Medical Evidence – Under both Part B and Part E, the burden of evidence for causation is borne by the worker/claimant and their medical professionals. DOL allows for evidence from “experts”, medical professionals of claimant’s choice; however, medical research, scientific papers or journal articles submitted by claimant are considered, but rarely accepted.
Dose Reconstruction – For cancer claims it is typically assumed exposure to radiation was the cause. For these claims DOL refers the case to the National Institute of Occupational Safety and Health (NIOSH) for Dose Reconstruction. Dose Reconstruction is a mathematical process which estimates the maximum likelihood radiation dose/exposure an individual received in the workplace, and then the likelihood radiation was the actual cause of the cancer. The likelihood, or Probability of Causation (PoC) has to be 50% or higher for a favorable decision by DOL.
Special Exposure Cohort – For designated work sites and time frames where Dose Reconstruction has been determined to not be possible, NIOSH has designated Special Exposure Cohorts. Cases considered under Special Exposure Cohort guidelines are adjudicated under the presumption that cancer was the most likely cause of cancer; Presumptive cancers, SEC Cancers, are generally internal organ related primary cancer(s), blood disorders related to bone cancer, or secondary cancer of the Lung, Kidney or Bone due to metastasis of any other primary cancer.
Site Exposure Matrix – The Site Exposure Matrix (SEM) is an on-line tool available to claimants for determining the toxic chemicals the worker may have been exposed to. SEM is a compilation of information from worker testimony and site records assembled by the Department of Energy. Most of the DOE designated facilities are represented, and in some cases, building specific or work function specific detail is accessible. Most importantly, the SEM can be searched by health effect and the set of toxic chemicals which have known and accepted casual links to each medical condition. This is the same resource DOL examiners use to adjudicate worker claims.
http://www.sem.dol.gov/ - Main Page
Scroll to bottom of page, select DOE Sites radio button, then select drop list for list of work sites. Select a work site, then Submit Selection. Go to Expanded SEM for details by Health Effect (medical condition), Work Function, Building, etc.
Using SEM to support your claim – A list of toxic chemicals from SEM for claimant’s work site and health condition should be provided to worker’s physician for review. Worker’s work history should be known to physician. If in the medical opinion of the physician is it “as least as likely as not” that the health condition was “caused by, contributed to, or aggravated by” the specific chemicals (with reference by name of substance), the DOL will more favorably consider your claim. DOL still has the latitude to weigh the totality of evidence. Hopefully, your physician agrees to write a supporting statement/medical opinion.
Under EEOICPA guidelines any medical condition which was likely to have been caused by, contributed to or aggravated by exposure to radiation or toxic chemicals may be claimed.
Part B – Medical conditions of cancer, chronic berylliosis and silicosis fall under the guidelines of Part B of EEOICPA.
Part E – Medical conditions such as pulmonary fibrosis, chronic obstructive pulmonary disease, chronic renal failure, toxic neuropathy, Parkinsonism, and all other conditions not covered under Part B, are covered under Part E of EEOICPA.
Concepts and Evidence
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