There really is only one way to get additional diagnosis codes added to your Medical Benefits ID Card. That is to make a claim under the Energy Employees Occupational Illness Compensation Act (EEOICPA). For any new conditions or diagnosis codes you would like added to your Medical Benefits ID card you will need to file a new claim under the EEOICPA.
There are two ways to make a claim under the EEOICPA. You can either claim a new condition is due to occupational exposures or as a consequence of an already accepted condition under the EEOICPA, which is also known as a “consequential illness”. When you are making a claim under the EEOICPA you will want to specify on your claim form if the new condition you are claiming is a consequential illness.
A claim for a consequential illness is a claim that your new condition is either caused, contributed to, or aggravated by an already accepted condition under the EEOICPA. You will need to submit medical documentation that establishes the claimed condition is a consequence of a condition you have been accepted for under the EEOICPA.
As an Example: You were diagnosed with pulmonary hypertension. You physician said that you developed pulmonary hypertension as a consequence to your accepted condition of pulmonary fibrosis under the EEOICPA. In such a case, you would file a claim for pulmonary hypertension as a consequence of pulmonary fibrosis and include the medical documentation or narrative letter in which your physician opines that your pulmonary hypertension is a consequence of your pulmonary fibrosis.
The Division of Energy Employees Occupational Illness Compensation (DEEOIC) will begin the adjudication process of your claim upon receipt. If accepted the new condition will be added to your Medical Benefits ID Card for payment of medical benefits. A properly submitted claim for a consequential illness can be processed and added to your Medical Benefits ID Card relatively quickly.
If the new diagnoses code or condition is not a consequential illness then you are claiming that the new condition is due to an occupational exposure from your employment at a covered facility. The DEEOIC will begin the adjudication process of your claim upon receipt. If accepted the new condition will be added to your Medical Benefits ID Card for payment of medical benefits. These types of claims can typically take longer than a claim for a consequential illness due to the evidentiary requirements and necessary development.
As one of our clients you do not need to go it alone in obtaining benefits under the EEOICPA. Loyal Service Agency Inc. not only provides you the best in-home health care services but we also provide you our expertise and knowledge of the EEOICPA. We can assist you in filing a claim for a new condition or consequential condition.
We specialize in assisting our clients and patients navigate the bureaucracy of the EEOICPA. Loyal Service Agency’s EEOICPA Liaison can also assist you in obtaining ancillary medical benefits, filing for reimbursement of out of pocket expenses, claims for travel expenses, and many other available benefits under the EEOICPA.
Isn’t time for you to have someone dedicated to assisting you with your claims and benefits under the EEOICPA? Get your questions answered and join our family today by calling 1-855-485-6925.