---
kind: "section"
citation: "20 C.F.R. § 30.232"
title: "20"
number: "30.232"
heading: "How does a claimant establish that the employee has been diagnosed with a covered illness, or sustained an injury, illness, impairment or disease as a consequence of a covered illness?"
url: "https://uscodex.org/cfr/20/30.232"
---

# §30.232. How does a claimant establish that the employee has been diagnosed with a covered illness, or sustained an injury, illness, impairment or disease as a consequence of a covered illness?

- (a) To establish that the employee has been diagnosed with a covered illness as required by [§ 30.230(d)](/cfr/20/30.230.md?p=d), the employee, or his or her survivor(s), must provide the following:
  - (1) Written medical evidence containing a physician's diagnosis of the employee's covered illness (as that term is defined in [§ 30.5(s)](/cfr/20/30.5.md?p=s)), and the physician's reasoning for his or her opinion regarding causation; and
  - (2) Any other evidence OWCP may deem necessary to show that the employee has or had an illness that resulted from an exposure to a toxic substance while working at either a DOE facility or a RECA [section 5](/cfr/20/5.md) facility.
- (b) An injury, illness, impairment or disease sustained as a consequence of a covered illness (as defined in [§ 30.5(s)](/cfr/20/30.5.md?p=s)) must be established with a fully rationalized medical report by a physician that shows the relationship between the injury, illness, impairment or disease and the covered illness. Neither the fact that the injury, illness, impairment or disease manifests itself after a diagnosis of a covered illness, nor the belief of the claimant that the injury, illness, impairment or disease was caused by the covered illness, is sufficient in itself to prove a causal relationship.

## Notes

### Amendments

[71 FR 78534, Dec. 29, 2006, as amended at 84 FR 3049, Feb. 8, 2019]

### Authority

Authority: 5 U.S.C. 301; 31 U.S.C. 3716 and 3717; 42 U.S.C. 7384d, 7384t, 7384u and 7385s-10; Executive Order 13179, 65 FR 77487, 3 CFR, 2000 Comp., p. 321; Secretary of Labor's Order No. 10-2009, 74 FR 58834.

### Source

Source: 71 FR 78534, Dec. 29, 2006, unless otherwise noted.

### Amendments

[71 FR 78534, Dec. 29, 2006, as amended at 84 FR 3049, Feb. 8, 2019]