<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 you have been diagnosed with colon cancer. A subsequent final decision was issued by the FAB on June 10, 2006, which denied your claim for this condition under Part E, again based on insufficient evidence to establish that you have been diagnosed with this illness.

 

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 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 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:

 

U.S. Department of Labor, DEEOIC

Cleveland District Office

1001 Lakeside Avenue, Suite 350

Cleveland, OH 44114

 

If you have any questions about the Director’s Order, you may contact the Unit for Policies, Regulations and Procedures at 202-693-0081.

 

Sincerely,

 

 

 

[Name]

[Title]

DEEOIC


 

 

EMPLOYEE:                                                                         Joe C. Claimant

 

CLAIMANT:                                                                        Joe C. Claimant

 

FILE NUMBER:                                                                   XXX-XX-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 the EEOICPA. You claimed that you had developed colon cancer as a result of your employment at a Department of Energy (DOE) facility.

 

Form EE-3, Employment History, states that you were employed 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, no medical evidence was submitted to establish that you had been diagnosed with this illness. As such, the district office issued four letters, dating from July of 2004 to December of 2004, requesting that you provide evidence to establish that you had been diagnosed with colon cancer, and that this condition was a result of occupational exposure. However, no evidence was received.

 

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 findings of the district office were later affirmed by the FAB in a final decision of March 6, 2005. Subsequently, on May 1, 2006, a recommended decision was also issued by the district office to deny your claim for colon cancer under Part E; again citing insufficient evidence that you had been diagnosed with the claimed illness. After independent assessment and review, the FAB affirmed the findings of the district office by final decision of June 10, 2006.

 

In a submission received by the district office on April 26, 2007, you provided a pathology report and additional medical records which confirm your diagnosis with colon cancer.   Accordingly, your case file was forwarded 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 that you have been diagnosed with the claimed condition of 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 that you were diagnosed with colon cancer. Additionally, various medical reports and progress notes establish your diagnosis and treatment for this illness ranging from 2002 to present. This new evidence negates the basis of the March 6, 2005 and June 10, 2006 final decision denying your Part B and Part E claims. As such, it is necessary to vacate these prior final decisions so that the new medical evidence may be evaluated by the district office and a new recommended decision issued.

 

 

 

CONCLUSION

 

The March 6, 2005 and June 10, 2010 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