U.S. DEPARTMENT OF LABOR   EMPLOYMENT STANDARDS ADMINISTRATION
OFFICE OF WORKERS' COMPENSATION PROGRAMS
DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL
ILLNESS COMPENSATION
FINAL ADJUDICATION BRANCH
  Department of Labor Seal

 

 

Case Information
EMPLOYEE: [Name Deleted]
CLAIMANT: [Name Deleted]
FILE NUMBER: [Number Deleted]
DOCKET NUMBER: 10017360-2006
DECISION DATE: August 22, 2006


NOTICE OF FINAL DECISION

This is the decision of the Final Adjudication Branch concerning your claim for compensation under the Energy Employees Occupational Illness Compensation Program Act of 2000, as amended, 42 U.S.C. § 7384 et seq. (EEOICPA or the Act). For the reasons stated below, your claim for benefits under Part E of the Act is denied.

STATEMENT OF THE CASE

On April 22, 2002, you filed a claim under EEOICPA for benefits as a surviving child of [Employee]. A copy of your mother’s death certificate shows that she died on October 18, 1999. A copy of your birth certificate shows that your date of birth is [Claimant’s date of birth].

On February 16, 2006, the Cleveland district office advised you of the criteria which must be met to establish that you are a “covered child” under Part E of the Act and requested that you submit documentation of your underlying condition and its severity at the time of you mother’s death.

In response to a telephone call from you to the district office, your were sent another letter on February 22, 2006, requesting that you provide medical evidence from your treating physician that provides a history of your condition(s), to include the first date of diagnosis and the first date of disability.

On March 3, 2006, the district office received a letter from Dr. Henry Gupton, dated February 23, 2006, in which he states that you have been his patient since 1991. He lists your medical problems as including diabetes mellitus, fibromyalgia, crippling arthritis with need for a wheelchair at times, walker and/or cane as well. Dr. Gupton states that you also suffer from hypothyroidism, GERD, hyperlipedemia, cataracts, back spasms, depression, restless leg syndrome, sleep disturbances, hypertension, osteoporosis, dependent edema, a knee replacement, and other joint problems. He states that you were definitely incapable of self-support in October 1999. Also received were treatment records for the period of May 20, 1998, to October 7, 1998, regarding moderately severe carpal tunnel syndrome of the left wrist. An open carpal tunnel release was performed on July 13, 1998. The final post-surgical report of October 7, 1998, indicates that you were doing very well and had full range of motion.

Also received on March 3, 2006, was a summary of FICA earnings, stamped by the Social Security Administration office in Oak Ridge, TN, for the years of 1968 through 1976.

Because Dr. Gupton’s summary of your medical status and his opinion that you were incapable of self-support at the time of your mother’s death was not corroborated by the submitted medical evidence, the district office sent you a letter on May 3, 2006, which discussed the evidence you had submitted and explained that the evidence did not address your status as of the date of your mother’s death. You were asked to provide medical records for 1998 and 1999 that documented all of your medical conditions and their severity as of October 1999. You were also asked to provide evidence, if any, showing that any other government agency had found you to be disabled as of October 1999.

On May 17, 2006, the district office received over 80 pages of medical records, the majority of which address the period after the time of your mother’s death. Records from the latter part of 1999 refer to your complaints of sore knees, elbows, and wrists, and of your being upset because of your mother’s death. You were treated for an upper respiratory infection in December 1999. Records which refer to your use of a walker, wheelchair and/or motorized scooter are all from the period subsequent to your mother’s death. In a letter dated May 17, 2006, the district office discussed the contents of these records and the need for you to submit documentation of the severity of your medical conditions proximate to October 1999. You were again requested to provide evidence, if any, showing that any other government agency had found you to be disabled as of October 1999. You were advised to provide the requested information by June 3, 2006. There is no indication in the record that you responded to that request.

On June 9, 2006, the district office recommended denial of your claim for compensation finding that you do not meet the criteria defining “covered child” under Part E.

FINDINGS OF FACT

1. You filed a claim for benefits as a surviving child of [Employee].

2. Your mother died on October 18, 1999.

3. You were over the age of 23 years on the date of your mother’s death.

4. You did not provide evidence sufficient to establish that you were incapable of self-support on the date of your mother’s death.

CONCLUSIONS OF LAW

I have reviewed the June 9, 2006 recommended decision. I find that you have not filed any objections to the recommended decision and that the 60-day period for filing such objections has expired. See 20 C.F.R. §§ 30.310(a), 30.316(a).

The term “covered child” means a child of the employee who, at the time of the employee’s death, was: under the age of 18 years; or under the age of 23 years and a full-time student who was continuously enrolled in an educational institution since attaining the age of 18 years; or incapable of self-support. See 42 U.S.C. § 7385s-3(d)(2).

The evidence of record shows that you were 60 years old at the time of your mother’s death. The evidence of record is not sufficient to establish that you were incapable of self-support on your mother’s date of death.

Therefore, your claim must be denied because the evidence does not establish that you meet the definition of a “covered child” as defined by 42 U.S.C. § 7385s-3(d)(2).

Cleveland, OH

_______________________________________

Anthony Zona

Hearing Representative

Final Adjudication Branch