Sample Recommended Decision, Deny

 

EMPLOYEE:                                                             [NAME]

 

CLAIMANT:                                                            [NAME]

 

CASE NUMBER:                                                     XXXXXXXX

                                               

NOTICE OF RECOMMENDED DECISION

 

This is a Recommended Decision concerning your claim for benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA or Act)The district office recommends a denial of your Part E claim for liver disease.

 

STATEMENT OF THE CASE

 

The history of your claim shows that you have filed for and received several final decisions regarding medical conditions you claimed as being related to occupational exposure to toxic substances.  As part of the development of those prior claims, the district office has accepted that you worked for a Department of Energy (DOE) contractor at the Lawrence Livermore National Laboratory (LLNL).  Specifically, you were an administrative assistant between July 18, 1989 and September 1, 1994.

 

Recently, you filed a claim for the condition of liver disease.   Along with your claim, you submitted a narrative report from your treating physician confirming your diagnosis with sarcoidosis of the liver. Additionally, you submitted a printout of toxic substances known to be present at LLNL, noting that both trichloroethylene and vinyl chloride were present at LLNL and claiming both contributed to the onset of liver disease.

 

The DEEOIC evaluated all information available with regard to known links between chemical or biological agents and the development of liver sarcoidosis. This included reviewing employment, occupational and medical evidence in your case. Moreover, claims staff searched the Site Exposure Matrix (SEM) for any information on sarcoidosis.  The SEM is an electronic repository of known toxic materials at covered DOE facilities, along with information on the known health effects of those exposures.  None of the research conducted produced any compelling evidence to document that you were potentially exposed to any toxic substance, including trichloroethylene and vinyl chloride, during your employment,  that are linked to sarcoidosis.

 

To provide you additional opportunity to support your claim, the DEEOIC asked you to supply any evidence that might assist with the analysis of your claim.  In particular, the district office requested you submit evidence to show that, during your employment at LLNL, you were exposed to any toxic substance linked to liver disease.  No response from you was forthcoming.

 

EXPLANATION OF FINDINGS

 

As outlined above, the district office finds that you worked at the LLNL as an administrative assistant between July 18, 1989 and September 1, 1994.

 

Medical evidence submitted in support of your latest claim is sufficient to allow the district office to find that you have sarcoidosis of the liver, which a physician diagnosed in 2010. Accordingly, you meet the employment and diagnostic criteria under Part E of the Act.

 

The issue for determination in this case is whether there exists sufficient evidence that occupational exposure to a toxic substance was “at least as likely as not” a significant factor that caused, contributed to, or aggravated your diagnosed condition of sarcoidosis. A toxic substance is defined under the Act as any biological, chemical or radioactive material that has the potential to cause illness or death. 

 

Research of case evidence and all other available resources did not reveal any known scientific link between any biological or chemical exposure and the onset of sarcoidosis.  Further, case records contained no reference or other information linking your liver disease to a specific toxin to which you, as an administrative assistant, would have been exposed while working at LLNL. 

 

With regard to your assertions that trichloroethylene and vinyl chloride are linked to liver disease, our research has found no such scientific consensus. As mentioned, you were asked to submit probative evidence to support such a link’; however, you did not provide any further evidence for the district office evaluate.   Moreover, research of records obtained from the DOE, including medical or employment records, revealed no evidence of your exposure to either trichloroethylene or vinyl chloride or any other hazard that is known to induce liver disease.  The Site Exposure Matrix (SEM), which provides scientifically scrutinized information on the health effects of various toxins encountered at LLNL, also provided no data to show that an administrative assistant at LLNL had the potential to encounter any toxic substance in performance of their duties that is linked to sarcoidosis.  

 

Given the lack of information we were able to obtain regarding your claim, you were notified of the need for evidence, specifically evidence linking your illness to a toxin you encountered at LLNL.   These requests also explained that you ultimately bore responsibility for providing the evidence necessary to establish your claim.   Unfortunately, you provided no response.

 

After reviewing all available evidence, there is presently no basis to conclude that occupational exposure was “at least as likely as not” a significant factor in aggravating, contributing to or causing your diagnosed disease of sacoidosis.  As such, the district office has to recommend that your Part E claim for liver disease be denied.

 

CONCLUSIONS OF LAW

 

Based on the above, is the district office recommends a denial of your claim for liver disease under Part E of the Act.

 

Prepared by:

                       

_____________________________                          ____________  

(Name of Appropriate Signatory)                         Date

(Title)

(District Office)