<Date>

 

Joe C.  Claimant

123 Main Street

City, State, Zip

 

Dear Mr. Claimant:

 

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

 

On March 6, 2005, the Final Adjudication Branch (FAB) issued a Final Decision denying your claim for colon cancer under Part B of the EEOICPA, citing the lack of medical evidence to establish that a physician diagnosed you with colon cancer. The FAB issued a subsequent Final Decision on June 10, 2006, which finalized the Part E denial of your claim because the case file did not contain evidence of your diagnosis with colon cancer.   

 

The EEOICPA allows for review by the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC) of decisions issued by the FAB.  It is solely within the Director’s discretion to review and reopen such claims as necessary.  The Director has delegated the authority to review and issue determinations for certain claims to the District Director having jurisdictional authority over the case.

 

A recent review of your case reveals that medical evidence received by the Cleveland District Office on April 26, 2007 confirms your diagnosis of colon cancer and this new evidence is sufficient to warrant reopening your claims under both Part B and Part E.  Accordingly, the attached Director’s Order vacates the March 6, 2005 and June 10, 2006 Final Decisions denying your claims for benefits for the condition of colon cancer under Part B and Part E, respectively.  The attached Director’s Order explains in more detail the reasons for this decision.  The district office is directed to evaluate the new medical evidence in support of your claims, and issue a new Recommended Decision to address your eligibility under both Part B and Part E of the Act.

 

 

Your case file is being returned to the [district office] of DEEOIC.  All future correspondence concerning your claim should be directed to:

 

DOL DEEOIC Central Mail Room Correspondence

P.O. Box 8306

London, KY 40742-8306

 

If you have any questions about the Director’s Order, you may contact the [district office] at [district office telephone number].

 

Sincerely,

 

 

 

[Name]

[Title]

DEEOIC


 

 

EMPLOYEE:                                                                         Joe C. Claimant

 

CLAIMANT:                                                                        Joe C. Claimant

 

CASE ID:                                                                              1234

 

DOCKET NUMBER(S):                                                     00000-2003

                                                                                                00000000-2006

 

DIRECTOR’S ORDER

 

The Energy Employees Occupational Illness Compensation Program Act (EEOICPA or the Act) Regulations at 20 C.F.R. § 30.320 state that a Final Decision, or any other decision issued by the Final Adjudication Branch (FAB), may be reopened at any time on motion of the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC).   It further states that the case may be reopened without regard to whether new evidence or information is presented or obtained, and that the decision whether or not to reopen a case is solely within the discretion of the Director of the DEEOIC.

 

For the reasons set forth below, the March 6, 2005 and June 10, 2006 Final Decisions denying your claims for benefits for the condition of colon cancer under Part B and Part E, respectively, are vacated.  The case is returned to the Cleveland District Office to proceed as outlined below.

 

BACKGROUND

 

The evidence of record shows that on March 7, 2004, you filed claims for benefits under both Part B and Part E of the EEOICPA.  You claimed that you developed colon cancer as a result of your employment at a Department of Energy (DOE) facility.

 

Form EE-3, Employment History, includes information describing your work as a production worker at the Iowa Army Ammunition Plant (IAAP) in Burlington, Iowa, from May 3, 1965 to May 25, 1971.  The DOE was able to verify the claimed dates of employment at the IAAP.

 

With regard to the claimed condition of colon cancer, you did not submit medical evidence to establish the diagnosis.  As such, the district office issued four letters, dating from July of 2004 to December of 2004, requesting that you provide evidence to establish your diagnosis with colon cancer, and that the condition  resulted from your occupational exposure to a toxic substance.  However, you provided no further evidence.

 

Accordingly, on January 28, 2005, the district office issued a Recommended Decision to deny your claim for colon cancer under Part B of the EEOICPA; finding insufficient evidence to establish that you were diagnosed with colon cancer.  The FAB finalized the recommendation in a Final Decision of March 6, 2005. 

 

Subsequently, on May 1, 2006, the district office also issued a Recommended Decision to deny your claim for colon cancer under Part E; again citing insufficient evidence that you were diagnosed with the claimed illness.  After an independent assessment and review, on June 10, 2006, the FAB issued a Final Decision finalizing the findings of the district office.

 

In a submission received by the district office on April 26, 2007, you provided a pathology report and additional medical records to confirm your diagnosis with colon cancer.  Accordingly, the district office referred your case file to the Office of the Director for review and consideration of reopening claims under both Part B and Part E of the Act.

 

DISCUSSION

 

After careful assessment of your case record, I find it necessary to vacate the March 6, 2005 and June 10, 2006 Final Decisions denying your claims for benefits for the condition of colon cancer under Part B and Part E, respectively.  Sufficient evidence exists to establish your diagnosis with colon cancer.  As such, additional development is required to determine your eligibility to benefits under both Part B and Part E of the EEOICPA.

 

On April 26, 2007, you submitted new medical evidence in support of your claims for colon cancer.  This new evidence includes a pathology report dated January 16, 2002, confirming your diagnosis with colon cancer.   Additionally, various medical reports and progress notes, ranging from 2002 to the present, establish your diagnosis and treatment for this illness.  This new evidence invalidates the basis of the March 6, 2005 and June 10, 2006 Final Decisions denying your Part B and Part E claims.  As such, it is necessary to vacate these prior Final Decisions so that the district office may proceed with a new examination of your eligibility under Part B and Part E for colon cancer. 

 

 

CONCLUSION

 

The March 6, 2005 and June 10, 2006 Final Decisions, respectively, denying your claim for colon cancer under Part B and Part E are vacated.  The district office is directed to evaluate the new medical evidence in support of your claims and issue a new Recommended Decision to encompass your eligibility to benefits for the condition of colon cancer under both Part B and Part E of the Act.

 

Should you disagree with the decision, you will be afforded the opportunity to file an objection and request an oral hearing or a review of the written record.

 

Washington, D.C.

 

 

 

[Name]

[Title]

DEEOIC


 

 

CERTIFICATE OF SERVICE

 

 

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

 

Joe C. Claimant

123 Main Street

City, State, Zip

 

 

 

[Name]

[Title]

DEEOIC