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CM-933b Radiologic Quality Rereading (Black Lung)

DCMWC uses this short form when a second physician rereads a coal miner's chest image to check its quality for a black lung claim. The reader grades the single image as 1, 2, 3 or U/R, records any other abnormalities with the obligatory symbols, and flags findings the miner should discuss with a personal physician. It complements the original interpretation filed on Form CM-933.

Who completes it

The rereading physician completes all sections and signs the 3C certification that the image was reread for quality under 20 CFR 718.102 and Appendix A, stating radiology board status and B-reader status. The miner's name and DOL case ID must appear.

Submitting and payment

How to submit it
Return it promptly to the office that requested the rereading, through DCMWC's C.O.A.L. Mine Portal or by mail to DCMWC.
Who pays
DOL pays only for images of acceptable quality (grades 1, 2 and 3); an unreadable (U/R) image must be retaken without cost to the Department.

Good to know

  • Item 1D grades quality as 1, 2, 3 or U/R; any grade other than 1 needs a reason written beside it.
  • Unlike CM-933, the rereading form has no parenchymal or pleural classification boxes; section 2 covers only other abnormalities, obligatory symbols and comments.
  • Section 3A asks whether a registered radiographer took the image, with the radiographer's name, state and registration number, plus the facility's DOL medical provider number.
  • Revised April 2020 under OMB 1240-0023. DOL's forms index titles it Roentgenographic Quality Rereading; the printed form says Radiologic Quality Rereading.

Get the official form

Download the current version from the source each time; forms change without notice.

Radiologic Quality Rereading

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Frequently asked questions

What is the difference between CM-933 and CM-933b?

CM-933 is the full interpretation of a miner's chest image, including small and large opacities and pleural abnormalities. CM-933b is a quality rereading: the second reader grades image quality, reports other abnormalities and comments, and certifies the reread, without repeating the full classification.

What if the rereader finds something clinically significant on CM-933b?

Section 2 has space for items of possible present clinical significance, including the date the personal physician was notified. Item 2D then asks whether the worker should see a personal physician because of the comments in section 2C.

Who may sign Form CM-933b?

A physician must sign it. Section 3B asks the interpreting physician to state whether they are a board-certified radiologist, a board-eligible radiologist or a B reader, and when their current B-reader certification expires, before signing and dating the rereading.