Energy Employees Occupational Illness Compensation Program September 2009 Mission of EEOICPA To deliver benefits to eligible employees and former employees of the Department of Energy (DOE), its contractors and subcontractors or to certain survivors of such individuals, as provided in the EEOICPA. The mission also includes delivering benefits to certain beneficiaries of Section 5 of the Radiation Exposure Compensation Act (RECA). 1 Background of EEOICPA Part B – became effective July 31, 2001 Part E – became effective October 28, 2004; created to replace Part D Program Agencies Department of Labor (DOL) Department of Energy (DOE) Department of Health & Human Services (HHS) Department of Justice (DOJ) 2 EEOICPA COMPENSATION $5 Billion Total MEDICAL 7% Compensation $3 Billion Part B PART E $1.65 Billion Part E 32% PART B 61% $350 Million Medical 3 Data as of July 27, 2009 A Quick Look at Part B Radiation induced cancer “Special Exposure Cohort” Beryllium Disease Silicosis (for miners in Nevada and Alaska) “Supplement” for RECA uranium workers 4 Part B: Who’s Eligible? DOE employees (Feds) DOE contractors/subcontractors Atomic Weapons Employers (AWE) Beryllium vendors (BV) Certain survivors of deceased workers RECA Section 5 uranium workers 5 Part B: Who’s Eligible? (cont’d) Presumptive coverage for workers with 22 specified cancers at SPECIAL EXPOSURE COHORT (SEC) sites Fourlegislated – 3 Gaseous Diffusion Plants, plus Amchitka 44 SEC classes added by HHS so far 6 Under Part B Eligible Survivors (at time of compensation payment): Spouse – married to covered employee for at least one year immediately prior to death Children (if there is no surviving spouse) Parents (when there is no surviving spouse or child) Grandchildren (when there are no preceding survivors) Grandparents (when there are no preceding survivors) 7 Basic Part B Claim Criteria – Employment DOE Employee DOE Contractor or Subcontractor Beryllium Vendors Atomic Weapons Employer Approved Section 5 RECA claims 8 Basic Part B Claim Criteria – Medical Illnesses Any malignant cancer (at least as likely as not caused by radiation exposure) Chronic Beryllium Disease Chronic Silicosis (only for employees who worked during the mining of atomic weapon test tunnels in Nevada or Alaska) Beryllium Sensitivity 9 Basic Part B Claim Criteria – Burden of Proof Claimant carries the burden to prove the elements of the claim DOL will assist in collection of evidence, i.e. medical documentation, employment & exposure records 10 Part B Benefits $150,000 lump sum compensation payment Medicalbenefits for covered conditions Medical treatment and monitoring only for beryllium sensitivity 11 Uranium Worker Part B Benefits under the EEOICPA DOL verifies RECA Section 5 award with the DOJ to determine coverage and compensation Section 5 awardees from DOJ receive $50,000 and medical benefits under Part B of the EEOICPA 12 A Quick Look at Part E Any occupational illness with causal relationship to toxic substance/chemical supported by well reasoned and rationalized medical evidence DOE contractor/subcontractor or worker at RECA Section 5 facility Certain survivors of deceased workers; eligible spouse; if no spouse, eligible child Available compensation based on permanent impairment, years of eligible wage loss, medical care for covered conditions, and for survivors, if employee’s death caused, contributed to, or aggravated by covered illness 13 Part E: Who’s Eligible? DOE contractors and subcontractors Does NOT include AWE, BV workers EXCEPTION: if AWE/BV is designated as a DOE contractor for remediation, and the employee worked on the remediation Eligible survivors 14 Part E Eligible Survivors (at time of employee’s death) Spouse – married to covered employee for at least one year immediately prior to death Covered Child – if no surviving spouse, a child is eligible for compensation if at the time of the employee’s death the child was: Under the age of 18, Under the age of 23 and a full-time student, continuously enrolled in an educational institution since age 18, or Any age, if incapable of self support 15 Basic Part E Claim Criteria Employment: Proof of Section 5 employment (uranium mining, uranium milling, or ore transporting) at a Section 5 facility (uranium mine or uranium mill), and exposure to a toxic substance Medical: Diagnosed illness, e.g. asbestosis, cancer, dermatitis, asthma, etc. 16 Basic Part E Claim Criteria cont’d Proof of Survivorship Eligibility: i.e. Marriage Certificate, Birth Certificate Burden of Proof: Claimant carries the burden to prove the elements of the claim DOL will assist in collection of evidence, i.e. medical documentation, employment & exposure records 17 Part E Benefits $250,000 maximum lump sum compensation payment per covered employee (includes wage loss and/or impairment $175,000 Maximum survivor benefit $125,000 standard survivor lump sum compensation benefit + additional $25,000 or $50,000 for established wage loss State Workers’ Compensation/Tort offset can be applied Medical benefits for covered conditions 18 Survivor – Compensation Categories Category 1 – employee death was caused, contributed to, or Category 1 $125,000 aggravated by toxic exposure Category 2 Category 2 – Category 1 plus $150,000 employee had 10 years- 19 years wage loss due to covered illness Category 3 $175,000 Category 3 – Category 1 plus employee had 20 years or more wage loss due to covered illness 19 Section 5 Uranium Workers and Part E of the EEOICPA Part E expands eligibility for Section 5 uranium workers (uranium miners, millers, and ore transporters) and their eligible survivors Treated same as covered DOE contractor/subcontractor employees and eligible for same benefits An award under Section 5 of RECA administered by DOJ is NOT required for consideration under Part E of the EEOICPA 20 Means of Verifying Exposure DOL Resource Centers Occupational History Questionnaires (OHQ) DOE Document Acquisition Request (DAR) Former Worker Protection Records (FWP) Claimant Records 21 Means of Verifying Exposure cont’d Site Exposure Matrices (SEM) Identifies toxic substances related to labor categories, processes, buildings, and major incidents Designed to assist with exposure evaluation and houses exposure information for uranium sites 4,170 Uranium Mines 48 Uranium Mills 17 Ore Buying Stations A version of the SEM database is available to the public on the DEEOIC website at http://www.sem.dol.gov/ 22 Proving Causation Under Part E of the EEOICPA “At least as likely as not” that exposure to a toxic substance (including radiation) at a Section 5 facility (uranium mine or uranium mill) was a significant factor in causing, contributing to, or aggravating the worker’s illness Automatic establishment of causation for the condition Part B condition accepted by DOL For survivor claims, causation between covered condition and death must also be established 23 Part E: Impairment Determination of % of permanent whole body impairment due to covered illness Impairment rating performed at maximum medical improvement (MMI) Well-stabilized and unlikely to improve with medical treatment Covered illness in terminal stage prior to MMI DOL proceeds to determine impairment rating Standard Applied – 5th Edit. AMA’s Guides to the Evaluation of Permanent Impairment Decreased function in a body part or organ established by medical evidence Claimant may request re-evaluation every two years or upon acceptance of new illness $2,500 awarded for each percentage point of impairment 24 Impairment Rating Procedures Options For Getting Impairment Rating: Option 1- Physician of the employee’s choice OR Option 2- DOL gathers appropriate tests and has a qualified physician complete an impairment evaluation based on the medical records Criteria for Physician Selection: Trained and certified to perform impairment ratings using the AMA’s Guides to the Evaluation of Permanent Impairment, or experience using the Guides 25 Part E: Wage Loss Evidence must show reduced earned wages prior to reaching normal SSA retirement age as a result of a covered illness due to exposure to a toxic substance at a DOE facility or RECA Section 5 facility Calculations based on evidence from multiple sources including SSA earnings, tax documents, & wage earnings records Earnings adjusted for inflation to determine years qualifying for wage loss award Claimants may file for additional qualifying years of wage loss 1 year after initial payment Employee potentially eligible for $10,000 or $15,000 per year in wage loss benefit depending on level of wage loss 26 Issuing Decisions Recommended decision – issued by the District Office (DO) Waive objections File objections Review of Written Record Oral Hearing Final decision – issued by the Final Adjudication Branch (FAB) Reconsideration within 30 days Reopening at any time (with new evidence or change in Program) Federal Court 27 Claimant Resources Resource Centers – 11 locations Takes claims and provides customer service Newly expanded assistance capabilities District Offices – 4 locations Toll Free Phone Numbers DEEOIC Website General program information Forms Sample decisions SEM Website 28 Program Statistics For Part B and Part E available at DOL’s web site: http://www.dol.gov/esa/owcp/energy/regs/compliance /weeklystats.htm By state and worksite available at: http://www.dol.gov/esa/owcp/energy/regs/compliance /statistics/Statistics.htm Updated daily 29 30 Resource Center Contact Info Las Vegas Resource Center Idaho Resource Center Office Manager Office Manager Name: Joe Krachenfels Name: Steve Beehler E-mail: email@example.com E-mail: firstname.lastname@example.org Resource Center Address/Phone Resource Center Address/Phone Flamingo Executive Park Exchange Plaza 1050 East Flamingo Road, Suite W-156 1820 East 17th Street, Suite 375 Las Vegas, NV 89119 Idaho Falls, ID 83404 Telephone: (702) 697-0841 Telephone: (208) 523-0158 Fax: (702) 697-0843 Fax: (208) 557-0551 Toll Free: (866) 697-0841 Toll Free: (800) 861-8608 Denver Resource Center Espanola Resource Center Office Manager Office Manager Name: Janele Horner Name: Karen Martinez E-mail: email@example.com E-mail: firstname.lastname@example.org Resource Center Address/Phone Resource Center Address/Phone 8758 Wolff Court, Suite 101 412 Paseo De Onate, Suite "D" Westminster, Colorado 80031 Espanola, NM 87532 Telephone: (720) 540-4977 Telephone: (505) 747-6766 Fax: (720) 540-4976 Fax: (505) 747-6765 Toll Free: (866) 540-4977 Toll Free: (866) 272-3622 31 District Office Jurisdictional Map 32 District Office Contact Info District Office 3 -- Denver, Colorado (Arkansas, Colorado, Iowa, Kansas, Louisiana, Missouri, Montana, Nebraska, North Dakota, Oklahoma, South Dakota, Texas, Utah, Wyoming and all claims from RECA Section 5 awardees) Address Phone Numbers U. S. Department of Labor, DEEOIC (720) 264-3060 (Main) 1999 Broadway, Suite 1120 (720) 264-3099 (Fax) P.O. Box 46550 (888) 805-3389 (Toll Free) Denver, Colorado 80201-6550 District Office 4 -- Seattle, Washington (Alaska, Arizona, California, Idaho, Hawaii, Marshall Islands, Nevada, New Mexico ,Oregon and Washington) Address Phone Numbers U. S. Department of Labor, DEEOIC (206) 373-6750 (Main) 719 2nd Avenue, 6th floor Suite 601 (206) 373-6798 (Fax) Seattle, Washington 98104 (888) 805-3401 (Toll Free) 33 Questions?
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