EEOICPA Cancer Claims – Dose Reconstruction and NIOSH Process

Unraveling the mysteries of the EEOICPA claim process when a worker files a claim for cancer(s) that do not meet Special Exposure Cohort criteria.

If a cancer claim requires “dose reconstruction”, about 2-3 months into the timeline, your EEOICPA Claims Examiner refers the claim to NIOSH DCAS for “dose reconstruction”. NIOSH’s Department of Compensation and Analysis Support (NIOSH DCAS) performs a mathematical analysis of a worker’s radiation exposure and an assessment as to whether there was sufficient exposure to have caused one or more instances of cancer. 

Dose reconstruction requires NIOSH to gather available dosimetry and site monitoring data from each of a worker’s known work sites, and then conduct an analysis. For some workers, there is a complete history of dosimetry. For many, there are holes and gaps, for which NIOSH uses a library of assumptions to fill those gaps, and eventually complete the analysis. NIOSH is very good at sending communication at the start of this process, but then there’s silence. This process can take 3-6 months or longer, and as a worker/claimant, you do not receive a lot of updates. 

At the conclusion, NIOSH DCAS sends a draft dose reconstruction report to the worker, which often creates more questions than providing answers. The focus of this blog is on what happens after that draft report is received, how to interpret, and next steps.

Dose Reconstruction report and next steps:

  • NIOSH sends out a draft dose reconstruction report and requests claimant to fill out the OCAS-1 form. Signing this form does not waive any current or future rights, it is claimant’s acknowledgment the report was received.
  • NIOSH staff will contact claimant via phone to schedule a phone review of the report, methodology and allows claimant to ask questions.
  • Claimant can ask questions, but frankly, rarely can claimant influence NIOSH to change or update the report unless claimant had additional unreported cancers (of any kind), or additional employment at a designated DOE facility.
  • For most of my clients, I advise to not spend the time on the phone interview, what NIOSH calls the “Close Out Interview”.
  • The Dose Reconstruction analysis estimates a probability that claimant’s workplace exposure to radiation caused claimed cancer(s). The key statistic is a Probability of Causation (PoC). If the PoC is 50% or greater, claim will be approved.
  • NIOSH is not permitted to tell claimant whether a claim will be approved or denied by policy. NIOSH does not “show” the resulting PoC on the dose reconstruction report. They leave that to EEOICPA to report in the Recommended Decision to approve or deny the claim.
  • But there is a way to see whether the Dose Reconstruction report is suggesting that PoC is less than 50% or not. On page 4 or 5 of the Dose Reconstruction report, there is a paragraph that reads as follows:
    • If the PoC was less than 50% … “Based on the doses calculated as described in this report, NIOSH has determined that further research and analysis will not produce a level of radiation dose resulting in a probability of causation of 50% or greater.”
    • If the PoC was 50% or greater … “Per the provisions in 42 CFR 82.10(k)(1), it was determined that the partially reconstructed dose was of sufficient magnitude to consider this dose reconstruction complete. That is, the partially reconstructed dose produced a probability of causation of 50% of greater.”
  • If the report shows a PoC of less than 50% NIOSH is not going to change the outcome; if the PoC is 50% or greater, why concern yourself with the details of the process?
  • After claimant returns the signed OCAS-1 form, NIOSH sends a “Final Copy” of the same report to claimant and forwards the result to your EEOICPA Claims Examiner for formal handling.
  • Next step is for EEOICPA to issue a Recommended Decision to deny the claim (if PoC < 50%), and eventually, the Final Decision to deny.
  • If in the future, claimant has any additional cancers, skin cancers or otherwise, claimant has the right to file for those cancers, and that starts the review and Dose Reconstruction over again.
  • I have seen several cases where one, or a few more skin cancers, push the PoC over 50%, and that results in an approval of ALL previously claimed cancer(s) retroactive to when each cancer was claimed.
  • If the PoC on the initial claim was 50% of greater, EEOICPA issues a Recommended Decision to approve, then a Final Decision to approve., awarding medical benefits and compensation under Part B.

At AtomicWorkers®, we help atomic workers and their families claim medical and financial benefits from the EEOICPA program faster and with less hassle.  Our only fee is 2% of any financial award you receive.  If you would like to speak with us about having an Authorized Representative handle your case, you can call us at (720) 644-9161 or fill out the contact form here.

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