Addressee

Address

City, State, Zip

 

Dear

 

I am writing in reference to your claim for benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA).

 

If you are not already aware, employees who worked at the Ames Laboratory in Ames, Iowa, for at least 250 work days during the timeframe from January 1, 1955 through December 31, 1960, were added to the Special Exposure Cohort (SEC) effective November 5, 2010.  Our records indicate you have verified employment that is potentially located at the Ames Laboratory during this timeframe.  We are in the process of re-examining your case to determine if you qualify for benefits under the rules of this new SEC class.  This may not result in an acceptance of your claim.

 

In order to begin this process, I must first vacate our previous decision(s) and reopen your case.  The attached Director’s Order explains the reason why the prior decision(s) is being vacated and your case reopened.  Please read this Order very carefully.  If any of the basic information has changed since your final decision was issued (such as medical condition(s) or employment dates), please contact this office immediately and ask for your assigned claims examiner.  Your information will be incorporated into your case file and considered in our decision.  Once we have completed our review of your file, a new recommended decision will be issued concerning your eligibility under this SEC designation.

 

If you have any questions about the Director’s Order, please feel free to call my office, toll free, at:  (xxx) xxx-xxxx.

 

Sincerely,

 

 

 

{Name of District Director}

District Director


 

 

 

 

EMPLOYEE:                                                             [Employee Name]

 

CLAIMANT:                                                            [Claimant(s) Name]

 

FILE NUMBER:                                                       [Last 4 Digits of File Number]

 

DOCKET NUMBER:                                              [Insert Docket Number]

 

 

DIRECTOR’S ORDER

 

On {date} you were issued a final decision denying your claim for benefits under [Part B/E] of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA).  A final decision may be reopened at any time on motion of the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC).  Because of new developments described in this Director’s Order, the {date} Final Decision under [Part B/E] of the Act is hereby vacated and your case reopened under this provision.

 

BACKGROUND

 

{Provide a concise and accurate synopsis of the claim’s history.  Some sample paragraphs are provided here, though these should be altered to tailor-fit the specifics of the case.}

 

The evidence of record shows that {claimant name} filed Form [EE-1 or 2] (Claim for [Survivor] Benefits under the EEOICPA) under Part B [and/or E, as appropriate] on {date}.  It was asserted that the employee {employee name} developed {cancer type} as a result of employment that is potentially located at the Ames Laboratory in Ames, Iowa.  Medical documentation established the claimed condition. 

 

Under the Act, most cancer cases must be referred to the National Institute for Occupational Safety and Health (NIOSH), a division of the Department of Health and Human Services (HHS), in order to receive a dose reconstruction.  A dose reconstruction allows the Department of Labor to run a program that provides a number called the probability of causation (PoC).  Under Part B of the Act, a cancer is “at least as likely as not” related to employment at a covered facility if the PoC is 50% or greater.  In your case, the PoC was calculated to be {XX.XX%}.

 

As a result, on {date}, the district office issued a recommended decision denying the claim under Part B of the Act because the PoC was less than 50%.

 

The recommended decision was forwarded to the Final Adjudication Branch (FAB), in accordance with our procedures, for an independent assessment and issuance of a final decision.  On {date}, the FAB issued a Final Decision, affirming the recommended decision to deny the claim.  [If there is also a claim for Part E – explain the decision in the next paragraph.]

 

DISCUSSION

 

Under the Act, there is a provision that allows for payment of some cases regardless of a previous PoC.  This provision becomes available when employees are included in a class of the Special Exposure Cohort (SEC).  To be included as a member in a class of the SEC, the employee must be diagnosed with a specified cancer and meet all the employment requirements of the SEC class.

 

A new class may be added to the SEC if NIOSH determines that they are unable to complete the dose reconstruction process for certain employees.  NIOSH can make such a determination on its own or based upon a petition from individuals.  NIOSH evaluated such a petition and recently completed the approval process.  Effective November 5, 2010, a class of employees who worked at the Ames Laboratory, as defined below, was added to the SEC.  The new SEC class is designated as follows:

 

All employees of the Department of Energy, its predecessor agencies, and its contractors and subcontractors who worked in any area of the Department of Energy facility at the Ames Laboratory from January 1, 1955 through December 31, 1960, for a number of work days aggregating at least 250 work days, occurring either solely under this employment, or in combination with work days within the parameters established for one or more other classes of employees in the Special Exposure Cohort.

 

CONCLUSION   (Note:  This paragraph is particularly important)          

 

Based on the designation of this new class into the SEC, the district office has reviewed the file and finds there is sufficient evidence to warrant reopening of this claim.  The evidence of record shows that the employee worked {describe evidence that shows the employee worked for at least 250 work days at the Ames Laboratory during the designated years for the new class in the SEC}.  This demonstrates that the employee performed work at the Ames Laboratory for at least 250 work days within the designated time period for the SEC class.  Moreover, the evidence establishes the employee was diagnosed with {type of cancer}, a SEC-specified cancer.

 

The above findings indicate potential eligibility as a member of the SEC.  Accordingly, the Final Decision pursuant to Part B [and/or Part E] [is/are] is hereby vacated, and the case is reopened so that a new recommended decision can be issued. 

 

If you disagree with the recommended decision, you will have the opportunity to file an objection and request an oral hearing or review of the written record.

 

{city of district office}

 

 

 

                                                                                    {Name of District Director}

                                                                                    District Director

 

 

 

 


CERTIFICATE OF SERVICE

 

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

 

Addressee

Address

City, State, Zip

 

 

                                                                                    {Name of District Director}

                                                                                    District Director