Energy Employees Occupational Illness Compensation Program

ExcavationThis is a guide to navigating the complicated EEOICP process.

It is nearly impossible to put these directions in simple terms. If you are seeking compensation under EEOICP, we recommend you read the following. We are building a referral list of helpful lawyers (like the author of this section) and specialists.

Guide for EEOICP Applicants – Sections

Guide for EEOICP Applicants, by Anne Block

The Energy Employees Occupational Illness Compensation Program (EEOICP) is a federal program designed to assist sick energy workers who have illnesses proving to be contributed to, aggregate, or caused as the result of the employee’s employment at a covered Department of Energy (DOE) facility. Adjudication of all claims for benefits under the EEOICPA is the responsibility of the Department of Labor (DOL). The DOL is supported in its role by the DOE, the Department of Health and Human Services, and the Department of Justice.

The purpose of the EEOICP is to provide lump-sum compensation and health benefits to eligible DOE nuclear weapons employees, former employees, contractors, and subcontractors, and lump-sum compensation to certain survivors, so long as the employee’s covered DOE employment contributed to, aggregated, or caused the death of the employee. Proving that the employee’s covered DOE employment contributed to, aggravated, or caused the employee’s medical conditions has proven to be a high ladder to climb.

Who is eligible:

 

  • Current and former DOE employees
  • Current and former DOE contractors and subcontractors
  • Atomic Weapons Employers (AWE)
  • Beryllium Vendors (BV)
  • Uranium miners, millers, and ore transporters who worked at facilities covered by Section 5 of RECA
  • Certain family members of deceased workers

What benefits are provided under Part B:

 

  • $150,000 maximum compensation (radiogenic cancer, chronic beryllium disease, chronic silicosis)
  • Medical benefits are available in addition to compensation
  • No monetary compensation for beryllium sensitivity, medical monitoring only


Special Exposure Cohort (SEC):

  • Certain DOE SEC facilities grant automatic acceptance under Part B of the EEOICP; see NIOSH SEC facilities list HERE.
  • Automatic SEC acceptance for the following cancers
  • Bone cancer
  • Renal cancers
  • Leukemia (other than chronic Special Exposure Cohort – listed cancers lymphocytic leukemia) provided the onset of the disease was at least two years after first exposure
  • Lung cancer (other than in-situ lung cancer that is discovered during or after a post-mortem exam)
  • The following cancers with onset at least five years after first exposure:
  • Multiple myeloma
  • Lymphomas (other than Hodgkin’s disease)
  • Primary cancer of the:
  • Bile ducts
  • Brain
  • Breast (female)
  • Breast (male)
  • Colon
  • Esophagus
  • Gall bladder
  • Liver (except if cirrhosis or hepatitis B is indicated)
  • Ovary
  • Pancreas
  • Pharynx
  • Salivary gland
  • Small intestine
  • Stomach
  • Thyroid
  • Urinary bladder

RECA:

  • If an employee or survivor received an award under Radiation Exposure Compensation Act (RECA) Section 5, the DOL only pays $50,000 in compensation.
  • Medical benefits are available in addition to compensation.

Proving Causation under Part B

  • The National Institute for Occupational Safety and Heath (NIOSH) performs a dose reconstruction.
  • NIOSH analyzes historical radiation dose records.
  • NIOSH claims that the employee receives a favorable dose estimate.
  • NIOSH issues a Probability of Causation (PoC) calculation; if the PoC is 50% or higher, the DOL must accept the claim.

Basic Part E Claim Criteria

  • Employment: proof of contractor or subcontractor employment at a covered DOE facility; Click HERE for a list of covered DOE facilities.
  • Medical: must have a firm diagnosed illness; examples include asbestosis, cancer, chronic beryllium disease, dermatitis, asthma, etc.
  • Toxic chemical exposure: The DOL designed a Site Exposure Matrices (SEM) website to assist employees in documenting whether or not the medical condition and toxic chemicals are liked to employment at a covered DOE facility. The examiner’s Part E Procedure Manual also requires that the examiner use Haz-Map.
  • Burden of Proof is on the claimant: Although Congress mandated that the EEOICP be a “claimant friendly” program, and even gave examiners explicit power to obtain medical documents on behalf of sick workers, examiners are trained and told not to contact the employee’s medical doctor for more information. Therefore, it’s vital that the claimant submit the necessary proof to establish a compensable claim.
  • Recognized children: a recognized natural child of the covered employee, a stepchild who lived with the covered employee in a regular parent-child relationship, or a legally adopted child of the employee who as of the date of the employee’s death establishes one of the following three: (1) s/he was under the age of 18 years at the time of the covered employee’s death, or (2) under the age of 23 years and a full time student at the time of the covered employee’s death, or (3) any age and incapable of self-support at the time of the covered employee’s death.

Proving Causation under Part E

  • “At least as likely as not” (50% or greater) that exposure to a toxic substance while employed at a covered DOE facility was a significant factor in aggravating, causing, or contributing to the employee’s medical condition(s) or caused the death of the employee.
  • If the employee receives a letter from their medical doctor stating that their illness(es) were “as likely as not” a significant factor in aggravating, causing or contributing to the employee’s illness(es) while employed at a covered DOE facility, the employee should submit that letter to the DOL as soon as possible.
  • Automatic approval for diagnosed asbestosis, pulmonary fibrosis, and lung diseases so long as medical documentation meets Part E eligibility requirements; see
  • Part D condition accepted by DOE
  • If a Part B condition has been accepted by the DOL, the DOL must accept for the same conditions under Part E.
  • RECA Section 5 condition accepted by DOJ

When eligible:

  • Eligible survivors become eligible upon the employee’s death.

What benefits are provided under Part E:

  • Wage loss: The employee is entitled to wage loss so long as wage loss occurs before retirement age (normally 65). Lost wages are based on the number of years that the employee was unable to work or sustained a reduction in earnings as a result of the accepted illness.
  • Wage loss compensation is calculated at:
  • $10,000 for each year in which wages were 25-50% less than the Average Annual Wage (AAW). The AAW is the average earnings for the 12 quarters (36 months) prior to the first quarter of wage loss.
  • $15,000 for each year in which wages were less than 50% of the AAW
  • Impairment is a decrease in the functioning of a body part or organ that affects the whole body, as a result of the accepted illness. An impairment rating is performed once the claimant has reached Maximum Medical Improvement. Impairment compensation is limited to $2500 for each one percent of whole body impairment. An employee is entitled to have a new impairment rating every two years for the same accepted medical condition(s).
  • Survivor benefits include compensation of $125,000, so long as the employee’s employment at a covered DOE facility contributed to, aggravated, or caused the employee’s death.
  • Survivors can also be awarded wage loss as a result of the employee’s covered illness(es), so long as the wage loss was prior to the employee’s Social Security Retirement age (usually age 65); additional survivor’s wage loss compensation may be awarded as follows:
  • $0 – if the employee had less than 10 years of wage loss
  • $25,000 – if the employee had between 10 and 19 years of wage loss
  • $50,000 – if the employee had 20 years or more wage loss
  • Total survivor compensation under Part E not to exceed $175,000

TIPS:

  • Always request a complete copy of your EEOICP file. To request a complete copy of your file, send a Privacy Request to the District Office that has jurisdiction over your claim; see DOL’s Office list HERE.
  • Claims are not post dated, so claims should be filed as soon as the employee becomes ill.
  • Check to see if your diagnosed medical conditions have known toxic chemical links; see the DOL’s SEM and Haz-Map websites
  • If you are sick, list an authorized representative on your claim so that the DOL can discuss your claim with someone else when you cannot.
  • Send the DOL all medical reports, x-rays, pathology reports, etc. as soon as possible. If you cannot locate cancer documents, contact the cancer registry in the state where the employee’s cancer was diagnosed.
  • For Part E claimed conditions, contact your medical doctor and a request that s/he write an “as likely as not” letter to establish that your employment at a covered DOE facility contributed to, was aggregated by, or caused your Part E medical conditions. If your doctor writes an “as likely as not” letter, send the DOL District Office a copy as soon as possible.
  • For survivor claims, the DOL often under reports employment, therefore request a copy of the employee’s SSA Earnings Report, start here to make the request. Once you receive a copy of the SSA earnings, double check reported employers against information inside the DOL’s file.
  • Survivors should always request an autopsy upon the employee’s death. Many Part E claims are denied because of a lack of medical evidence to establish a link between the employee’s death and the claimed medical condition.
  • Always fax documents. Complaints from claimants and statements from a former EEOICP examiner, confirm that the DOL loses mail and misfiles documents consistently. Examiners “drop file” mailed in documents without reviewing the information, while faxed documents are placed directly into the examiner’s mailbox. Even when documents are faxed in, call your assigned examiner to double check receipt – and ask the examiner to log the call inside the Energy Case Management System (ECMS).
  • Once your claim is over 300 days old, the DOL removes your claim from the examiner’s status report, and it’s filed inside a file room until the overtime staff reviews it. So call your assigned examiner often; examiners are overloaded with hundreds of claims, so establishing communication with your examiner helps personalize your claim.
  • Ask the DOL examiner for their direct telephone number. The DOL’s main number is open from 8:00 am – 5 pm, Monday- Friday; however, examiners work flex hours between 6:00 am – 7:00 pm. Knowing the examiners direct telephone number allows the claimant access to their assigned examiner during the examiner’s actual work hours.
  • If you are entitled to a whole body impairment rating, do not use the DOL’s District Medical Consultants. Consistently, the DOL uses doctors who are not qualified to review specific medical conditions; example: the DOL sent a cancer claim to a psychiatrist. Find your own doctor.

File a Claim for EEOICP Benefits

  • Current and former employees should file a claim for benefits using an EE-1 form.
  • Eligible survivors should file a claim for benefits using an EE-2 form.
  • Claim forms can be mailed to the District Office where the employee last worked. Click HERE For a list of District Offices.
  • Hanford EEOICP claimants should mail or fax their applications to:

U.S. Department of Labor, DEEOIC
719 2nd Ave., Suite 601
Seattle, Washington 98104

Fax: 206-373-6798 or 206-373-6690