Claimant Name

Street Address

City, State Zip Code

 

Dear [Insert]:

 

I am writing in reference to your claim for benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA).  On [Insert Date], the Final Adjudication Branch (FAB) issued a Final Decision under the EEOICPA denying your claim for compensation.

 

The regulations governing the EEOICPA allow the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC) to review decisions issued by the FAB.  It is within the Director’s discretion to vacate such decisions as necessary.  In the exercise of the Director’s discretion over the reopening process, authority has been delegated to the District Director for the District Office to reopen certain claims.

 

Based upon the National Institute for Occupational Safety and Health (NIOSH)’s revision to the underlying scientific assumptions by which dose reconstructions are performed and the revised NIOSH Interactive RadioEpidemiological Program (IREP) model used for calculating the probability of causation, I have issued the attached Director’s Order vacating the Final Decision of the FAB.

 

If you have any questions about the Director’s Order, you may contact the District Office at [phone number].

 

Sincerely,

 

 

 

District Director

Division of Energy Employees

Occupational Illness Compensation


EMPLOYEE:                                                             [Employee Name]

 

CLAIMANT:                                                             [Claimant(s) Name]

 

FILE NUMBER:                                                       [File Number]

 

DOCKET NUMBER:                                               [Insert Docket Number]

 

 

DIRECTOR’S ORDER

 

Pursuant to the authority granted by 20 C.F.R. § 30.320 and for the reasons set forth below, the [insert date] Final Decision of the Final Adjudication Branch (FAB) under [Part B and/or E as appropriate] of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA or the Act) is hereby vacated. 

 

EEOICPA Regulations at 20 C.F.R. § 30.320 state that a final decision, or any other decision issued by the FAB, may be reopened at any time on motion of the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC).  It further states that the case may be reopened without regard to whether new evidence or information is presented or obtained, and that the decision whether or not to reopen a case is solely within the discretion of the Director of the DEEOIC.  In the exercise of discretion over the reopening process, the Director has delegated limited signature authority to the District Director of the DEEOIC to reopen cases under certain circumstances. 

 

The evidence of record shows that on [Insert Date], Form [Insert Form Number] (Claim for Benefits under the EEOICPA) was filed.  It was claimed that the employee, [Insert Employee Name] developed [Insert Condition] as a result of employment at [Insert Site Name].  Medical records established a diagnosis of [Insert Diagnosed Condition].

 

Form EE-3 (Employment History) was submitted claiming employment at [Insert Site Name] from [Insert Dates].  Evidence was received which verified employment from [Insert Dates]

 

NIOSH conducts dose reconstructions to estimate radiation doses to which workers have been exposed.  EEOICPA regulations at 20 C.F.R. § 30.115 require DEEOIC to obtain a dose reconstruction analysis from NIOSH to determine the probability of causation (PoC) that a covered employee’s cancer was at least as likely as not (50% or greater probability) related to occupational exposure to radiation.  On [date], your case was referred to NIOSH for a dose reconstruction. In this case, the dose reconstruction resulted in a PoC of less than 50%, indicating that it was not at least as likely as not that the cancer was related to radiation while employed at [Insert Site].

 

On [Insert Date], the [Insert District Office]  issued a recommended decision denying the claim for compensation finding that [Insert Employee Name] did not meet the criteria of


a covered employee with cancer as defined under 42 U.S.C. § 7384l(9)(B) and § 7384n(b).  The recommended decision was forwarded to the FAB in accordance with EEOICPA procedures for an independent assessment and issuance of a final decision.  On [Insert Date], FAB issued a final decision affirming the recommended decision to deny the claim.

 

On September 25, 2007, NIOSH issued OCAS-PER-016, “Implementation of IREP procedure for claims near 50% probability of causation.”  As indicated in the Program Evaluation Report (PER), the revision to the Interactive RadioEpidemiological Program (IREP) was employed in order to provide better statistical precision for cases approaching the compensation threshold of 50%.  Furthermore, NIOSH has issued a multitude of revisions to the underlying scientific assumptions by which a dose reconstruction is performed.  As a result of these changes to the dose reconstruction methodology and the revision to the IREP procedural guidance, the prior dose reconstruction/Probability of Causation (PoC) calculation on your claim may be invalid

 

Given that the DEEOIC is responsible for the fair and consistent administration of the claim adjudication process, these changes initiated by NIOSH necessitates reevaluation of the claim to determine the impact (if any) of the revised dose reconstruction methodology to the calculation of the PoC.  Accordingly, there is sufficient basis to warrant additional investigation of the claim, including referral of the case back to NIOSH for a new dose reconstruction.

 

The Final Decision of [Insert Date] is hereby vacated.  The claim will be forwarded to NIOSH for a new dose reconstruction.  Upon return of the case from NIOSH, the district office will complete any necessary development and issue a new recommended decision.  Should there be disagreement with the recommended decision, opportunity to file an objection and request an oral hearing or review of the written record will be afforded.

 

Washington, D.C.   

 

 

 

District Director

Division of Energy Employees

Occupational Illness Compensation


 

 

CERTIFICATE OF SERVICE

 

 

I hereby certify that on                                       a copy of the Director’s Order was sent by regular mail to the following:

 

Claimant Name

Street Address

City, State Zip Code

 

 

 

                                                                                                                                                                                               

                                                                        District Director
                                                                        Division of Energy Employees

                                                                        Occupational Illness Compensation