TABLE OF CONTENTS
Paragraph and Subject Date Trans. No.
Chapter 2-0100 Introduction
Table of Contents . . . . . . . 03/16 16-05
1 Purpose and Scope . . . . . . . 03/16 16-05
2 Staff Responsibilities . . . . 03/16 16-05
3 Reference Materials for
Claims Examiners . . . . . . . 03/16 16-05
1. Purpose and Scope. Part 2 of the Federal (EEOICPA) Procedure Manual (PM) outlines the policies, guidelines and procedures for developing, adjudicating and managing claims under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Topics included in Part 2 relate to claim intake, eligibility criteria, developing evidence, application of program policy, and issuing decisions.
2. Staff Responsibilities. District Office and Final Adjudication Branch (FAB) staff within the Division of Energy Employees Occupational Illness Compensation (DEEOIC) develop and adjudicate claims, provide courteous and timely responses to requests for information, comply with program policy to reach fair and consistent claim outcomes, initiate compensation payments, and monitor assigned caseloads.
a. Processing Claims. The mission of a DEEOIC Claims Examiner (CE), FAB Hearing representative (HR), and FAB CE is to exercise keen judgment, derived from experience, background, and acquired knowledge, tempered with compassion and common sense. This involves the ability to assess evidence, consider pertinent issues, and make well-rationalized judgments. DEEOIC claims staff are to evaluate each case comprehensively based on the unique characteristics of the information present. Moreover, staff are to apply an objective analysis of the evidence that comports with the legal, regulatory and procedural guidance in guiding claim adjudication. Decisions issued by DEEOIC staff are to include a description of evidence considered; analysis and interpretation of information supporting factual findings; and provide a clear, understandable decision.
3. Reference Materials for Claims Examiners. DEEOIC district and FAB offices have full access to a range of reference materials and programmatic resources that are available through a publically accessible website. In addition, DEEOIC makes locally available other material that assists its staff in adjudicating claims. Reference materials available to staff include:
a. Energy Employees Occupational Illness Compensation Program Act (EEOICPA) of 2000, as amended, 42 U.S.C. § 7384 et seq.
b. 20 CFR Parts 1 and 30 (Regulations) – Claims for Compensation Under the Energy Employees Occupational Illness Compensation Program Act, issued December 29, 2006.
c. Executive Order 13179, signed December 7, 2000.
d. Federal EEOICPA PM.
e. Bulletins, Circulars and Program Memoranda.
f. Guides to the Evaluation of Permanent Impairment, 5th Edition, American Medical Association.
g. ICD9/10 coding manuals or online resources.
h. NIOSH Regulations on dose reconstruction and probability of causation (42 CFR Parts 81 and 82, Guidelines for Determining the Probability of Causation and Methods for Radiation Dose Reconstruction Under the Employees Occupational Illness Compensation Program Act of 2000; Final Rules).
i. The Federal Register publications listing covered facilities.
j. User’s Guide for the Interactive RadioEpidemiological Program (NIOSH-IREP).
k. Interagency contacts or website links
l. Shared Drive maintained by the NO.
m. Site Exposure Matrix (SEM).
n. Energy Compensation System (ECS) user guidance and procedures
o. OWCP Imaging System (OIS) User Guide and indexing guidance