| U.S. DEPARTMENT OF LABOR | OFFICE OF WORKERS' COMPENSATION PROGRAMS DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FINAL ADJUDICATION BRANCH |  |
(date) FILE NUMBER: (file number)
NAME OF EMPLOYEE: (name / employee)
(Claimant name)
(Claimant address)
(Claimant address)
Dear :
We recently received the results of the dose reconstruction conducted by the National Institute for Occupational Safety and Health (NIOSH) in regards to your claim for compensation under the Energy Employees Occupational Illness Compensation Program Act. After review of the dose reconstruction and the evidence received in support of your claim, it was discovered that [insert reason].
We determined that your claim must be returned to NIOSH so that they can review and revise the dose reconstruction, as appropriate, to include this information. This may not affect the outcome of your claim, but the information used in the dose reconstruction must accurately reflect what is shown in the evidence received by the district office. Your NIOSH tracking number xxxxx will remain the same. Your claim will receive priority consideration and the revised dose reconstruction should be completed within 60 days.
You will have the opportunity to review the revised dose reconstruction report, and will again be required by NIOSH to sign the OCAS-1 to acknowledge your receipt of the revised report and initial dose reconstruction results.
When NIOSH finishes its revised study and sends us the results, we will apply a formula to the dose reconstruction to determine whether the claimed cancer was at least as likely as not (50% or greater chance) related to the covered employment. We will then notify you in writing regarding the status of your claim.
If you have specific questions regarding the status of the dose reconstruction, you may contact the NIOSH office located in
Sincerely,
Claims Examiner
cc: NIOSH Public Health Advisor