - Used 

when causation and impairment are being accepted 

simultaneously under Part E. 

 

(4) IMP – ‘Impairment Only Accepted (Causation 

Previously Accepted)’ - Used when causation was 

established on a previous decision and impairment is 

all that is being accepted in this decision under Part 

E. 

 

(5) WAG – ‘Wage Loss Only Accepted’ - Used when 

causation was established on a previous decision and 

wage loss is all that is being accepted in this 

decision under Part E. 

 

(6) IMW – ‘Impairment and Wage Loss Accepted’ - Used 

when causation was established in a previous decision 

and the current decision accepts for wage loss and 

impairment. 

(7) CIW – ‘Causation, Impairment, and Wage Loss 

Accepted’ - Used when causation, impairment, and wage 

loss are all being accepted in the current Part E 

decision. 

 

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7. FAB Decision Codes. (Continued) 

b. G1 - ‘Final Partial Accept/Partial Develop/Defer’. 

When the CE/HR renders a final decision where part of the 

claim is going to be approved for benefits, while another 

part of the claim needs further development/deferral 

(including additional medical conditions, wage loss, or 

impairment), the CE/HR enters the ‘G1’ code. The status 

effective date is the date of the final decision. 

This code allows for benefits to be administered while 

development continues. Status code ‘G1’ is used with 

reason code ‘B’ [Part B] in ECMS B for final decisions that 

describe a partial acceptance for one claimed condition 

under Part B and partial development/deferral for one or 

more other conditions under B. 

For Part E cases only, the CE/HR must select the 

appropriate reason code from the drop-down menu for input 

into ECMS E. The reason code for the decision explains 

only what is being accepted in the current decision. These 

are the Part E reason codes available in the drop down 

menu: 

(1) CAU – ‘Accept Causation’ - Used when causation 

for a claimed condition is accepted for benefits and 

additional development of another claimed element is 

required. 

(2) CAW – ‘Accept Causation and Wage Loss’ - Used 

when causation and claimed wage loss are being 

accepted and additional development of another claimed 

element is required. 

(3) CAI – ‘Accept Causation and Impairment’ - Used 

when causation and claimed impairment are being 

accepted and additional development of another claimed 

element is required. 

(4) IMP – ‘Accept Impairment’ - Used when causation 

has previously been accepted, claimed impairment alone 

is being accepted, and the additional development of 

another claimed element is required. 

(5) WAG – ‘Accept Wage Loss’ - Used when causation 

has previously been accepted, claimed wage loss alone 

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7. FAB Decision Codes. (Continued) 

is being accepted, and the additional development of 

another claimed element is required. 

(6) IMW – ‘Accept Impairment and Wage Loss’ - Used 

when causation was previously accepted, impairment and 

wage loss are both claimed, a decision is being issued 

that accepts both impairment and wage loss for 

benefits, and the additional development of another 

claimed element is required. 

(7) CIW – ‘Accept Causation, Impairment, and Wage 

Loss’ - Used when causation is accepted along with 

both claimed impairment and wage loss, and the 

additional development of another claimed element is 

required (e.g., a cancer claim is pending dose 

reconstruction at NIOSH). 

The portion(s) of the claim being held in abeyance for 

additional development or because the decision cannot be 

issued at this time (possibly because of a partial waiver) 

are identified by the secondary decision status code ‘DV’ 

[Partial Develop] and corresponding reason code as set out 

in Paragraph 4 above. 

 

c. F1 - ‘Final Deny - Employee Not Covered’. When the 

CE/HR renders a final decision to deny benefits due to 

employment that is not covered, the CE/HR enters the ‘F1’ 

code. The status effective date is the date the final 

decision was issued. 

 

d. G2 - ‘Final Partial Accept/Partial Deny/Partial 

Develop/Defer’. When the CE/HR renders a final decision 

where part of the claim is going to be approved for 

benefits, while another part of the claim is going to be 

denied, and yet another part of the claim requires further 

development or is being deferred, the FAB CE/HR enters the 

‘G2’ code. The status effective date is the date of the 

final decision. 

This code allows for benefits to be administered while 

development continues. Status code ‘G2’ is used with reason 

code ‘B’ [Part B] in ECMS B for final decisions that 

describe a partial acceptance for one claimed condition 

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7. FAB Decision Codes. (Continued) 

under Part B and partial denial and partial development for 

one or more other conditions under Part B. 

For Part E cases, the CE/HR must select the appropriate 

reason code from the drop-down menu. The reason code for 

the decision explains only what is being accepted in the 

current decision. These are the Part E reason codes 

available in the drop down menu: 

(1) CAU – ‘Accept Causation’ - Used when causation 

for a claimed condition is accepted for benefits and a 

portion of the claim is being denied and a portion of 

the claim requires additional development. 

(2) CAW – ‘Accept Causation and Wage Loss’ - Used 

when causation and wage loss are being accepted, a 

portion of the claim is being denied, and a portion of 

the claim requires additional development. 

(3) CAI – ‘Accept Causation and Impairment’ - Used 

when causation and impairment are being accepted, a 

portion of the claim is being denied, and a portion of 

the claim requires additional development. 

(4) IMP – ‘Accept Impairment’ - Used when causation 

has been previously accepted, impairment alone is 

being accepted, a portion of the claim is being 

denied, and a portion of the claim requires additional 

development. 

(5) WAG – ‘Accept Wage Loss’ - Used when causation 

has been previously accepted, wage loss alone is being 

accepted, a portion of the claim is being denied, and 

a portion of the claim requires additional 

development. 

(6) IMW – ‘Accept Impairment and Wage Loss’ - Used 

when causation has been previously accepted, a 

decision is being issued that accepts both impairment 

and wage loss, a portion of the claim is being denied, 

and a portion of the claim requires additional 

development. 

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7. FAB Decision Codes. (Continued) 

(7) CIW – ‘Accept Causation, Impairment, and Wage 

Loss’ - Used when causation is accepted along with 

both impairment and wage loss, a portion of the claim 

is being denied, and a portion of the claim requires 

additional development (e.g., a cancer claim is 

undergoing dose reconstruction at NIOSH). 

The portion(s) of the claim being held in abeyance for 

additional development or because the decision cannot be 

issued at this time (possibly because of a partial waiver) 

is identified by the secondary decision code ‘DV’ [Partial 

Develop] and corresponding reason codes set out in 

Paragraph 4 that are only available in ECMS E. The 

portion(s) of the claim denied are identified by the 

secondary decision status codes ‘PD’ [Partial Denial]. 

e. F3 - ‘Final Deny - Survivor Not Eligible’. When the 

CE/HR renders a final decision to deny benefits because the 

claimed survivor is not eligible, the CE/HR enters the ‘F3’ 

code. The status effective date is the date of the final 

decision. 

 

f. F4 – ‘Final Deny – Condition Not Covered’. (B only) 

When the CE/HR renders a final decision to deny Part B 

benefits because the condition is not covered under Part B, 

the FAB CE/HR enters a ‘F4’ code in ECMS B. The status 

effective date is equal to the date of the Final Decision. 

g. F5 - ‘Final Deny - Cancer Not Work Related (PoC)’. 

When the CE/HR renders a final decision to deny benefits 

because the PoC result from NIOSH is less than 50%, the 

CE/HR enters the ‘F5’ code. This means if more than one 

condition is being denied, but at least one of them is a 

cancer case that went to NIOSH, the D5 primary decision 

code must be selected. This code is also to be used in 

cases of CLL-cancer only, wherein the PoC is presumed to be 

zero. The status effective date is the date of the final 

decision. This code is used for BOTH Part B and Part E 

cancer denials based upon a PoC of less than 50%. 

Upon entry of the ‘F5’ code, the CE/HR selects a specific 

reason code from the "reason cd" field, which is a dropdown box that corresponds with the ‘F5’ claim status code. 

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7. FAB Decision Codes. (Continued) 

The reason codes available for the ‘D5’ claim status code 

are listed below. 

The only reason code allowable for ECMS B is ‘B’ [Part B]. 

Note 1: In ECMS E, the ‘F5’ code can also be used in 

conjunction with the ‘DV’ code to capture partial 

deny/partial develop decisions, for which there isn’t a 

single, unique primary decision status code. The CE/HR 

enters the ‘F5’ code with a reason code denoting what is 

being denied. The CE/HR then enters the ‘DV’ status code 

and appropriate associated reason code listed in paragraph 

4 above to identify which benefits are being held for 

further development. The status effective date of both 

codes is the date of the decision. 

Note 2: If there is also a finding in the Part E decision 

to deny one or more claimed conditions because medical 

evidence was not provided to support diagnosis of the 

claimed condition, in addition to the cancer(s) 

specifically included in the NIOSH PoC determination 

(described by using the ‘F5’ code), it is appropriate to 

enter, in tandem with the ‘F5’ entry, status code ‘PD’ 

[Partial Deny] with ‘IN’ reason code to describe/record the 

additional denial. Essentially, the coding would be 

deny/partial deny. This captures one or more conditions 

were denied because causation could not be established and 

at least one other condition had insufficient medical to 

establish the diagnosis of the claimed illness. Additional 

elements being denied, such as impairment, wage loss, and 

other causation denials can be captured in the reason code 

for ‘F5’, unless specifically requested in relation to the 

condition(s) being denied under ‘PD’. 

For example, if prostate cancer and wage loss are denied 

for lack of causation (PoC and toxic exposure) and 

asbestosis is denied because medical evidence was not 

provided, the Part E case would be coded ‘F5’-‘CAW’ and 

‘PD’-‘IN’. 

The reason codes associated with the F5 code are: 

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7. FAB Decision Codes. (Continued) 

(1) B – ‘Part B’ (B only) - Used when cancer is 

claimed under Part B, but is being denied based on the 

NIOSH PoC. 

(2) CAU – ‘Causation’ (E only) - Used when cancer is 

claimed under Part E, but causation cannot be 

established (through dose reconstruction or toxic 

exposure development). 

(3) WAG – ‘Wage Loss’ (E only) - Used in the rare 

circumstance when a wage loss claim is received and 

adjudicated after a cancer denial. 

 

(4) CAW – ‘Causation and Wage Loss’ (E only) - Used 

when cancer and wage loss are claimed under Part E, 

but causation cannot be established (through dose 

reconstruction or toxic exposure development) and wage 

loss must also be denied. 

(5) IM0 – ‘Impairment – 0%’ (E only) - Used in the 

rare circumstance when an impairment claim is received 

and adjudicated after a cancer denial. The impairment 

rating may not have been completed because causation 

was not established or if one was provided with a 0% 

impairment rating. 

(6) IMN – ‘Impairment – Not Ratable’ (E only) - Used 

in the rare circumstance when an impairment claim is 

received and adjudicated after a cancer denial and 

the claim for impairment is for a non-ratable 

condition, such as certain psychiatric conditions. 

(7) IMR – ‘Impairment – Resolved’ (E only) - Used in 

the rare circumstance when an impairment claim is 

received and adjudicated after a cancer denial and the 

claimed impairment was resolved (i.e., does not exist 

anymore) prior to the issuance of the decision. 

(8) I0W – ‘Impairment (0%) and Wage Loss’ (E only) -

Used when wage loss and impairment related to a 

previously denied cancer are both being denied. The 

claim for impairment is denied because it has a 0% 

rating or because an impairment rating was not 

completed due to lack of causation. 

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7. FAB Decision Codes. (Continued) 

(9) INW – ‘Impairment (Not Ratable) and Wage Loss’ (E 

only) - Used when wage loss and impairment are both 

being denied related to a previously denied cancer are 

both being denied. The claim for impairment is denied 

because the condition being claimed is not ratable for 

impairment, such as certain psychiatric conditions. 

(10) IRW – ‘Impairment (Resolved) and Wage Loss’ (E 

only) - Used when wage loss and impairment are both 

being denied related to a previously denied cancer. 

The claim for impairment is being denied because the 

impairment was resolved (i.e., does not exist anymore) 

prior to the issuance of the decision. 

(11) C0W – Causation, Impairment (0%), and Wage Loss’ 

(E only) - Used when claims for causation, impairment, 

and wage loss are denied simultaneously. Impairment 

is denied because the impairment rating is 0% or 

because the claimant failed to provide the necessary 

medical documentation or because the impairment rating 

was not performed because causation could not be 

established. 

(12) CNW – ‘Causation, Impairment (Not Ratable), and 

Wage Loss’ (E only) - Used when a claim is made for 

causation, wage loss, and impairment, all of which are 

being denied simultaneously. The impairment claim is 

being denied because it is for a non-ratable 

condition. 

(13) CRW – ‘Causation, Impairment (Resolved), and 

Wage Loss’ (E only). Used when claims for causation, 

impairment, and wage loss are being denied 

simultaneously. The impairment claim is denied 

because the impairment was resolved (i.e., does not 

exist anymore) prior to issuance of the decision. 

(14) CA0 – ‘Causation and Impairment (0%)’ (E only) -

Used when causation and 0% impairment are being denied 

simultaneously. Impairment is denied because the 

impairment rating is 0% or because the claimant failed 

to provide the necessary medical documentation or 

because the impairment rating was not performed 

because causation could not be established. 

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7. FAB Decision Codes. (Continued) 

(15) CAN – ‘Causation and Impairment (not ratable)’ (E 

only) - Used when causation and an impairment for a 

non-ratable condition, such as certain psychiatric 

conditions, are being denied simultaneously. 

(16) CAR – ‘Causation and Impairment (Resolved)’ (E 

only) - Used when causation and impairment that is 

resolved (i.e., does not exist anymore) prior to the 

issuance of the decision are being denied 

simultaneously. 

h. F6 - ‘Final Accept – Reversal From Denial.’ When the 

CE/HR renders a final decision to approve benefits despite 

the recommended decision to deny, the CE/HR enters the ‘F6’ 

code. The status effective date is the date of the final 

decision. 

This code should also be used if the recommended decision 

is a partial accept/partial deny and the denial portion is 

reversed. 

Upon entering the ‘F6’ code, the CE/HR must select a 

specific reason code from the “reason cd” field, which is a 

drop-down box corresponding to the ‘F0’ claim status code. 

To record any accepted Part B component of the decision, 

the CE/HR must select reason code ‘B’ [Part B] for entry in 

ECMS B. 

If a Part B final decision reversed at least a portion of a 

recommended decision to deny, while the other Part B 

elements are accepted, the CE/HR must use an additional 

primary final decision code to capture the denial. The 

CE/HR must enter the ‘F6’ code with reason code ‘B’ and 

another applicable final decision for the element that is 

being denied. 

To record any accepted Part E component of the decision, 

the CE/HR must select one of the following reason codes 

from the drop-down menu to record all of the claimed 

elements being accepted in the current decision. These 

reason codes are to be entered exclusively in ECMS E: 

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7. FAB Decision Codes. (Continued) 

(1) CAU – ‘Causation Accepted’ - Used when causation 

is established under Part E, which results in medical 

benefits for an employee or death benefit for an 

eligible survivor. 

(2) CAW – ‘Causation and Wage Loss Accepted’ - Used 

when causation and wage loss are being accepted 

simultaneously under Part E. 

 

(3) CAI – ‘Causation and Impairment Accepted’ - Used 

when causation and impairment are being accepted 

simultaneously under Part E. 

 

(4) IMP – ‘Impairment Only Accepted (Causation 

Previously Accepted)’ - Used when causation was 

established on a previous decision and impairment is 

all that is being accepted in this decision under Part 

E. 

 

(5) WAG – ‘Wage Loss Only Accepted’ - Used when 

causation was established on a previous decision and 

wage loss is all that is being accepted in this 

decision under Part E. 

 

(6) IMW – ‘Impairment and Wage Loss Accepted’ - Used 

when causation was established in a previous decision 

and the current decision accepts for wage loss and 

impairment. 

(7) CIW – ‘Causation, Impairment, and Wage Loss 

Accepted’ - Used when causation, impairment, and wage 

loss are all being accepted in the current Part E 

decision. 

If a Part E final decision reversed at least a portion of a 

recommended decision to deny to a final decision to accept, 

while other Part E elements are still being denied and/or 

deferred, the CE/HR must use the secondary decision codes 

‘PD’ and/or ‘DV’ along with the ‘F6’ code. The reason code 

associated with the ‘F6’ will show what elements are being 

accepted, including what was reversed. The reason codes 

associated with the ‘PD’ and/or ‘DV’ code(s) will reflect 

what is still being denied and/or deferred, respectively. 

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7. FAB Decision Codes. (Continued) 

If a Part B final decision reversed at least a portion of a 

recommended decision to deny to a final decision to accept, 

while other Part B elements are still being denied and/or 

deferred, the CE/HR must use a primary decision code along 

with the ‘F6’ code with reason code ‘B’. The primary 

decision code will reflect what is still being denied 

and/or deferred. 

i. F7 – ‘FAB Remanded’. This code is entered when FAB 

remands a decision of the DO/CE2 Unit. Upon issuance of 

the remand order, the CE/HR must enter the claim status 

code ‘F7’ in the Claim Status History. The status 

effective date is equal to the date of the remand 

order. The CE/HR must also select the appropriate reason 

code from the drop-down menu that best describes the reason 

the case is being remanded. 

The reason code reflects whether the remand is based on a 

DO/CE2 Unit error that could have been avoided or an 

unavoidable reason that was not a DO/CE2 Unit error. The 

reason codes (listed below) give more detail to the reason 

for the remand (“other” is the catch-all if no other reason 

codes fit.) 

The FAB CE/HR codes ‘F7’ into the appropriate system (ECMS 

B for a B only remand, ECMS E for an E only remand, and 

both for a Part B/E remand. If the Part B and E decisions 

are remanded, an ‘F7’ goes into ECMS B and E, but could 

have different reason codes in each. 

Do not enter multiple ‘F7’s and reason codes per system to 

capture multiple types of errors, instead select the reason 

code that captures the most egregious error (per part type) 

or “other” if none really fit. If there are multiple 

reasons for a remand, some avoidable and some unavoidable, 

select the avoidable reason code. 

 

(1) DO/CE2 Unit Error – Any remand that the FAB 

considers to be have been avoidable by the DO/CE2 

Unit: 

(a) ERM – ‘Error – Medical (Dx, Disease, 

Causation, DMC related)’ – This reason code is 

selected if the remand is based on an error in 

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7. FAB Decision Codes. (Continued) 

the medical development or conclusions, such as 

incorrect causation determinations, DMC 

referrals, and diagnoses. 

(b) ERE Error – ‘Employment (Dates/Time Pd, 

Exposure, SEM Use)’ – This reason code is 

selected if the remand is based on an error in 

the employment development or conclusions, such 

as incorrect employment dates/facilities, 

exposures, or SEM usage. 

(c) ERS Error – ‘Survivorship’ – This reason code 

is selected if the remand is based on an error in 

the survivorship development or conclusions. 

(d) ERO Error – ‘Other (Error – Not Med, Emp, or 

Survivorship)’ – This reason code is selected if 

the remand is based on a DO/CE2 Unit error that 

is not predominately medical, employment, or 

survivorship in nature. 

 

(2) No DO/CE2 Unit Error – Any remand that FAB 

considers to have been unavoidable by the DO/CE2 Unit: 

(a) DEA – ‘No DO Error – Death of Claimant’ – 

This reason code is selected when the FAB becomes 

aware of the claimant’s death while the case is 

pending a final decision. 

(b) RTN – ‘No DO Error – Recommended Decision 

Returned by Post Office’ – This reason code is 

selected when the recommended decision is 

returned by the post office and a new address 

cannot be obtained to re-issue the recommended 

decision and issue the final decision to the 

claimant(s). 

(c) CLS – ‘No DO Error – Administrative Closure 

(not claimant death) – This reason code is 

selected when the claim must be remanded to the 

DO/CE2 Unit for an administrative closure for a 

reason other than death or bad address. 

 

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7. FAB Decision Codes. (Continued) 

(d) OTH – ‘Error – Other (Error – Not Med, Emp, 

or Survivorship)’ – This code is used for remands 

that could not be avoided for a reason other than 

death of claimant, bad address, or administrative 

closure. An example of ‘OTH’ errors that are 

unavoidable are remands based on new evidence, 

change in law, regulation, policy or procedure, 

new SECs, and new PEPs. 

 

When issuing partial decisions that include a remand order, 

codes should be entered in this order: 

(1) Partial Accept/Partial Remand – ‘F0’ + reason 

code to show what is accepted, followed by ‘F7’ + 

remand reason code. 

(2) Partial Reverse to Accept/Partial Remand – ‘F6’ + 

reason code to show what is accepted, followed by ‘F7’ 

+ remand reason code. 

(3) Partial Deny/Partial Remand – Denial code (‘F1’, 

‘F3’, ‘F4’, ‘F5’, or ‘F9’) + reason code showing what 

is denied, followed by ‘F7’ + remand reason code. 

(4) Partial Accept/Partial Deny/Partial Remand – 

(a) If the Partial Accept/Partial Deny/Partial 

Remand is for Part B – code ‘F8’ (FAB Accept in 

Part/Deny in Part) + reason code ‘B’, followed by 

‘F7’ + remand reason code in ECMS B. 

 (b) If the Partial Accept/Partial Deny/Partial 

Remand is for Part E – code ‘F8’ (FAB Accept in 

Part/Deny in Part) + reason code that shows what 

is accepted, ‘PD’ + reason code to show what is 

denied, and ‘F7’ + remand reason code in ECMS E. 

(5) Partial Accept/Partial Deny/Partial Develop/ 

Partial Remand – 

(a) If the Partial Accept/Partial Deny/Partial 

Develop/Partial Remand is for Part B – code ‘G2’ 

(FAB Accept in Part/Deny in Part/Develop in Part) 

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7. FAB Decision Codes. (Continued) 

+ reason code ‘B’, followed by ‘F7’ + remand 

reason in ECMS B. 

(b) Partial Accept/Partial Deny/Partial 

Develop/Partial Remand is for Part E – code 

‘G2’(FAB Accept in Part/Deny in Part/Develop in 

Part) + reason code, ‘PD’ + reason code to show 

what is denied, ‘DV’ + reason code to show what is 

deferred, and ‘F7’ + remand reason code in ECMS E. 

(6) Partial Accept/Partial Develop/Partial Remand – 

(a) If the Partial Accept/Partial Develop/ 

Partial Remand is for Part B – code ‘G1’ (FAB 

Accept in Part/Develop in Part) + reason code ‘B’, 

followed by ‘F7’ + remand reason code in ECMS B. 

(b) If the Partial Accept/Partial Develop/ 

Partial Remand is for Part E – code ‘G1’(FAB 

Accept in Part/Develop in Part) + reason code, 

‘DV’ + reason code to show what is deferred, and 

‘F7’ + remand reason code in ECMS E. 

The status effective date for all the primary and secondary 

decision codes is the date of the final decision. 

j. F8 - ‘Final Partial Accept/Partial Deny’. When the 

CE/HR renders a final decision where part of the claim is 

approved for benefits, while another part of the claim is 

denied, the CE/HR enters the ‘F8’ code. The status effective 

date is equal to the date of the final decision. 

For Part B cases, status code ‘F8’ is used with reason code 

‘B’ [Part B] in ECMS B for final decisions that describe a 

partial acceptance for one claimed condition under Part B 

and partial denial for one or more other conditions under 

B. 

For Part E cases, the CE/HR must select the appropriate 

reason code from the drop-down menu and enter it into Part 

E ECMS. The reason code for the decision explains only 

what is being accepted in the current decision. These are 

the Part E reason codes available in the drop down menu: 

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7. FAB Decision Codes. (Continued) 

(1) CAU – ‘Accept Causation’ - Used when causation 

for a claimed condition is accepted for benefits and a 

portion of the claim is being denied. 

(2) CAW – ‘Accept Causation and Wage Loss’ - Used 

when causation and wage loss are being accepted and a 

portion of the claim is being denied. 

(3) CAI – ‘Accept Causation and Impairment’ - Used 

when causation and impairment are being accepted and a 

portion of the claim is being denied. 

(4) IMP – ‘Accept Impairment’ - Used when causation 

was previously accepted, impairment alone is currently 

being accepted, and a portion of the claim is being 

denied. 

(5) WAG – ‘Accept Wage Loss’ - Used when causation 

was previously accepted, wage loss alone is currently 

being accepted, and a portion of the claim is being 

denied. 

(6) IMW – ‘Accept Impairment and Wage Loss’ - Used 

when causation was previously accepted, impairment and 

wage loss are both currently being accepted, and a 

portion of the claim is being denied. 

(7) CIW – ‘Accept Causation, Impairment, and Wage 

Loss’ - Used when causation is accepted along with 

impairment and wage loss, and a portion of the claim 

is being denied (e.g., a cancer claim is pending dose 

reconstruction at NIOSH). 

The portion(s) of the claim being denied in the decision is 

identified by the secondary decision status code ‘PD’ 

[Partial Deny] and corresponding reason code set out in 

Paragraph 4 above. 

k. F9 - ‘Final Deny - Medical Information Insufficient To 

Support Claim/Non-Cancer Causation Denial’. This code is 

used when the CE/HR renders a final decision to deny 

benefits because there is insufficient medical evidence to 

support an acceptance; for any non-cancer causation 

denials; for when the maximum payable benefit is met; or 

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7. FAB Decision Codes. (Continued) 

for decisions that solely address impairment and/or wage 

loss claims (whose related conditions were not previously 

denied under F5). The status effective date is the date of 

the final decision. 

Upon entry of the ‘F9’ code, the CE/HR selects a specific 

reason code from the "reason cd" field, which is a dropdown box that corresponds with the ‘F9’ claim status code. 

The reason codes available for the ‘F9’ claim status code 

are listed below. The reason code ‘B’ [Part B] is only to 

be used in ECMS B. 

Note 1: In ECMS E, the ‘F9’ code can also be used in 

conjunction with the ‘DV’ code to capture partial 

deny/partial develop decisions, for which there isn’t a 

single, unique primary decision status code. The CE/HR 

enters the ‘F9’ code with a reason code denoting what is 

being denied. The CE/HR then enters the ‘DV’ status code 

and appropriate associated reason code listed in Paragraph 

4 above to identify which benefits are being held for 

further development. The status effective date of both 

codes is the date of the decision. 

Note 2: If the decision contains findings to deny multiple 

claimed conditions, and one denial is for insufficient 

medical evidence to establish the claimed illness and 

another denial is for inability to establish causation, 

impairment or wage loss, the CE/HR should enter ‘F9’ with 

the reason code describing the causation/impairment/wage 

loss denial. In tandem with the ‘F9’ entry, the CE should 

enter ‘PD’ [Partial Deny] with reason code ‘IN’ to record 

the denial for insufficient medical to establish illness. 

(1) B – ‘Part B’(B only) - Used when a condition is 

denied in ECMS B. 

(2) DMB – ‘Deny Specific Medical Benefits On Accepted 

Condition’ (B and/or E) - Used when a specific medical 

benefit is being denied on an accepted condition in a 

formal decision (not just a letter). (See EEOICPA PM 

3-0300.) 

(3) RMB – ‘Reduce Medical Benefits On Accepted 

Condition’ (B and/or E) - Used when a medical benefit 

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7. FAB Decision Codes. (Continued) 

on a previously paid item for a covered condition is 

reduced in a formal decision (not just a letter). 

(See EEOICPA PM 3-0300.) 

 

(4) IN – ‘Insufficient Medical To Establish Claimed 

Illness’(E only) - Used when a covered illness is 

claimed under Part E but medical evidence is 

insufficient to establish the illness. 

 

(5) R4C – ‘RECA 4 Cancer’(E only) - Used when a Part E 

cancer case is denied because the claimant had 

received benefits under RECA Section 4. 

(6) CAU – ‘Causation’ (E only) - Used when a covered 

illness is claimed under Part E, but causation cannot 

be established. 

(7) WAG – ‘Wage Loss’ (E only) - Used when the claim 

for wage loss is being denied due to lack of medical 

evidence to support the claimed period of wage-loss is 

causally related to the covered illness. 

(h) CAW – ‘Causation and Wage Loss’ (E only) - Used 

when a covered illness is claimed under Part E, but 

causation cannot be established and claimed wage loss 

must also be denied. 

(9) IM0 – ‘Impairment – 0%’ (E only) - Used when the 

claim for impairment is being denied because the 

impairment rating is 0% under the AMA Guides or 

because a claim for impairment was filed, but the 

claimant failed to provide the necessary medical 

documentation. 

(10) IMN – ‘Impairment – Not Ratable’ (E only) - Used 

when the claim for impairment is being denied because 

the claimed impairment is non-ratable, such as certain 

psychiatric conditions. 

(11) IMR – ‘Impairment – Resolved’ (E only) - Used 

when the claim for impairment is being denied because 

the claimed impairment was resolved (i.e., does not 

exist anymore) prior to the issuance of the decision. 

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7. FAB Decision Codes. (Continued) 

(l2) I0W – ‘Impairment (0%) and Wage Loss (E only) - 

Used when wage loss and impairment are both being 

denied. The claim for impairment is denied because it 

has a 0% rating or because a claim for impairment was 

filed, but the claimant failed to provide the 

necessary medical documentation. 

(13) INW – ‘Impairment (Not Ratable) and Wage Loss (E 

only) - Used when wage loss and impairment are both 

being denied. The claim for impairment is denied 

because the condition being claimed is not ratable for 

impairment, such as certain psychiatric conditions. 

(14) IRW – ‘Impairment (Resolved) and Wage Loss (E 

only) - Used when wage loss and impairment are both 

being denied. The claim for impairment is being 

denied because the impairment was resolved (i.e., does 

not exist anymore) prior to the issuance of the 

decision. 

(15) C0W – Causation, Impairment (0%) and Wage Loss 

(E only) - Used when claims for causation, impairment, 

and wage loss are denied simultaneously. Impairment 

is denied because the impairment rating is 0% or 

because a claim for impairment was filed, but the 

claimant failed to provide the necessary medical 

documentation. 

(16) CNW – ‘Causation, Impairment (Not Ratable), and 

Wage Loss’ (E only) - Used when a claim is made based 

on causation, wage loss, and impairment, all of which 

are being denied. The impairment is being denied 

because it is for a non-ratable condition. 

(17) CRW – ‘Causation, Impairment (Resolved), and Wage 

Loss’ (E only) - Used when claims for causation, 

impairment and wage loss are being denied 

simultaneously. The impairment claim is being denied 

because the impairment was resolved (i.e., does not 

exist anymore) prior to the issuance of the decision. 

(18) CA0 – ‘Causation and Impairment (0%)’ (E only) - 

Used when causation and impairment are being denied 

simultaneously. Impairment is denied because the 

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7. FAB Decision Codes. (Continued) 

impairment rating is 0% or because a claim for 

impairment was filed, but the claimant failed to 

provide the necessary medical documentation. 

(19) CAN – ‘Causation and Impairment (Not Ratable)’ (E 

only) - Used when causation and an impairment that is 

not ratable are being denied simultaneously. 

(20) CAR – ‘Causation and Impairment (Resolved)’ (E 

only) - Used when causation and impairment that is 

resolved (i.e., does not exist anymore) prior to the 

issuance of the decision are being denied 

simultaneously. 

(21) MBM – ‘Maximum Payable Benefit Met’ (E only) – 

Used when the maximum payable benefit is already met 

and a formal decision is required for an impairment 

and/or wage loss claim. 

l. F10 - ‘Regulatory Final Decision’. The FAB CE/HR 

enters this claim status code if a case is identified as 

having a “regulatory/administrative” decision based on the 

“one year/365-day rule.” The claim status date of the code 

is different depending on whether objections are present, 

or if it is a Director’s Order to reopen for a new final 

decision and a decision is pending for more than one year: 

(1) For cases where no objection was filed, the 

recommended decision becomes final 365 days from the 

time the 60-day objection period expires (if no final 

decision has been issued), that is, 425 days after the 

recommended decision date. 

(2) For cases where an objection was filed, the 

recommended decision becomes final on the one-year 

anniversary date that the letter of objection was 

received (if no final decision has been issued.) 

(3) For cases where a Director’s Order was issued 

reopening a case for issuance of a new final decision, 

the recommended decision becomes final on the one-year 

anniversary date of the Director’s Order (if no new 

final decision has been issued.) 

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7. FAB Decision Codes. (Continued) 

All of these cases must be submitted to National Office for 

reopening. See Paragraph 12 in this chapter for reopening 

coding instructions. 

8. Alternative Filing Codes. When a claimant requests an 

alternative filing under Part E, the ECMS codes below are used. 

(1) XR – ‘Alternative Filing Review Requested’ – Used when 

a claimant requests an alternative filing. The status 

effective date is the postmark date or date stamp the 

letter is received in the office, whichever is earlier. 

 

(2) XC – ‘Alternative Filing Review Completed’ – Used when 

the CE/SrCE sends out a final response to the alternative 

filing request. The status effective date is the date of 

the written response. Depending upon the determination 

reached in the review, two findings are possible: positive 

and negative. 

The CE/SrCE selects the appropriate reason code from the 

drop-down menu to indicate whether or not a causal link was 

found to have existed. If the finding of the causal review 

is positive, the CE/SrCE selects ‘P’ (Positive). If the 

finding of the causal review is negative, the CE/SrCE 

selects ‘N’ (Negative) to show that no causal link was found 

to exist. 

 

9. Reconsideration Codes. When a claimant submits a request 

for reconsideration, it must be appropriately coded on the 

reconsideration screen (this screen is completed only for the 

claimant(s) who request reconsideration). 

To access the reconsideration screen, the CE/HR presses the 

“Appeals/Recons” button on the claim screen, highlights a field 

in the “Reconsiderations” section of the FAB screen, and clicks 

insert. The following fields are completed as information on 

the reconsideration becomes available: 

 

a. Claimant Objections. This field is completed using 

the associated drop-down menu. The CE/HR selects the 

reason that best describes why the claimant wants 

reconsideration, e.g., “challenges law” or “non-specific”. 

 

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9. Reconsideration Codes. (Continued) 

b. Date to HR. This field is the date the HR is made 

aware of the reconsideration request. 

 

c. Recon Req Date. This field is completed with the date 

the reconsideration request was received in any FAB office 

only (not the DO, National Office, or a Resource Center). 

 

d. Hearing Rep. This field is completed with the 

code/name of the CE/HR assigned to the case. 

 

e. Recon Status. This field is completed by selecting 

the status of the reconsideration process, granted or 

denied, from the drop-down box associated with the recon 

status field. Then, the date associated with the 

reconsideration status is entered in the box associated 

with the recon status date field. 

This entry reflects whether the request for reconsideration 

has been granted or denied, not the case itself. If the 

reconsideration is granted, it will have a new, postreconsideration final decision code entered [see item “g” 

below]. If the reconsideration is denied, the reason will 

be annotated in the note section [see item “f” below]. 

 

f. Note. This field is used to input any applicable notes 

regarding the request for reconsideration. For example, if 

the received date for reconsideration appears untimely 

because the reconsideration receipt date is more than 30 

days after the final decision, but the postmark date is 

within 30 days, the timely postmark date would be mentioned 

in the notes section. 

A note should be entered when a request for reconsideration 

is denied, because there is an untimely filing, no new 

argument or evidence is submitted, or the new argument or 

evidence does not contradict the conclusions of the final 

decision. 

 

g. Post-Recon Final Decision. This field is completed 

when FAB accepts the request for reconsideration. A 

reconsideration code is not entered on cases where there is 

an untimely filing, no new argument or evidence is 

submitted, or the new argument or evidence does not 

contradict the conclusions of the final decision. A note 

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9. Reconsideration Codes. (Continued) 

should be entered for those types of reconsideration 

denials. 

When a reconsideration decision is made, the appropriate 

post-reconsideration final decision code must be entered 

into this field for all active claimants (even though the 

reconsideration screen is only completed for the 

individual(s) who requested the reconsideration). The codes 

are listed below. The status effective date of the 

reconsideration code is the date the new final decision is 

issued. (Do not overwrite the previous final decision 

code.) 

 

R0 FAB RECON - ACCEPT

R1 FAB RECON – DENY, EMPLOYMENT NOT COVERED

R2

FAB RECON - DENY, CONDITION NOT RELATED TO 

EMPLOYMENT

R3 FAB RECON - DENY, SURVIVOR NOT ELIGIBLE

R4 FAB RECON - DENY, CONDITION NOT COVERED

R5 FAB RECON - DENY, CANCER NOT WORK-RELATED, POC

R6 FAB RECON - REVERSED TO ACCEPT

R7 FAB RECON - REMANDED

R8 FAB RECON - ACCEPT IN PART/DENY IN PART

R9

FAB RECON - DENY, MEDICAL INSUFFICIENT TO 

SUPPORT CLAIM

 

10. Closure Codes. The CE must enter the following ECMS closure 

codes in the Claim Status History screen as appropriate. 

 

a. C0 - ‘Closed-Administrative Error’. This claim status 

code is used if a claim was created in error. The status 

effective date is the date of the memo to the file 

explaining the administrative closure. This code was 

created for use by the DO prior to the claims delete 

capability being given to the field. Now that the field 

has the ability to delete or administratively close the 

claim, they need to know when to use each option. In 

situations where the claim has already started to be 

developed and related actions are coded into ECMS, use the 

C0 code. If the claim was created in error and discovered 

prior to any real development, the claim is be deleted. 

The status effective date is the date of the memo to the 

file explaining the administrative closure. 

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10. Closure Codes. (Continued) 

b. C1 - ‘Closed-Claim Withdrawn by Claimant’. This claim 

status code is used if the claimant withdraws all 

unadjudicated claimed conditions in a system. (A claim in 

which a final decision has been issued cannot be 

withdrawn.) The CE will send a letter to the claimant, 

advising of the closure of the claim(s). The ‘C1’ is coded 

with a status effective date equal to the date of the 

letter to the claimant. 

If there are multiple claimed conditions that have not yet 

been adjudicated, and the claimant wants to withdraw only 

one or some of the conditions, delete the withdrawn 

condition(s) and input a case note in ECMS and a memo to 

the file explaining the situation. The ‘C1’ is not entered 

in ECMS. However, if there is only adjudication of one 

illness pending or all the pending conditions are being 

withdrawn (no other conditions or wage loss or impairment), 

‘C1’ is entered in ECMS. If wage loss or impairment is 

pending, wait to code ‘C1’ to ensure the claim remains on 

reports. Be aware that if ‘C1’ is used to close remaining 

claimed conditions after other conditions have been 

accepted, medical benefits will not be affected. 

Essentially, ‘C1’ should only be entered into ECMS B or E 

if everything on the claim is adjudicated and withdrawn or 

withdrawn for that Part (B or E). 

 

c. C2 - ‘Closed-Administrative Closure’. This claim 

status code is used if the claimant does not complete and 

return required forms, and therefore adjudication cannot 

continue. These include: tort suit or state workers’ 

compensation information, NIOSH smoking history, race and 

skin questionnaires, and OCAS-1 (only if there is one 

claimant). 

The CE will send a letter to the claimant, advising of the 

closure of the claim. The ‘C2’ is coded with a status 

effective date equal to the date of the letter to the 

claimant. 

The types of administrative closures listed above do not 

require a reason code. However, there are some specific 

circumstances that require a reason code be selected from 

the drop down menu associated with the ‘C2’ claim status 

code: 

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10. Closure Codes. (Continued) 

FS – ‘Failure To Sign Claim Form’. When a claimant 

files a claim telephonically with a Resource Center 

but then either refuses or fails to sign an actual 

claim form, the CE enters the ‘C2’ claim status code 

with the corresponding ‘FS’ (Failure to sign claim 

form) reason code. The status effective date is the 

date of the memo to the file explaining the 

administrative closure. 

d. C3 - ‘Closed-Employee Died’. This claim status code 

is used when the employee dies. If the death notification 

(i.e., phone call, letter) is received, and the case is 

either pre-recommended decision or post-final decision, the 

CE enters the ‘C3’ code, with a status effective date of 

when the Resource Center, DO, or FAB has been notified, 

whichever is earlier. 

If the death notification is received between the 

recommended and final decision, meaning FAB has yet to 

issue the final decision, and will in fact remand the case 

back to the DO due to the death of the claimant, then the 

‘C3’ code should not be entered until the DO receives the 

remand. The status effective date of code ‘C3’ will be 

that of the receipt date of the remand order, which is 

equivalent to the transfer-in date to the DO in ECMS. This 

code can be used in adjudicated and unadjudicated claims. 

If the first written notification of an employee’s death is 

on a newly-filed Form EE-2 from a survivor, where the date 

of death is included on the form, the status effective date 

is that of the date stamp of receipt in the Resource 

Center, DO, or FAB of the Form EE-2, whichever is earlier. 

[The date of death should also be entered on the Case 

screen.] 

Bills submitted for unadjudicated and denied cases will be 

denied for processing and payment. Bills submitted for 

approved cases will be accepted for processing and possible 

payment up to the employee’s date of death. 

e. C8 - ‘Closed-Survivor Died Prior to Payment Being 

Made’. This claim status code is used on a survivor claim 

if the survivor dies before compensation is paid. If the 

death notification (i.e., phone call, letter) is received, 

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10. Closure Codes. (Continued) 

and the case is either pre- recommended decision or postfinal decision, the CE enters the ‘C8’ code, with a status 

effective date of when the Resource Center, DO, or FAB has 

been notified, whichever is earlier. 

If the death notification is received between the 

recommended and final decision, meaning FAB has yet to 

issue the final decision, and will in fact remand the case 

back to the DO due to the death of the claimant, then the 

‘C8’ code should not be entered until the remand is 

received back at the DO. 

The status effective date of the ‘C8’ code will be that of 

the receipt date of the remand order, which is equivalent 

to the transfer in date to the DO in ECMS. 

f. C9 - ‘Closed-RECA Awaiting DOJ Adjudication’. This 

claim status code is used if a claim is filed with EEOICPA 

prior to adjudication by the Department of Justice (DOJ), 

and the claim is still pending with DOJ. The CE will send 

a letter to the claimant, advising of the closure of the 

claim. The ‘C9’ is coded with a status effective date 

equal to the date of the letter to the claimant. 

Note: Once DOL receives a decision from DOJ that was 

pending, development is resumed. At that time, the CE 

codes ‘RD’ (development resumed) with a status effective 

date equal to the date-stamp of receipt of the DOJ 

decision. 

g. C10 – ‘Partial Claim Closure’. This claim status code 

is used when the wage loss or impairment portion of the 

claim is being closed without the issuance of a recommended 

or final decision. (Other closure codes reflect a closure 

of the entire claim, but this code closes only the 

individual impairment or wage loss component.) Once the 

‘C10’ status code is entered, the CE selects the reason 

code from the drop-down menu that corresponds with the 

reason the impairment or wage loss claim is being closed. 

(1) NM – ‘Not at MMI’ - When impairment is claimed, 

but the employee has not reached Maximum Medical 

Improvement (MMI), the CE enters the ‘C10’ claim 

status code with the corresponding reason code ‘NM’ 

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10. Closure Codes. (Continued) 

(Not at MMI) reason code. The status effective date 

of the code is the date of the letter to the claimant 

informing him or her that an impairment rating cannot 

be made at this time due to the fact that he or she 

has not reached MMI. 

Note: Once medical evidence is received in the DO 

indicating that the claimant is at MMI, development is 

resumed and the ‘RD’ (Development Resumed) code will 

be entered into ECMS. The status effective date will 

be the date the DO/CE2 Unit receives such evidence of 

MMI. 

(2) WLW – ‘Wage Loss Claim Withdrawn’ - Where wage 

loss had been claimed, but the claimant chooses to 

withdraw the claim for wage loss in writing, the CE 

codes the ‘C10’ claim status code with the ‘WLW’ (Wage 

Loss Claim Withdrawn) reason code. The status 

effective date is the date stamp of receipt in the 

Resource Center, DO, or FAB, whichever is earlier. 

If the claimant decides to file at a later date, enter 

a new ‘WC’ code. 

(3) ICW – ‘Impairment Claim Withdrawn’ - Where 

impairment had been claimed, but the claimant chooses 

to withdraw the claim for impairment in writing, the 

CE codes the ‘C10’ claim status code with the ‘ICW’ 

(Impairment Claim Withdrawn) reason code. The status 

effective date is the date stamp of receipt in the 

Resource Center, DO, or FAB, whichever is earlier. 

If the claimant decides to file at a later date, enter 

a new ‘IC’ code. 

Note: If claims for wage loss and impairment are 

withdrawn simultaneously, the CE will enter two ‘C10’ 

claims status codes, one with the ‘WLW’ reason code 

and the other with the ‘ICW’ reason code. 

 

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11. New Claims for New Medical Conditions. When a case has a 

final decision, and a current claimant submits a subsequent 

claim form for a new medical condition, the new claim filing is 

recorded in ECMS by entry of claim status code ‘RD’-(Development 

Resumed). A new claim form for new covered medical conditions 

is required once a final decision is issued. 

a. Case File at DO. If the case file is at the DO, and a 

new claim form is received after a final decision has been 

issued: 

 

(1) The CE enters the new claim in ECMS by entering 

an ‘RD’- Development Resumed in the claim status 

history screen of ECMS. The status effective date 

will be the new claim filing date. This is the 

earliest of the following: postmark date or date stamp 

of receipt on the claim form, or the initial piece of 

evidence that instigated the claim in a DO or FAB 

office, or Resource Center. [The envelope must be kept 

with the claim form, and put in the case file.] 

Once the ‘RD’ code and status effective date are 

entered in ECMS, the CE enters the newly claimed 

medical condition on the Medical Condition screen. 

The CE reviews the new condition and begins 

development of the new medical evidence. 

 

(2) Development of the case will continue through new 

recommended and final decisions. All previously 

entered ECMS codes in the Claim Status History are 

still relevant for the case and will apply to the new 

claim. They do not need to be re-entered following 

the ‘RD’ code. However, all new development for the 

claim must now be entered in ECMS, including all 

further development claim status history codes. 

 

(3) If the new medical condition becomes an accepted 

condition, and the CE enters an “A” in the cond status 

field, then the med status effective date is 

determined by the following: 

 

(a) If the original claim was for Beryllium 

Sensitivity, and was accepted, and the new claim 

is for CBD, the med status effective date of the 

CBD is the same as the final decision acceptance 

date of the Beryllium Sensitivity. 

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11. New Claims for New Medical Conditions. (Continued) 

Similarly, if the original claim was for pleural 

plaques, and was accepted, and the new claim is 

for asbestosis, the med status effective date of 

the asbestosis is the same as the final decision 

acceptance date of the pleural plaques. 

 

(b) For all other medical conditions, including 

consequential conditions, regardless of the 

diagnosis date, the med status effective date is 

the new claim filing date for any conditions 

eventually accepted, prior to issuance of the 

final decision. 

 

b. Case File at FAB. If the case file is at FAB, and a 

new claim form or medical evidence for a new covered 

medical condition is received prior to a final decision: 

 

(1) If the case is in posture for acceptance, FAB 

will enter the new claim in ECMS by entering an ‘RD’- 

Development Resumed in the claim status history 

screen. The entry of the ‘RD’ code follows the same 

process as in the DO/CE2 Unit, with a status effective 

date equal to the new claim filing date. 

Once the ‘RD’ code is entered into ECMS, the FAB sends 

a letter to the claimant, addressing the receipt of 

the new claim form and instructing the claimant that 

the DO/CE2 Unit will further develop the new 

condition. 

The CE/HR then enters the newly claimed medical 

condition on the Medical Condition screen. The CE/HR 

does not begin development of the new medical 

condition. This is completed by either the CE2 or the 

CE upon case return to the DO. 

 

(2) If the case is in posture for denial, it 

is remanded back to the DO/CE2 Unit for development 

and adjudication of the new claimed condition. 

 

(3) If a new claim form or medical evidence for the 

same medical condition(s) is received after a final 

decision, regardless of its current location, and the 

claimant sends in additional medical evidence for the 

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11. New Claims for New Medical Conditions. (Continued) 

original medical condition(s) or a new claim form for 

the same medical condition(s) already adjudicated in 

the final decision, this is not considered a new 

claim. 

For either of these occurrences, the ‘RD’ - 

Development Resumed claim status code is not entered. 

Development cannot be resumed for any claims after a 

final decision without either a new claimed medical 

condition or a Director’s Order. New evidence for 

previously adjudicated medical conditions must be 

properly reviewed. 

12. Director’s Orders. At any time after FAB has issued a 

decision, the Director of the Division of Energy Employees 

Occupational Illness Compensation (DEEOIC) may reopen a claim 

and/or vacate FAB’s decision. 

For certain routine reopenings, signature authority has been 

delegated to the Policy Branch Chief, the Unit Chief for Policy, 

Regulations and Procedures (UPRP) or the District Director 

(DD). This rule applies to all decisions issued by the FAB. 

The reopening process, whether it originates with the claimant, 

the DO/CE2 Unit, the FAB, or under the auspices of the 

Director’s own discretionary authority, requires certain ECMS 

codes for identification and tracking, as follows: 

 

a. ‘MC’ - Claimant Requests Reopening. This code is used 

when the DO or FAB receives a request for reopening 

directly from the claimant, or an untimely request for 

reconsideration containing the requisite evidence 

warranting further review. The DO or the FAB enters the 

‘MC’ code into ECMS. The status effective date is the 

postmark date, if available, or the date the request is 

received in the Resource Center, DO, or FAB, whichever is 

earlier. 

For cases with multiple claimants, this code is entered in 

the claim status history only for the claimant(s) who 

submitted the request. (This is the only code related to 

Director’s Orders for which this is true. All other codes 

for Director’s Orders are entered for all active 

claimants.) 

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12. Director’s Orders. (Continued) 

b. ‘MI’ – District Director (DD) Requests Reopening. 

When the DD or FAB manager asks the Director of DEEOIC (or 

designee) to review a claim for possible reopening, a memo 

outlining the DD or FAB manager’s concerns must be 

submitted. The DO or FAB will enter the ‘MI’ code prior to 

forwarding the file to the National Office (NO). This code 

is used whether a reopening request is based on a 

claimant’s request or the DD or FAB manager’s, except in 

the case of a FAB remand order sent to NO for a possible 

Director’s Order (i.e., remand challenge). The status 

effective date is the date of the DD or FAB manager’s memo 

to the Director of DEEOIC. 

 

c. ‘M7’ – DO Submits FAB Remand for Possible Vacate 

Order. When the DD disagrees with a FAB remand order, the 

DD will prepare a memo outlining his or her concerns and 

forward the memo and case file to the NO for review by the 

Director of DEEOIC. The DO will enter the ‘M7’ code into 

ECMS prior to sending the case file to NO. The status 

effective date is the date of the DD’s memo to the Director 

of DEEOIC. 

 

d. ‘MQ’ - Reopening Request Received in NO. NO staff 

enter this code. When a reopening request is received in 

NO from the DO, or the FAB, this code is required to denote 

receipt of the request and to indicate that the case file 

is physically present at the NO. The status effective date 

is the date of receipt of the request for a reopening in 

the NO. 

This code is also entered when the DD disagrees with a FAB 

remand order and submits a challenge to the remand order to 

the NO for review by the Director of DEEOIC. In this 

circumstance, the status effective date of the ‘MQ’ is the 

date the NO received the case file. 

 

e. ‘MN’ – NO Initiates Review for Reopening. NO staff 

(and DO staff when appropriate) enter this code. When the 

Director reviews a claim under the Director’s own 

initiative for either administrative purposes, a change in 

the law, or for reasons within the sole discretion of the 

Director, the NO staff (or DO staff when authority has been 

delegated) enter the ‘MN’ code to denote that the Director 

has identified the case as one necessitating a review for 

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12. Director’s Orders. (Continued) 

possible reopening and/or vacating of a FAB decision. The 

status effective date is the date the NO received the case 

file unless there is other specific guidance for this date, 

such as in new SEC or PEP bulletins. 

 

f. ‘MX’ – Reopening Request Denied. After the DD, the 

Director of the DEEOIC, the Policy Branch Chief, or Unit 

Chief for UPRP has reviewed the request for reopening and 

has determined that the request must be denied, the ‘MX’ 

code is entered to denote the status of the review. 

DO staff enters the ‘MX’ code if the DD is denying the 

reopening. NO staff enters the ‘MX’ code if the Director 

of the DEEOIC, Policy Branch Chief, or Unit Chief for UPRP 

is denying the reopening. The status effective date is the 

date of the letter denying the request for reopening. 

This code is also used by NO staff for remands that were 

submitted to the Director of the DEEOIC for review, where 

the remand is found to be correct. In this circumstance, 

the status effective date is the date of the memo to the DD 

explaining that the remand order stands. 

 

g. ‘MF’ – Claim Reopened, File Returned to FAB. After 

the Director has determined a claim must be reopened and a 

new FAB final decision must be issued, NO staff enters the 

‘MF’ code to denote that a reopening has been granted and 

that the file has been returned to the FAB for a new final 

decision. This ‘MF’ code is not used when a remand order 

has been vacated and requires a new final decision by FAB. 

The status effective date is the date of the order granting 

the reopening. 

 

h. ‘MD’ - Claim Reopened, File Returned to DO. NO staff 

enter this code into ECMS to denote that the Director of 

the DEEOIC, Policy Branch Chief, or Unit Chief for UPRP has 

granted the reopening request and the file is being 

returned to the DO for further action and the issuance of a 

new recommended decision. The status effective date of the 

‘MD’ code is the date of the Director’s Order vacating the 

final decision and granting the reopening. 

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12. Director’s Orders. (Continued) 

In situations where reopening authority has been delegated 

to the DDs, the DO will enter the ‘MD’ code with a status 

effective date of the date of the Director’s Order. 

 

i. ‘MV’ – FAB Remand Order Vacated, Requires New Final 

Decision. This code is used when the Director of the 

DEEOIC has determined that the remand order was improper 

and must be set aside, and a new final decision must be 

issued. NO staff enters this code into ECMS when the 

Director’s Order vacating the Remand Order is issued. The 

status effective date is the date of the order vacating the 

FAB remand order. 

 

j. ‘MZ’ – Receipt of Director’s Order in DO or FAB. Once 

the Director’s Order and accompanying case file is received 

from NO in the DO/FAB, the DO/FAB staff will enter the ‘MZ’ 

code to denote date of receipt. The status effective date 

is the date the DO/FAB receives the Director’s Order. 

This code is required for the return of every requested 

Director’s Order, regardless of whether the order was 

granted or denied. This code is also to be used where a 

remand order was submitted to the Director for review and 

the file was returned with a memo to the DD explaining that 

the remand order stands or returned with a Director’s Order 

to FAB vacating the remand order. 

In cases where the DD reopens the case, there is no need to 

enter the ‘MZ’ code. 

k. ‘MA’ – Residual Contamination Reopening. This code is 

used to denote that a reopening has been granted based on 

residual contamination. Authority has been delegated to 

the DDs to handle these types of reopenings, so this code 

is entered by the DD with a status effective date of the 

Director’s Order vacating the final decision and granting 

the reopening. 

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