EEOICPA BULLETIN NO.08-22                  

 

Issue Date: April 23, 2008

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Effective Date: April 23, 2008

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Expiration Date: April 23, 2009

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Note: This bulletin updates Bulletin No.07-15, Processing Claims for Allied Chemical Corporation Plant Special Exposure Cohort (SEC)Class, January 1, 1959 through December 31, 1976; Bulletin No. 07-17, Processing Claims for the General Atomics Special Exposure Cohort (SEC) class, January 1, 1960 through December 31, 1969; Bulletin No. 07-23, Processing Claims for a new Special Exposure Cohort (SEC) Class for covered employees of the Los Alamos National Laboratory (LANL), March 15, 1943 through December 31, 1975; Bulletin No. 07-25, Processing claims for a new Special Exposure Cohort (SEC) class for the Dow Chemical Company (Madison Site) in Madison, IL, from January 1, 1957 through December 31, 1960

 

Subject:  SEC coding   

 

Background:  New SEC coding instruction was incorporated into recent SEC bulletins to better track the development action taken by the District/Final Adjudication Branch (FAB) offices on potential SEC cases. In particular, the reason code “NA” (No Action Necessary) was created to identify a case that the adjudicator has reviewed and determined does not meet the SEC criteria or where there is no need to for NIOSH to perform a partial dose reconstruction.

 

This bulletin provides instruction for the use of “NA” (No Action Necessary) as it pertains to the above-noted prior bulletins and establishes corresponding reason codes.  

 

References: Energy Employees Occupational Illness Compensation Program Act of 2000, 42 U.S.C. § 7384 et seq.; 42 C.F.R. Part 83, Procedures for Designating Classes of Employees as Members of the Special Exposure Cohort Under EEOICPA; EEOICPA Bulletin No.07-15, Processing Claims for Allied Chemical Corporation Plant Special Exposure Cohort (SEC)Class, January 1, 1959 through December 31, 1976; EEOICPA Bulletin No. 07-17, Processing Claims for the General Atomics Special Exposure Cohort (SEC) class, January 1, 1960 through December 31, 1969; EEOICPA Bulletin No. 07-23, Processing Claims for a new Special Exposure Cohort (SEC) Class for covered employees of the Los Alamos National Laboratory (LANL), March 15, 1943 through December 31, 1975; EEOICPA Bulletin No. 07-25, Processing claims for a new Special Exposure Cohort (SEC) class for the Dow Chemical Company (Madison Site) in Madison, IL, from January 1, 1957 through December 31, 1960

 

Purpose: To provide guidance on the proper use of the “NA” reason code for reporting and tracking purposes.

 

Applicability: All staff. 

 

Actions:

 

1.  When each respective bulletin noted above was issued, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) provided the District/Final Adjudication Branch (FAB) offices with a comprehensive list of cases to be reviewed for SEC eligibility.

 

For cases on the comprehensive list that have been reviewed and where it is determined that no action needs to be taken (either a new recommended decision to accept based on the SEC, or return to NIOSH, or a FAB reversal or remand) the CE/FAB HR must write a brief memo to the file explaining that the case was reviewed under the respective bulletin, no additional action was necessary, and why. A case classified as not requiring any action is a case that does not meet the SEC criteria or there is no need to return it to NIOSH for partial dose reconstruction.

 

The CE must then code “NA” (No Action Necessary) in ECMS B and then select the appropriate reason code from the reason code drop down list. The following corresponding reason codes have been added to the drop down list in ECMS B:

 

Reason Code “715”       Allied Chemical (Bulletin 07-15)  

Reason Code “717”       General Atomics (Bulletin 07-17)

Reason Code “723”       LANL          (Bulletin 07-23)

Reason Code “725”       Dow Chemical  (Bulletin 07-25) 

 

The status effective date of the “NA” code is the date of the memo to the file stating review is complete and the CE has determined there is no further action necessary. For those instances in which further development is necessary, the “NA” and its corresponding reason code is not entered initially. The “NA” code is only entered when the CE determines after development that the case does not meet the SEC criteria or there is no need to return it to NIOSH for partial dose reconstruction. For those cases on the comprehensive list that are still with NIOSH, the CE enters the “NA” code only after the CE determines that the case does not meet the SEC criteria. These cases will remain at NIOSH for completion of a partial dose reconstruction.

 

If a case is reviewed under multiple lists for different SECs, a “NA” code (and accompanying documentation) must be entered along with the appropriate drop down reason code each time the case is reviewed and it is determined that no action needs to be taken under the bulletin.   

 

Please note that if the CE discovers the claimant(s) is/are deceased, the CE must still enter the “NA” code in addition to the closure code. The status effective date is the date of the memorandum to file.

 

2. The comprehensive list not only identifies cases requiring review for SEC eligibility, it also serves as a means of tracking progress. For tracking purposes, the list becomes the "pending" list. The objective is to successfully and accurately review cases and enter appropriate ECMS coding which will result in “the case being removed from the pending list.” In other words, certain ECMS codes act as an indicator that the initial review was completed and/or that subsequent action was taken. The following are examples of subsequent actions, as tracked in ECMS B coding, which would remove a case from the pending list.  

 

1.     Any recommended decision/final decision on or after the SEC effective date

2.     The case is sent to NIOSH for dose reconstruction after the SEC effective date

3.     The case is closed after the SEC effective date

4.     The case is reviewed and the CE determines that no additional action is required under the respective SEC bulletin (as denoted by the “NA” code in ECMS B)

 

ECMS coding is at the claim level. Failure to input a code that will remove the case from the pending list on even one claim associated with a case, will result in the case still showing up as still “pending” review or action. In addition, the “NA” coding is specifically tied to the comprehensive list generated by DEEOIC. The “NA” code and its corresponding reason code is restricted to ECMS B because the comprehensive review list is derived from Part B data.  

 

3. Since most cases on the comprehensive lists (sent with the issuance of the prior bulletins) should already have subsequent action completed, the DEEOIC will provide the District Office/FAB with a pending list of cases that still require review by the District Office/FAB. This pending list will be updated and sent weekly by the Branch of Automated Services (BAS) to the District Directors and FAB managers via E-mail. Cases on the pending list must be reviewed to determine if any further action is necessary under their respective bulletins. If no further action is necessary, the “NA” (No Action Necessary) code with the corresponding reason code can now be entered in ECMS B in accordance with this bulletin. All cases on the pending list for these four SEC classes must be reviewed and/or subsequent action taken to remove the case from the pending list.

 

4. Actions described above for the cases on the pending list for these four SEC classes should be completed within 30 days of the date of this Bulletin.

 

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, and District Office Mail & File Sections