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September 23, 2008    DOL Home > Find It! By Form > DOL Form   

DOL Form CM-933

View ESA-OWCP-DCMWC's Form 1215-0090 Online htm
Agency: ESA-OWCP-DCMWC
Title: CM-933, Roentgenographic Interpretation
Form Description: CM-933, Roentgenographic Interpretation: The CM-933 form is used by the examining physician or radiologist to record the results of the diagnostic x-ray. The X-ray is a required diagnostic test used to determine if a claimant has pneumoconiosis.
OMB Control Number: 1215-0090
OMB Expiration Date: Wednesday, August 31, 2011




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