Outside the federal coal miner program, a B Reader classifying a chest radiograph for pneumoconiosis under the ILO system can record the reading on this NIOSH general purpose form. It mirrors the official coal program layout, covering image quality, parenchymal and pleural abnormalities, other symbols and findings, and whether the worker should see a personal physician, but adds hospital or clinic and medical record number fields.
A certified B Reader completes the whole two-page form and signs section 5 with their NIOSH reader ID, name and address, marking the reading type and classification purpose.
Download the current version from the source each time; forms change without notice.
Chest Radiograph Classification Form (General Purpose)
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
No. NIOSH's Coal Workers' Health Surveillance Program forms page states that it is not an official government form, and the form itself says do not submit to NIOSH. It gives B Readers a standard ILO layout for readings outside the coal program.
Form 2.8 is the official classification, carrying OMB number 0920-0020, used for coal miner surveillance radiographs and submitted to the program. The general purpose form uses the same ILO sections but swaps the miner identifiers for hospital or clinic, medical record number and classification purpose fields, and stays with the requester.
The form is designed for a certified B Reader. Section 5 records the NIOSH reader ID, name, address and signature, the reading type (A reader, B reader, facility or other), the reading date and the purpose of the classification.