EEOICPA BULLETIN NO.  08-18

 

Issue Date: April 7, 2008

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Effective Date: April 7, 2008

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Expiration Date: April 7, 2009

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Subject: NIOSH coding in ECMS E.

 

Background: The Federal EEOICPA Procedure Manual at Chapter E-500.20.e states the following in regards to coding NIOSH cases in ECMS E:

 

“Coding NIOSH Referrals for Part E ECMS.  When a non-SEC cancer claim is referred to NIOSH or was originally referred to NIOSH as a Part B claim and a new Part E claim is now extant, the CE does not input the ‘NI’ SENT TO NIOSH code into ECMS E to show that the claim is pending dose reconstruction at NIOSH.  The ‘NI’ code is input into the Part B only (unless RECA Section 5 case with claim for cancer other than lung cancer).  Instead, while the CE is concurrently developing for exposure to a toxic substance, the ‘DO’ code is entered into ECMS E and the CE selects ‘TD’ (Toxic Exposure Development) from the corresponding drop down menu.  ECMS codes must reflect a particular development action.  If CE takes a development action (i.e. sends a letter to a claimant or a DAR to DOE), then and only then may a ‘DO’ code be entered.  The status effective date is the date of the letter. 

 

When toxic exposure development is complete and the CE cannot accept causation, the CE creates a memorandum to file stating that toxic exposure development is complete.  The CE then codes ‘NI’ into ECMS E with the status effective date of the date memorandum.”

 

These coding instructions do not address how to code cases that are returned from NIOSH prior to the completion of toxic exposure development, or how to code ECMS E if a claim is withdrawn from NIOSH or administratively closed. This bulletin serves to provide that missing information.

 

Reference:  Federal (EEOICPA) Procedure Manual, Chapter E-500 (EEOICPA Tr. No. 06-04, June 2006) and Chapter 2-1500 (EEOICPA TR. No. 06-08, July 2006)

 

Purpose: To provide procedures for coding cases that are withdrawn from NIOSH, administratively closed with NIOSH, or returned from NIOSH prior to the completion of toxic exposure development.

 

Applicability: All Staff

 

Actions:

 

1.   As stated above, the CE does not code the ‘NI’ into ECMS E until toxic exposure development is complete. Once the ‘NI’ code has been entered into ECMS E, the CE should code any additional NIOSH actions into ECMS B and E.  This includes coding the Probability of Causation (PoC), the ‘NO’ (NIOSH Administrative Closure) code, ‘NR’ (Returned from NIOSH) code, and ‘NW’(Withdrawn from NIOSH) code as outlined in EEOICPA PM Ch 2-1500.4.e(4):

 

‘NO’ - ‘NIOSH, Administrative Closure’

For cases at NIOSH, the OCAS-1 form is provided to the claimant after completion of the dose reconstruction report.  The claimant is required to sign and return the form to NIOSH before NIOSH can return the case to DOL.  If none of the claimants sign the OCAS-1 form or submit comments within 60 days, NIOSH will administratively close the case.  NIOSH will send a letter to DOL addressing the administrative closure.  The CE enters the ‘NO’ claim status code in ECMS, with a status effective date of the receipt of the letter from NIOSH.

 

‘NR’ - ‘NIOSH Dose Reconstruction Received’ When a case is returned from NIOSH with a dose reconstruction or it is returned from NIOSH because a dose reconstruction could not be performed, the CE enters the ‘NR’ (Received from NIOSH) claim status code in ECMS with a status effective date of the date the dose reconstruction is date-stamped into the District Office.  When after full medical development the only claimed primary cancer is CLL or a non-specified cancer at an SEC site where no dose reconstruction can be performed, the CE enters the ‘NR’ (Received from NIOSH) claim status code in ECMS, even though there will not be an ‘NI’ code.  On these cases, the status effective date is the date of the Recommended Decision to deny based on CLL (0% POC) or no dose reconstruction possible.  Upon entry in ECMS of the ‘NR’ code, the CE selects the appropriate reason code.

 

 

‘NW’ - ‘NIOSH, Returned without a Dose Reconstruction’ When withdrawing a case from NIOSH for any reason (i.e. the CE realizes there was no covered employment and the case shouldn’t have been sent to NIOSH) wherein the District Office will not be sending the case back to NIOSH, the CE requests the return of the case from NIOSH without a dose reconstruction and enters the ‘NW’ code in ECMS.  The CE sends notification to NIOSH that the dose reconstruction is no longer needed for the case. The status effective date is the date the notification is sent to NIOSH.

 

2.   When cases are received back from NIOSH and toxic exposure development has not yet been completed (NI has not yet been coded in ECMS E), the CE does not code ‘NR’ into ECMS E.  However, the POC must be entered into ECMS E.  This information will reflect that the dose reconstruction has been completed for Part E, even though the toxic exposure development has not.  Similarly, if the claim is administratively closed by NIOSH (NO) or the claim is withdrawn from NIOSH (NW), this coding does NOT go into ECMS E if the ‘NI’ code has not yet been coded in ECMS E.   

 

3.   There are no changes/additions to how ‘NI’, ‘NR’, ‘NO’, ‘NW’, and PoC are coded into ECMS B.

 

Disposition: Retain until incorporated in the Federal (EEOICPA)

Procedure Manual.

 

 

 

 

PETER M. TURCIC

Director, Division of Energy Employees

Occupational Illness Compensation

 

 

Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, District Office Mail & File Sections