EEOICPA BULLETIN NO.08-24
Issue Date: May 9, 2008
Effective Date: May 9, 2008
Expiration Date: May 9, 2009
Subject: Chapman Valve, Argonne National Laboratory – West, General Steel Industries, and the Huntington Pilot Plant (Reduction Pilot Plant) Program Evaluation Reports.
Background: On September 20, 2007, NIOSH released two separate Program Evaluation Reports (PERs) addressing Technical Basis Document (TBD) revisions; OCAS-PER-022, entitled “Chapman Valve TBD Revision,” which includes a revision to the internal dose methodology; and OCAS-PER-023, entitled “Argonne National Lab – West,” which includes a revision to the default frequency of x-ray examinations between 1954 and 1974. On September 25, 2007, NIOSH issued OCAS-PER-024, entitled “General Steel Industries TBD Approval.” This PER involved a revision to the external dose to Radiographers. On September 28, 2007, NIOSH issued OCAS-PER-025, entitled “Huntington Pilot Plant TBD Revision,” which provides for an estimate of shallow dose (electron dose) that did not appear in the original TBD version.
NIOSH issued the PERs to document the changes in the TBDs for these particular sites and their potential effect on previously completed dose reconstructions. Since the revisions to the TBDs change the dose reconstruction methodology by which dose reconstructions are performed, NIOSH has requested the return of several cases for a new dose reconstruction. A copy of each PER is included as Attachment 1.
A list of cases that are potentially affected by the release of the PERs identified above has been generated. All of the cases on the list have a final decision issued and therefore require reopening. The comprehensive list of cases will be distributed to the appropriate district offices under separate cover.
References: NIOSH document, OCAS-PER-022, “Chapman Valve TBD Revision,” effective September 20, 2007; OCAS-PER-023, “Argonne National Lab – West TBD Revision,” effective September 20, 2007; OCAS-PER-024, “General Steel Industries TBD Approval,” effective September 25, 2007; and OCAS-PER-025, “Huntington Pilot Plant,” effective September 28, 2007.
Purpose: To provide procedures for processing claims affected by NIOSH’s Program Evaluation Reports.
Applicability: All staff.
1. In the exercise of the Director’s discretion over the reopening process, the Director is delegating limited authority to the District Directors to sign Director’s Orders for reopening. This delegated authority is limited to reopenings for those cases that are potentially affected by the PERs established for the Chapman Valve, Argonne National Lab – West, General Steel Industries, and Huntington Pilot Plant TBD revisions. The Director is retaining sole signature authority for all other types of reopenings not otherwise delegated. If the District Director is unsure of whether the delegated authority to reopen applies, the case should be referred to the National Office.
2. For those cases that have a final decision to deny based on a less than 50% Probability of Causation, the responsible District Director issues a Director’s Order vacating the final decision and reopening the claim. The Director’s Order states that the case is being reopened as a result of the change in scientific methodology by which the dose reconstruction is performed by NIOSH, and that a new dose reconstruction is necessary based on guidance provided in OCAS-PER-022 (Chapman Valve), OCAS-PER-023 (Argonne National Lab – West), OCAS-PER-024 (General Steel Industries), or OCAS-PER-025 (Huntington Pilot Plant), as appropriate. The District Director enters the status code “MN” (NO Initiates Review for Reopening) into ECMS B with a status effective date as the effective date of this bulletin. If the District Director is also reopening Part E, the “MN” code is also input in ECMS E.
For all reopenings per this bulletin, upon completing the Director’s Order to reopen the claim, the District Director enters status code “MD” (Claim Reopened – File Returned to DO) into ECMS B to reflect that the case has been reopened and is in the district office’s jurisdiction. (The “MZ” status code is not necessary.) The status effective date of the “MD” code is the date of the Director’s Order. If the Director’s Order reopens the Part E claim, the “MD” code is also input in ECMS E.
Please note that while the “MD” code is generally input by National Office staff, entry of this code has been delegated to the District Director, just as the authority to grant reopenings has been in this specific circumstance.
3. The Claims Examiner (CE) then prepares the case for a return to NIOSH for a new dose reconstruction. When referring these cases to NIOSH for a new dose reconstruction, a request to the National Office Health Physicist is not required. Instead, the Claims Examiner (CE) completes an amended NIOSH Referral Summary Document (ANRSD) and forwards the ANRSD to the Public Health Advisor (PHA) assigned to the district office at NIOSH. The ANRSD should include the following statement in the “DOL Information” section, “Rework request due to the release of [identify appropriate PER] and any other changes.” The CE also:
a. Sends a letter to the claimant explaining that the case has been returned to NIOSH for a new dose reconstruction as a result of a change in the dose reconstruction methodology. A sample letter to the claimant is included as Attachment 2.
b. Sends a copy of this letter to the PHA at NIOSH assigned to the DO with the weekly DO submissions to NIOSH. The dates on the ANRSD and the letter to the claimant must both be the same, since this will be the date used for the status code entry into ECMS. The CE enters status code “NI” (Sent to NIOSH) into ECMS B and selects the “PEP” (Rework based on Program Evaluation Plan) reason code.
The “NI” status code should only be entered in ECMS E after toxic exposure development is complete and the CE cannot accept causation. In that case the CE creates a memorandum to file stating that toxic exposure development is complete. The CE then enters status code “NI-PEP” into ECMS E with the date of the memorandum as the status effective date.
(Note: Since this is considered a new dose reconstruction, the CE should not change the existing NR/DR status code to NR/RW as typically done for rework cases. Furthermore, if a POC value is already entered into ECMS, the CE should not delete the POC. The new Probability of Causation (POC) will simply be updated into both ECMS B and E once it is calculated.)
Upon receipt of the revised dose reconstruction report, the CE proceeds in the usual manner and prepares a recommended decision. The CE enters status code “NR” (Received from NIOSH) into ECMS B and selects the “DR” (Dose Reconstruction Received-POC) reason code. The status effective date is the date the dose reconstruction is date stamped into the district office. If the CE had previously entered “NI” in ECMS E, the CE also enters codes “NR” and “DR” into ECMS E. If the case is an E/B case, the CE enters the Probability of Causation into ECMS B and ECMS E regardless of whether an “NI” status code had previously been entered.
4. All cases on the DEEOIC generated list must be reviewed to determine if it qualifies for a return to NIOSH for a new dose reconstruction. If after review, the adjudicator determines that a case on the list does not require any action to be taken, the CE/FAB HR must write a brief memo to the file that explains the case was reviewed under this bulletin, no additional action is necessary, and why. A case classified as not requiring any action is a case that does not meet the criteria for a return to NIOSH, the case is already at NIOSH, or NIOSH has determined that a dose reconstruction is not necessary.
The CE must then code “NA” (No Action Necessary) and select the appropriate reason code from the reason code drop down list. The “NA” coding is specifically tied to the review list generated by DEEOIC and the “NA” code is restricted to ECMS B only because the review list is derived from Part B data. For cases that were reviewed under this bulletin and require no additional action, the reason code that must be selected is “24P” (Reviewed under Bulletin 08-24). Even if the case is an E/B case, the NA-24P must be coded into ECMS B only. 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.
Please note that if the CE discovers that the claimant(s) is/are deceased, the CE must still enter the “NA-24P” code in addition to the closure code. The status effective date for the “NA” coding is the date of the memorandum to file.
5. It is possible that during the course of the review of these cases, NIOSH may supply the National Office with individual Program Evaluation Reports (PER) or Individual Case Evaluations (ICE) for cases (or a PER that represents a population of cases) potentially affected by this PER. The individual PER or ICE will serve as documentation that the case file has been reviewed by NIOSH and that NIOSH has determined that:
· the change outlined in the PER affects the outcome of the claim and a return to NIOSH for a new dose reconstruction is necessary, or
· there are multiple changes that affect the dose reconstruction and a return to NIOSH for a new dose reconstruction is necessary, or
· the change outlined in the PER does not affect the dose reconstruction, nor do any other changes affect the dose reconstruction and a return to NIOSH is not necessary.
If NIOSH provides DEEOIC with an individual case PER or ICE, the CE enters the code “LNR” (Letter/Response Received from NIOSH) and “824” reason code from the reason code drop down menu into ECMS B. The claim status date of the code is the date the response is received in the appropriate office, which is the date of the date stamp. If the “NI” status code had previously been entered in ECMS E, the CE also enters codes “LNR” and “824” into ECMS E.
If the individual case PER or ICE indicates that the case should “Return to NIOSH” for a new dose reconstruction, the District Director issues a Director’s Order (if appropriate) reopening the case. Upon reopening, the district office should refer the case to NIOSH for a new dose reconstruction as instructed in this bulletin.
If the individual case PER or ICE indicates that the case was “Evaluated with No Change” but does not include a dispositive statement, the District Director issues a Director’s Order referring the case to NIOSH for a new dose reconstruction. In order to be dispositive, NIOSH must indicate that they have evaluated the case against this PER and any other changes, and determined that a new dose reconstruction is not necessary. If the individual case PER or ICE is dispositive, then no action is necessary and the CE enters the “NA” status code into ECMS B as instructed in Action Item #4.
Individual case PERs or ICEs received in the National Office, will be forwarded to the appropriate district office for inclusion in the case file.
6. If a claimant requests a reopening of his/her claim as a result of the PERs released for Chapman Valve, Argonne National Lab – West, General Steel Industries, or the Huntington Pilot Plant, and the case is not on the list referenced in the Background Section of this Bulletin the District Director prepares a memorandum to the Director of DEEOIC and forwards the case file to National Office for review using the standard reopening process.
7. In carrying out the policy outlined in this Bulletin, personnel must understand that the comprehensive list not only provides the "to do" list of cases requiring attention, but it also serves as a means of tracking progress. As part of tracking progress, the list becomes the "pending" list and it is the goal to successfully and accurately review cases and enter appropriate ECMS coding which will result in “the case being removed from the list” (in other words, will result in an indicator for reporting purposes showing that the initial review was completed and/or that subsequent action was taken). ECMS coding is at the claim level and so the 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 terms of ECMS coding, it is crucial to be thorough and precise. The most obvious example of this is the use of the “C2” (administrative closure) code. “C2” will not remove a case from the pending list; the "NA" code must be entered for each claim to which it applies after input of the “C2” code. In terms of codes that will remove cases off the pending list, any “NI” code entered after the bulletin effective date will remove it and proper use of the “NA” code will remove it from the pending list. These are not the only codes that will remove cases from the pending list, but rather are provided as examples to show their importance. Any additional questions regarding proper ECMS coding must be directed to the Policy Branch.
8. The operational plan goal for the list of cases identified for review as part of a new SEC class, PEP, or PER is to complete the Part B recommended decision, return to NIOSH, or determine that no action is necessary within 45 days of the date of this Bulletin for at least 50% of the cases, and within 90 days for 95% of the cases. All cases requiring action due to this Bulletin should be completed within 120 days.
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: All DEEOIC Employees
Distribution List No. 7: Resource Centers