Energy Employees Occupational Illness Compensation Program Overview

 
 
 
 
Energy Employees Occupational
Energy Employees Occupational
Illness Compensation Program
Illness Compensation Program
 
Program Overview
 - 
April 2016
Rachel P. Leiton
Rachel P. Leiton
Director, Division of Energy Employees
Director, Division of Energy Employees
Occupational Illness Compensation
Occupational Illness Compensation
 
 
1
 
The EEOICPA
The EEOICPA
 
Administered by the Labor
Administered by the Labor
Department’s Division of Energy
Department’s Division of Energy
Employees Occupational Illness
Employees Occupational Illness
Compensation (DEEOIC)
Compensation (DEEOIC)
Provides lump-sum compensation and
Provides lump-sum compensation and
medical benefits to current and former
medical benefits to current and former
nuclear weapons workers
nuclear weapons workers
Survivors of qualified workers may also
Survivors of qualified workers may also
be entitled to benefits
be entitled to benefits
 
 
 
2
 
Administration of the EEOICPA
Administration of the EEOICPA
 
Agencies:
Department of Labor (DOL)
Department of Energy (DOE)
Department of Health and Human
Services
 
National Institute for Occupational
Safety and Health (NIOSH)
Department of Justice (DOJ)
 
 
 
Eligibility – Two Paths
Eligibility – Two Paths
 
3
 
 
4
 
4
 
Employee Eligibility
Employee Eligibility
 
 
Eligibility – Medical
Eligibility – Medical
 
Part B
Part B
Cancer
Cancer
Chronic Beryllium
Chronic Beryllium
Disease
Disease
Chronic Silicosis
Chronic Silicosis
RECA Section 5
RECA Section 5
awardees
awardees
 
Part E
Part E
Any condition
Any condition
related to toxic
related to toxic
substances
substances
 
5
 
5
 
 
Eligibility – Survivors
Eligibility – Survivors
 
Part B
Part B
Spouse
Spouse
Adult Children
Adult Children
Grandchildren
Grandchildren
Grandparents
Grandparents
 
Part E
Part E
Spouse (death
Spouse (death
related)
related)
Children (<age 18,
Children (<age 18,
<age 23 if full time
<age 23 if full time
student, Medically
student, Medically
incapable of self
incapable of self
support)
support)
 
6
 
6
 
 
7
 
7
 
Benefits
Benefits
 
 
8
 
8
 
Means of Verifying Employment
Means of Verifying Employment
 
DOE – Earnings Records
Oak Ridge Institute for Science and
Education (ORISE)
Corporate Verifiers
SSA Wage Data
Other Sources
Affidavits
Records/documents created by
state/federal agencies
 
 
9
 
Part B: Dose Reconstruction &
Part B: Dose Reconstruction &
Probability of Causation (PoC)
Probability of Causation (PoC)
 
Part B Cancer Cases and Dose Reconstruction
NIOSH
Level and extent of occupational radiation
dose
PoC
Scientific calculation of likelihood that
radiation exposure caused cancer
NIOSH Computer System
PoC -  50% or greater for award
 
 
10
 
10
 
Part B: Special Exposure Cohort (SEC)
Part B: Special Exposure Cohort (SEC)
 
Presumption of causation - cancer
Employment
Covered in class defined by NIOSH
Work day requirement – 250 work
days
“Specified” Cancer
22 cancers 
named in law
No need for dose reconstruction
 
 
 
11
 
Part B: Adding New SEC Classes
Part B: Adding New SEC Classes
 
 
NIOSH designates new SEC classes
4 statutory SEC classes; plus
As of December 31, 2015, HHS has designated
115 additional SEC classes
 
DOL administers SEC cases
No role in designation
 
 
12
 
12
 
Part E:  Causation
Part E:  Causation
 
Exposure to 
toxic substances
Causation standard different than under Part B
Includes aggravation, contribution
DOL Tools:
Occupational History Questionnaire (OHQ)
Site Exposure Matrices (SEM)
DAR records
Former Worker Medical Screening Program
(FWP)  work history interviews
Other Sources:  Affidavits/facility records
 
 
13
 
Site Exposure Matrices (SEM) Website
Site Exposure Matrices (SEM) Website
 
Toxic substances present at DOE and
RECA Section 5 Facilities
Information gathered from a variety of
sources
Scientifically established links between
certain toxic substances and certain
illnesses
Available at http://192.104.4.234/
 
 
 
 
14
 
Part E:  Employee Impairment
Part E:  Employee Impairment
 
% permanent whole person
impairment due to covered illness
AMA’s Guides to the Evaluation
of Permanent Impairment, 5
th
Edition
$2,500 awarded for each % of
impairment
 
 
15
 
Part E:  Employee Wage Loss
Part E:  Employee Wage Loss
 
Decreased capacity to work due to an
accepted medical condition
 
Employee Compensation:
Any year <50% of pre-disability annual
wage = $15,000 compensation
Any year > 50% but <75% of pre-
disability annual wage = $10,000
compensation
 
 
Application – Claimant
Application – Claimant
Responsibilities
Responsibilities
 
16
 
 
DOL Responsibilities
DOL Responsibilities
 
17
 
 
18
 
Advocate Outreach (2009 – 2016)
Advocate Outreach (2009 – 2016)
 
5 In-person Meetings
5 In-person Meetings
October 11, 2011
October 11, 2011
November 8, 2012 (Training session hosted by NIOSH
November 8, 2012 (Training session hosted by NIOSH
Ombudsman)
Ombudsman)
February 20, 2014
February 20, 2014
March 19, 2015
March 19, 2015
March 30, 2016
March 30, 2016
4 Conference Calls
4 Conference Calls
2 in 2009
2 in 2009
2 in 2015 (Including listening session regarding proposed
2 in 2015 (Including listening session regarding proposed
rulemaking under the EEOICPA)
rulemaking under the EEOICPA)
 
 
 
19
 
Public Outreach (2010 – 2016)
Public Outreach (2010 – 2016)
 
80 Events Nationwide
80 Events Nationwide
28 Events to inform the public about new SECs
28 Events to inform the public about new SECs
20 Joint Outreach Task Group (JOTG) events
20 Joint Outreach Task Group (JOTG) events
33 Events to inform claimants, providers &
33 Events to inform claimants, providers &
physicians general information about the Program
physicians general information about the Program
and/or  medical benefits covered under the Program
and/or  medical benefits covered under the Program
 
 
20
 
EEOICPA Compensation Nationwide
EEOICPA Compensation Nationwide
 
 
$12.4 Billion Total
Compensation
 
$5.93 Billion Part B
 
$3.70 Billion Part E
 
$2.75 Billion Medical
 
 
Data as of April 10, 2016
undefined
 
Covered Facilities
Covered Facilities
Website
Website
 
https://ehss.energy.gov/Search/Facility/findfacility.aspx
 
21
 
 
22
 
Resources
Resources
 
11 Resource Centers Nationwide
 
4 District Offices Nationwide
 
DEEOIC Website
 
www.dol.gov/owcp/energy/
General program information
Telephone & Fax Numbers
SEM public website
Forms
Sample Decisions
 
23
 
24
 
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The DEEOIC looks forward to
The DEEOIC looks forward to
working with you and welcomes
working with you and welcomes
your recommendations…..
your recommendations…..
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The Energy Employees Occupational Illness Compensation Program (EEOICPA) provides compensation and benefits to nuclear weapons workers and their survivors. Administered by various government agencies, the program offers lump-sum payments, medical benefits, and support for eligible employees and their families. With two paths for eligibility based on employment history and medical conditions, the program assists those affected by occupational illnesses related to toxic substances. Verification of employment is done through DOE earnings records and other designated institutions.

  • Compensation Program
  • Occupational Illness
  • Nuclear Workers
  • Government Benefits
  • Medical Benefits

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  1. Energy Employees Occupational Illness Compensation Program Program Overview - April 2016 Rachel P. Leiton Director, Division of Energy Employees Occupational Illness Compensation

  2. The EEOICPA Administered by the Labor Department s Division of Energy Employees Occupational Illness Compensation (DEEOIC) Provides lump-sum compensation and medical benefits to current and former nuclear weapons workers Survivors of qualified workers may also be entitled to benefits 1

  3. Administration of the EEOICPA Agencies: Department of Labor (DOL) Department of Energy (DOE) Department of Health and Human Services National Institute for Occupational Safety and Health (NIOSH) Department of Justice (DOJ) 2

  4. Eligibility Two Paths Employment Medical Survivors Part B (Enacted 2000) Employment Medical Survivors Part E (Enacted 2004) 3

  5. Employee Eligibility Employed By Part B Part E DOE Contractors and Subcontractors DOE Federal Employees AWE Employees Yes Yes Yes No Yes No Beryllium Vendors RECA Yes No Yes Yes 4 4

  6. Eligibility Medical Part B Part E Cancer Chronic Beryllium Disease Chronic Silicosis RECA Section 5 awardees Any condition related to toxic substances 5 5

  7. Eligibility Survivors Part B Part E Spouse Adult Children Grandchildren Grandparents Spouse (death related) Children (<age 18, <age 23 if full time student, Medically incapable of self support) 6 6

  8. Benefits Part B Part E $150,000 Employee + Survivor Impairment $2,500 per % (Employee) $50,000 RECA Employee + Survivor Wage Loss $10,000 - $15,000 per year (Employee) $125,000 Survivor (+ lump-sum Wage Loss if eligible) $400,000 CAP for B+E combined 7 7

  9. Means of Verifying Employment DOE Earnings Records Oak Ridge Institute for Science and Education (ORISE) Corporate Verifiers SSA Wage Data Other Sources Affidavits Records/documents created by state/federal agencies 8 8

  10. Part B: Dose Reconstruction & Probability of Causation (PoC) Part B Cancer Cases and Dose Reconstruction NIOSH Level and extent of occupational radiation dose PoC Scientific calculation of likelihood that radiation exposure caused cancer NIOSH Computer System PoC - 50% or greater for award 9

  11. Part B: Special Exposure Cohort (SEC) Presumption of causation - cancer Employment Covered in class defined by NIOSH Work day requirement 250 work days Specified Cancer 22 cancers named in law No need for dose reconstruction 10 10

  12. Part B: Adding New SEC Classes NIOSH designates new SEC classes 4 statutory SEC classes; plus As of December 31, 2015, HHS has designated 115 additional SEC classes DOL administers SEC cases No role in designation 11

  13. Part E: Causation Exposure to toxic substances Causation standard different than under Part B Includes aggravation, contribution DOL Tools: Occupational History Questionnaire (OHQ) Site Exposure Matrices (SEM) DAR records Former Worker Medical Screening Program (FWP) work history interviews Other Sources: Affidavits/facility records 12 12

  14. Site Exposure Matrices (SEM) Website Toxic substances present at DOE and RECA Section 5 Facilities Information gathered from a variety of sources Scientifically established links between certain toxic substances and certain illnesses Available at http://192.104.4.234/ 13

  15. Part E: Employee Impairment % permanent whole person impairment due to covered illness AMA s Guides to the Evaluation of Permanent Impairment, 5th Edition $2,500 awarded for each % of impairment 14

  16. Part E: Employee Wage Loss Decreased capacity to work due to an accepted medical condition Employee Compensation: Any year <50% of pre-disability annual wage = $15,000 compensation Any year > 50% but <75% of pre- disability annual wage = $10,000 compensation 15

  17. Application Claimant Responsibilities Respond to letters from DOL Submit evidence File claim 16

  18. DOL Responsibilities Gather Evidence Issue Recommended Decision Respond to Objections Issue Final Decision Pay Benefits 17

  19. Advocate Outreach (2009 2016) 5 In-person Meetings October 11, 2011 November 8, 2012 (Training session hosted by NIOSH Ombudsman) February 20, 2014 March 19, 2015 March 30, 2016 4 Conference Calls 2 in 2009 2 in 2015 (Including listening session regarding proposed rulemaking under the EEOICPA) 18

  20. Public Outreach (2010 2016) 80 Events Nationwide 28 Events to inform the public about new SECs 20 Joint Outreach Task Group (JOTG) events 33 Events to inform claimants, providers & physicians general information about the Program and/or medical benefits covered under the Program 19

  21. EEOICPA Compensation Nationwide Part B Part E Medical $12.4 Billion Total Compensation 22% $5.93 Billion Part B 48% $3.70 Billion Part E 30% $2.75 Billion Medical 20 Data as of April 10, 2016

  22. Covered Facilities Website https://ehss.energy.gov/Search/Facility/findfacility.aspx 21

  23. Resources 11 Resource Centers Nationwide 4 District Offices Nationwide DEEOIC Website www.dol.gov/owcp/energy/ General program information Telephone & Fax Numbers SEM public website Forms Sample Decisions 22

  24. 23

  25. District Office Jurisdictional Map 24

  26. The DEEOIC looks forward to working with you and welcomes your recommendations ..

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