The EEOICPA was passed in 2000. It provides compensation to workers who became ill as a result of their employment manufacturing nuclear weapons in the USA, as well as their spouses, children, and grandchildren.

Are you eligible for compensation? If you or a family member worked at any of the Atomic Weapons Employer (AWE) and Department of Energy (DOE) Covered Facilities listed on this website and became ill, you may be entitled to compensation of up to $400K plus medical benefits. Call EEOICPA Counsel Hugh Stephens at 1-855-548-4494 or fill out our free claim evaluation, We can help even if you’ve already filed, even if your claim was denied!

In these pages, we present general definitions of Illnesses covered by the Act, followed by specific references to the disease from the EEOICPA Procedure Manual, Bulletins, and Final Decisions of the Final Adjudication Board to clarify how these maldies might relate to the Energy Employees Occupational Illness Compensation Program Act.

Thyroid Cancer

 
Below we have collected specific references to thyroid cancer from the DEEOIC Procedure Manual, Bulletins, and Final Decisions, to illustrate how this illness is viewed under the EEOICPA.

 

A.D.A.M. Medical Encyclopedia.

Thyroid cancer

Tumor – thyroid; Cancer – thyroid

Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located inside the front of your lower neck.

 

Procedure Manual

 

Page 47

uu.  Specified Cancers are listed in Section 30.5(ff) of the regulations.  An employee must be diagnosed with one of these specific types of cancer to be considered eligible for benefits as a member of the Special Exposure Cohort (SEC).  The list of specified cancers, which is derived from section 4(b)(2) of the RECA Amendments of 2000, is as follows:

(5) The following diseases, provided onset was at least five years after first occupational exposure:

(c)  Primary cancer of the:

(i) Thyroid;

 

Page 176

e. Other Diseases. For the following diseases, onset must have been at least five years after initial exposure during qualifying SEC employment:

(3) Primary cancer of the:

(a) Thyroid;

 

Page 292

2. RECA Background.

c. Section 4 of RECA.

(1) Downwinders.

(b) Covered Illnesses: Leukemia (other than chronic lymphocytic leukemia), multiple myeloma, lymphomas (other than Hodgkin’s disease), and primary cancer of the thyroid, male or female breast, esophagus, stomach, pharynx, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary bladder, brain, colon, ovary, liver (except if cirrhosis or hepatitis B is indicated), or lung.

 

Page 353

 

5. Metastasized Cancer(s). Metastasized cancer(s) is a secondary cancer that originates from the primary cancer site.

b. Examples of Metastasized Cancers. It is widely accepted that certain carcinomas and/or sarcomas metastasize from the primary site. For example:

(1) Carcinomas of the lung, breast, kidney, thyroid, and prostate tend to metastasize to the lungs, bone, and brain.

 

Bulletins

 

Page 662

03-06 ECMS noncovered condition

EEOICPA BULLETIN NO. 03-06

Issue Date:  November 6, 2002

________________________________________________________________

Effective Date:  November 6, 2002

________________________________________________________________

Expiration Date:  November 6, 2003

________________________________________________________________

Subject:  Claims Filed for Non-Covered Condition(s) and Claims Filed with No Reported Condition(s).

Background:  Recent analysis of denied claims has shown that more detailed information is required to definitively capture and report in the Energy Case Management System (ECMS) medical condition types on claims that are:

1.  denied due to lack of claimed medical condition; or

2.  denied due to lack of a covered condition.

With the exception of specific cancers, most non-covered conditions currently fall into the ECMS condition type of “Other Condition – not in table.”  The use of this “Other Condition” category obscures the types of conditions that are being recommended for denials in the District Offices.  Further definition is required.  To achieve this objective, more comprehensive condition types, which fall into the category of non-covered conditions, have been added to the condition type listbox in ECMS.

These codes are to be used at the outset of development by the Case Create Clerk (CCC) and Claims Examiner (CE) in order to help identify those claims that do not meet the criteria to receive compensation under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA).

Reference:  ECMS Frequently Asked Questions (FAQs).

Purpose:  To provide guidance to District Office personnel in capturing and updating medical condition data in ECMS.  To more clearly identify claims denied because no condition was ever claimed, claims denied due to non-covered conditions, and the frequency of conditions by type that are being denied as non-covered.   

Applicability:  All staff.

Actions:

1.  The CCC looks at all the conditions claimed on the EE-1 (Box 8) or EE-2 (Box 14) claim form and matches each covered and non-covered condition with a code from the listbox in the Cond Type field on the Medical Condition Screen. 

If no condition is reported on the EE-1 or EE-2, the CCC selects NR (no condition reported) from the listbox in the Cond Type field on the Medical Condition screen.

The ECMS Medical Condition Type listbox has been expanded (beyond covered and consequential conditions) to include specific non-covered medical condition types.  These additional condition types are identified in the table below.  If any of these conditions are reported on the EE-1 or EE-2 claim form, they are entered by the CCC as noted above.

CODE	Non-Covered Medical Condition Types
99	Other Condition – not listed in table
AN	Anemia
AS	Asbestosis
BK	Back or Neck problems
BT	Benign Tumors, Polyps, Skin Spots
BU	Burns
CL	CLL (Chronic Lymphocytic Leukemia)
CT	Cataracts
DI	Diabetes
HF	Heart Failure/ Heart Attacks/Hypertension
HL	Hearing Loss
HM	Other Heavy Metal Poisoning (e.g. chromium, cadmium, arsenic,  lead, uranium, thorium, and plutonium)
MC	Multiple Chemical Sensitivity
MP	Mercury Poisoning
NE	Neurological Disorder
NR	No condition reported
OL	Other Lung Conditions:  Bronchitis; Asthma; Pulmonary Edema (except for RECA claims)
PD	COPD (Chronic Obstructive Pulmonary Disease); Emphysema
PK	Parkinson’s Disease
PL	Pre-Leukemia (note:  review attached reference for specific conditions)
PS	Psychological Conditions
RN	Renal Conditions (kidney failure, kidney stones)
TH	Thyroid Conditions (e.g. Hypothyroidism)

2.  The CCC selects from the listbox any conditions shown on the claim form.  For example, if the illness claimed is hearing loss, the CCC selects HL from the listbox in the Cond Type field on the Medical Condition screen. 

3.  The CCC selects 99(Other Condition – not in table) from the listbox if the reported condition does not appear in the listbox.  S/he also types the reported condition in the Note Text Field as it appears on the claim form.  For example, if the condition reported on the claim form is not in the listbox (e.g. cuts/bruises), the CCC selects 99 from the listbox and in the Note section s/he types “cuts/bruises.”

4.  If no condition is reported on the EE-1 or EE-2, the CCC selects NR from the listbox.

5.  The CE verifies the accuracy of the information entered by the CCC and makes changes as needed.  For example, if the claimed illness on the EE-1 or EE-2 is asbestosis and the Medical Condition screen shows that OL (Other Lung Condition) had been incorrectly entered as the Cond Type, the CE changes the claimed illness to AS (asbestosis).

6.  The CE updates the Condition Type field on the Medical Condition screen as new conditions are reported during case development.  The CE enters these updates as they occur. For example, recent medical evidence submitted by the claimant shows his/her physician is also linking COPD and multiple chemical sensitivity to his/her work exposure.  (The claim was originally filed for CBD.)  The CE selects the appropriate codes for COPD and multiple chemical sensitivity from the listbox in the Condition Type field on the Medical Condition screen.  The Claim screen would then show the three claimed conditions:

  BD  =  CBD

PD =  COPD

MC  =  Multiple Chemical Sensitivity

7.  When the selection is made from the listbox for non-covered conditions (e.g. COPD and multiple chemical sensitivity) or no condition reported, the Medical Condition Status Field on the Claim screen defaults to the R (reported) status code.  This status code will not be changed by the CE to A (accept) or D (deny) as the A and D codes are exclusively reserved for covered conditions.  An A or D status code would never be used in conjunction with a non-covered condition.  

Note:  Only when a covered condition is claimed, does the CE develop the condition and determine whether the covered condition will be A (accepted) or D (denied).  The only time this procedure would not apply is the rare situation when benefits for a condition covered under the EEOICPA are not payable because the claimed condition could not have developed at the employee’s work site.  For example, if an employee worked at Savannah River and filed a claim for silicosis, the claimed condition, silicosis, would be considered a non-covered condition and the Medical Condition Status field would remain in the R status to indicate the condition is non-covered.

8.  ICD-9 codes should not be entered for non-covered conditions.

9.  Before a recommended decision is signed by a Senior Claims Examiner (SrCE), s/he must ensure that the recommended decision accurately cites all non-covered medical conditions claimed and that correct codes from the listbox have been entered into ECMS.  The SrCE is responsible for adding any conditions that were omitted (e.g. conditions that were reported after the initial entries were made by the CCC or while the CE processed the claim) or correcting any entries that were made in error (e.g. the condition was incorrectly identified). 

10.  If a claim was filed, but no medical condition was ever reported by the claimant, the SrCE ensures the recommended decision reflects this and that ECMS contains the NR code.

11.  Backfill of medical condition types for cases denied due to lack of a claimed condition or lack of a covered condition will be mandatory in all District Offices.  This backfill project will be completed through the National Office.   

Disposition:  Retain until incorporated into the EEOICPA Procedure Manual.

PETER M. TURCIC

Director, Division of Energy Employees

Occupational Illness Compensation

Distribution List No. 1: (Claims Examiners, Supervisory Claims Examiner, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, District Office Mail & File Sections.)

Final Decisions

Page 195

EEOICPA Fin. Dec. No. 1002-2005 (Dep’t of Labor, January 17, 2006)

NOTICE OF FINAL DECISION

This is the decision of the Final Adjudication Branch concerning your claim for compensation under Part B of the Energy Employees Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or the Act), 42 U.S.C. § 7384 et seq.  For the reasons set forth below, the Final Adjudication Branch accepts and approves your claim for compensation and medical benefits for the condition of thyroid cancer, and denies your claim based on the condition of brain tumor, under Part B of the Act.

STATEMENT OF THE CASE

On August 6, 2001, you filed a Form EE-1 (Claim for Benefits under the EEOICPA), based on the conditions of thyroid cancer and brain tumor.   

You submitted a Form EE-3 (Employment History) indicating that you worked for Pan American Airlines (September 3, 1963 to April 21, 1970) and Reynolds Electrical & Engineering Company (REECo) (April 21, 1970 to February 2, 1994), at the Nevada Test Site.  A representative of the Department of Energy (DOE) verified that you were employed with REECo for four periods:  November 16 to December 30, 1970; April 21 to October 11, 1971; March 30, 1972 to July 27, 1973; and March 11, 1974 to September 30, 1993.  Based on dosimetry records, which indicated you were present at the Nevada Test Site from September 3, 1963 to April 21, 1970, that employment was verified for Pan American World Airways.  The Nevada Test Site is recognized as a covered Department of Energy facility site from 1951 to the present.  REECo is indicated as a contractor of the DOE from 1952 to 1995.  See DOE, Office of Worker Advocacy Facility List, http://www.eh.doe.gov/advocacy/faclist/showfacility.cfm (retrieved January 16, 2006).

The medical documentation you submitted included pathology reports and medical reports for your treatment of a brain tumor and thyroid cancer.  On May 22, 1993 you were diagnosed with a large meningioma of the brain and underwent resection, which reoccurred necessitating resection again on October 16, 2000.  The district office requested an opinion from your physician, Jay Tassin, M.D, whether your brain tumor was benign or cancerous.  On November 27, 2001, he responded reluctantly that “It’s a difficult question, as [] meningioma is ‘benign’ by histologic criteria, and unlikely to spread through the body via hematogenous or lymphatic seeding.”  Dr. Tassin noted the tumor has affected your condition of health and quality of life.  Other evidence of record indicates that on April 22, 1998 you underwent total throidectomy and Stephen D. McBride, M.D., diagnosed “follicular carcinoma.” 

To determine the probability of whether you sustained cancer in the performance of duty, the Seattle district office referred your claims to the National Institute for Occupational Safety and Health (NIOSH) for radiation dose reconstruction.  See 20 C.F.R. § 30.115.  The district office received the final NIOSH Report of Dose Reconstruction dated May 27, 2005. 

The radiation dose reconstruction report indicates that an efficiency model was used for the dose reconstruction.  For purposes of your radiation dose reconstruction, NIOSH used only your external dose and calculated missed dose during your work as a janitor and painter, at the Nevada Test Site.  The dose reconstruction was 8.428 rem to the thyroid.  NIOSH Report of Dose Reconstruction, p. 4.  Thus the dose is reported is an “underestimate” of your total occupational radiation dose.  NIOSH Report of Dose Reconstruction, p. 6.  The Final Adjudication Branch notes that the employment period used by NIOSH, based on dosimetry records provided by the DOE, was January 1963 to September 30, 1993 (more than the period noted above). 

Using the information provided in the Report of Dose Reconstruction, the Seattle district office utilized the Interactive RadioEpidemiological Program (IREP) to determine the probability of causation of thyroid cancer and reported in its recommended decision that there was a 51.43% probability that your thyroid cancer was caused by radiation exposure at the Nevada Test Site.  

On September 2, 2005, the Seattle district office recommended acceptance of your claim for compensation based on the condition of thyroid cancer, with medical benefits retroactive to the date of filing, August 6, 2001. 

FINDINGS OF FACT

1.  On August 6, 2001, you filed a claim for benefits. 

2.  You were diagnosed with thyroid cancer on April 22, 1998.    

3.  You worked in covered employment for REECo and Pan American World Airways, at the Nevada Test Site from September 3, 1963 to April 21, 1970, and for REECo, at the Nevada Test Site from November 16 to December 30, 1970; April 21 to October 11, 1971; March 30, 1972 to July 27, 1973; and March 11, 1974 to September 30, 1993. 

4.  The diagnosis of cancer was made after you started work at a Department of Energy facility.

5.  The NIOSH Interactive RadioEpidemiological Program indicated a 51.43% probability that your thyroid cancer was caused by radiation exposure at the Nevada Test Site.

CONCLUSIONS OF LAW

The undersigned has reviewed the recommended decision issued by the Seattle district office on September 2, 2005.  I find that you have not filed any objections to the recommended decision as provided by § 30.316(a) of the regulations, and that the 60-day period for filing such objections, as provided for in § 30.310(a) has expired.  See 20 C.F.R. §§ 30.310(a), 30.316(a). 

The Final Adjudication Branch calculated the probability of causation for your thyroid cancer using the NIOSH-IREP software program.  These calculation confirmed the 51.43% probability of causation that your thyroid cancer was “at least as likely as not” (a 50% or greater probability) caused by radiation exposure you incurred while employed at the Nevada Test Site.

While you provided proof you were diagnosed with a brain tumor, it is not a covered occupational illness.  Under Part B of EEOICPA, “only malignant tumors are covered.”  Federal (EEOICPA) Procedure Manual, Chapter 2-600.3a(1)(a) (Sept. 2004).  The available medical information does not support that meningioma is a malignant cancer, to fit within the coverage of Part B of EEOICPA.  Your claim based on brain tumor under Part B is denied, although you may wish to file a claim under Part E. 

Based on your covered employment at a covered DOE facility site and the medical documentation showing your diagnosis of thyroid cancer, and the determination that your cancer was at least as likely as not related to your occupational exposure at the Nevada Test Site, and thus sustained in the performance of duty, you are a “covered employee with cancer” under EEOICPA.  See 42 U.S.C. § 7384l(1)(B), (9)(B); 20 C.F.R. § 30.213(b); 42 C.F.R. § 81.2. 

You are entitled to $150,000.00 compensation and reimbursement of medical expenses related to the condition of thyroid cancer, retroactive to August 6, 2001, the date you filed your claim.  See 42 U.S.C. §§ 7384s and 7384t; 20 C.F.R. § 30.400(a). 

Washington, DC

Rosanne M. Dummer

Hearing Representative

Page 786

EEOICPA Fin. Dec. No. 61108-2004 (Dep’t of Labor, November 4, 2004)

NOTICE OF FINAL DECISION

This is the decision of the Final Adjudication Branch concerning your claims for compensation under the Energy Employees Occupational Illness Compensation Program Act of 2000, as amended, 42 U.S.C. § 7384 et seq. (EEOICPA or the Act).  For the reasons stated below, your claims are accepted.

STATEMENT OF THE CASE

On December 21, 2001, [Employee], (hereinafter referred to as the employee), filed a claim for benefits under the EEOICPA, Form EE-1, in which he indicated that he suffered from ulcers, thyroid problems, a kidney cyst and prostate cancer.  On July 7, 2004, the employee filed a second claim for benefits, Form EE-1, in which he identified lung cancer with brain metastases as the medical condition being claimed.  On the EE-3 form, the employee indicated that he worked at the Oak Ridge Gaseous Diffusion Plant (K-25) from April, 1957 until an unspecified date and that he worked at Y-12 from September of an unspecified year until September, 1995.[1]  The Department of Energy verified that the employee worked at K-25 from May 27, 1957 until September 1, 1985 and at Y-12 from September 2, 1985 until September 29, 1995.  The DOE also verified that the employee was monitored through the use of a dosimetry badge.

As part of the medical documentation that the employee submitted was a January 25, 2001 pathology report by Dr. Stephen C. Lawhorn, in which he diagnosed adenocarcinoma of the prostate, and a June 25, 2004 pathology report by Dr. Joseph B. Eatherly, in which he diagnosed large cell carcinoma of the left lung.  On July 28, 2004, the district office issued a recommended decision, which concluded that as a member of the Special Exposure Cohort the employee was entitled to compensation and benefits for his specified lung cancer. 

On August 10, 2004, [Claimant 1], and on August 13, 2004, [Claimant 2], [Claimant 3], [Claimant 4] and [Claimant 5] each filed a claim for survivor benefits, Form EE-2.  You each indicated on your EE-2 forms that your late father, the employee, died on August 1, 2004 from lung cancer with brain metastases.  You submitted the following evidence in support of your claims as the employee’s eligible surviving beneficiaries: the employee’s death certificate, which indicated that he was divorced when he died on August 1, 2004; each of your birth certificates; [Claimant 1]‘s, [Claimant 3]‘s, and [Claimant 4]‘s marriage certificates; and [Claimant 5]‘s marriage certificates and divorce decrees. 

On September 8, 2004, the Final Adjudication Branch (FAB) vacated the July 28, 2004 recommended decision and remanded the employee’s claim to the district office for development of your survivor claims.  On September 28, 2004, the district office issued a new recommended decision, which concluded that the employee suffered from lung cancer, that the employee was a member of the Special Exposure Cohort in that he worked at least 250 aggregate days at K-25 in a job that was monitored through the use of a dosimetry badge and that you were the employee’s surviving beneficiaries.  As such, the district office recommended that you each be entitled to $30,000 in survivor’s compensation, in addition to medical benefits for medical bills that were incurred between July 7, 2004 and August 1, 2004 for treatment of the employee’s lung cancer.  The district office also concluded in their recommended decision that the employee’s claimed conditions of ulcers, thyroid problems and a kidney cyst are not covered occupational illnesses under the Act.  On October 5, 2004, [Claimant 1], on October 6, 2004, [Claimant 3], and on October 8, 2004, [Claimant 2], [Claimant 4] and [Claimant 5] each submitted their waivers of objection to the recommended decision. 

With regard to the employee’s established prostate cancer, as this is not a specified cancer the district office submitted an application package to the National Institute for Occupational Safety and Health (NIOSH) for dose reconstruction on May 10, 2002, in accordance with § 30.115 of the implementing regulations.  20 C.F.R. § 30.115.  The district office indicated in their new recommended decision that they were awaiting the NIOSH final report of dose reconstruction prior to determining whether or not the employee’s prostate cancer was “at least as likely as not” related to his covered employment. 

Therefore, based upon a review of the case file evidence, I make the following:

FINDINGS OF FACT

1.  On December 21, 2001, and again on July 1, 2004, the employee filed a claim for benefits under the EEOICPA, Form EE-1.

2.  The employee’s employment from May 27, 1957 until September 1, 1985 at K-25 and from September 2, 1985 until September 29, 1995 at Y-12 was verified.    

3.  The employee provided medical evidence, which established that he was diagnosed with prostate cancer on January 25, 2001 and with lung cancer on June 25, 2004.

4.  The employee’s claimed conditions of ulcers, a kidney cyst and thyroid problems are not covered occupational illnesses under the Act.

5.  On July 28, 2004, the district office issued a recommended decision, which concluded that the employee was entitled to compensation and medical benefits for lung cancer.

6.  On August 10, 2004, [Claimant 1], and on August 13, 2004, [Claimant 2], [Claimant 3], [Claimant 4] and [Claimant 5] each filed a claim for survivor benefits, Form EE-2. 

7.  On September 8, 2004, the FAB remanded the employee’s claim to the district office for development of your survivor claims.

8.  You established that you are the late employee’s eligible surviving beneficiaries.  

9.  The district office issued a recommended decision on September 28, 2004, which concluded that you each were entitled to $30,000 in survivors’ compensation, in addition to medical benefits for medical bills that were incurred between July 7, 2004 and August 1, 2004 for treatment of the late employee’s lung cancer.

Therefore, based upon a review of the case file evidence, I make the following:

CONCLUSIONS OF LAW

Pursuant to § 7384l(15) of the Act, a covered occupational illness “means a covered beryllium illness, cancer referred to in § 7384l(9)(B) of this title, specified cancer, or chronic silicosis, as the case may be.” 42 U.S.C. § 7384l(15).  The late employee’s claimed conditions of ulcers, a kidney cyst and thyroid problems are not covered occupational illnesses under the Act.

Pursuant to § 7384l(14)(A)(i) of the Act, a member of the Special Exposure Cohort (SEC) is defined as a Department of Energy employee, Department of Energy contractor employee, or atomic weapons employee who was employed for at least 250 aggregate workdays before February 1, 1992 at a gaseous diffusion plant located in Paducah, Kentucky, Portsmouth, Ohio, or Oak Ridge, Tennessee, “and, during such employment (i) was monitored through the use of dosimetry badges for exposure at the plant of the external parts of the employee’s body to radiation.” 42 U.S.C. § 7384l(14)(A)(i).  The evidence of record established that the employee worked at least 250 days during a covered time period at K-25 and that he worked in a job that was monitored through the use of a dosimetry badge.  Therefore, the undersigned finds that the employee was a member of the SEC, pursuant to § 7384l(14)(A)(i) of the Act. Pursuant to § 30.5(dd)(5)(2) of the implementing regulations, lung cancer is considered a specified cancer provided that its onset occurred at least five years after the employee’s first exposure to radiation.  20 C.F.R. § 30.5(dd)(5)(2).  Additionally, pursuant to § 7384l(9)(A) of the Act, a covered employee with cancer is “an individual with a specified cancer who is a member of the Special Exposure Cohort, if and only if that individual contracted that specified cancer after beginning employment at a Department of Energy facility (in the case of a Department of Energy employee or Department of Energy contractor employee) or at an atomic weapons employer facility (in the case of an atomic weapons employee).” 42 U.S.C. § 7384l(9)(A).  The evidence of record established that as a member of the SEC the employee was diagnosed with lung cancer more than five years after he began his employment at K-25.  Therefore, the undersigned finds that the employee was a covered employee with cancer, pursuant to § 7384l(9)(A) of the Act.   

The undersigned has reviewed the facts and the district office’s September 28, 2004 recommended decision and finds that you each are entitled to $30,000 in survivor’s compensation for the employee’s lung cancer, pursuant to §§ 7384s(a), 7384s(e)(1)(A) of the Act, and that you are entitled to medical benefits for medical bills that were incurred between July 7, 2004 and August 1, 2004 for the treatment of the employee’s left lung cancer, pursuant to § 7384t of the Act.  42 U.S.C. §§ 7384s(a), 7384s(e)(1)(A),7384t.

Washington, DC

Richard Koretz

Hearing Representative

[1] According to the Department of Energy’s (DOE) Office of Worker Advocacy on the DOE website at http://tis.eh.doe.gov/advocacy/faclist/showfacility.cfm, Y-12 in Oak Ridge, TN is a covered DOE facility from 1942 to the present, and the Oak Ridge Gaseous Diffusion Plant (K-25) in Oak Ridge, TN is a covered DOE facility from 1943 to the present.