Savannah River Site Health Effects Subcommittee (SRSHES) Meeting

Final Meeting Minutes
June 06, 2002

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OICP is divided into two components. The federal program is administered by the Department of Labor (DOL) Office of Workers’ Compensation Programs, while the state program is administered by the DOE Office of Worker Advocacy (OWA). The DOL federal component of OICP covers employees, contractors or subcontractors at DOE facilities; employees of DOE contractors, beryllium vendors or atomic weapons employers; survivors of deceased employees; and persons and survivors covered under Section 5 of the Radiation Exposure Compensation Act (RECA).

The following conditions are covered under the federal component of OICP: cancer, chronic beryllium disease, beryllium sensitivity, silicosis and other illnesses accepted under Section 5 of RECA. Claims can be filed for lung, bone, kidney, esophageal, non-Hodgkin’s lymphoma, colon, skin and any other type of cancer; NIOSH will then perform a dose reconstruction to determine cause and effect. However, only workers who were actually involved in underground mining operations related to testing of nuclear weapons can file claims for silicosis. Persons can submit claims directly to DOL or obtain assistance in filing claims from one of ten resource centers throughout the United States.

Workers must provide medical documentation of an eligible illness and survivors must show proof of relationship to the worker. A verification form of DOE employment must be completed as well. This information is evaluated by DOL claims examiners. Silicosis and beryllium disease claims are immediately forwarded to the Final Adjudication Branch (FAB) to determine if compensation will be made under OICP. Cancer claims are forwarded to NIOSH for a radiation-dose reconstruction and cause/effect study. However, a dose reconstruction is not performed for cancer claims by workers at the Oak Ridge, Paducah and Portsmouth plants who were involved with gaseous diffusion processes to produce enriched uranium. Persons who developed cancer after working 250 cumulative days at one of the three atomic weapons facilities are automatically entitled to compensation.

After the data are evaluated, the claims examiner makes a recommended decision and notifies the claimant. Objections must be filed within 60 days; the recommended decision and any objections are then forwarded to FAB. If the claim is approved, employees will be compensated for covered medical costs associated with the eligible illness and receive a lump-sum tax-free payment of $150,000. Survivors will also receive the lump-sum payment and be compensated for covered medical costs under an approved claim that were not paid before the employee’s death. RECA claimants receive an additional $50,000.

The federal component of the program is administered by the OICP National Office in Washington, DC; four district offices in Cleveland, Denver, Jacksonville, Florida and Seattle; ten resource centers in areas with major DOE facilities; and the FAB. DOL shares responsibility for the federal component of OICP with DOE, but NIOSH, Department of Justice, Social Security Administration, corporate entities, medical providers, and claimants play a significant role as well. Of the 27,227 claims received as of May 2, 2002, 17,393 were for cancer; 909 for total beryllium sensitivity; 923 for chronic beryllium disease; 536 for total silicosis; 3,237 for RECA illnesses; and 4,229 for other medical conditions.

Of claims processed with a recommended decision, 3,419 were approved and 2,128 were denied. Of claims processed with a final decision, 3,026 were approved and 618 were denied. Of claims in a pending status, 6,242 are awaiting employment verification and 4,020 have been forwarded to NIOSH for dose reconstruction. Of 2,162 individual cases, 2,479 payments have been issued, since some deceased employees have multiple survivors. As of May 2, 2002, $190.4 million has been paid. The OICP statistics are updated on a monthly basis; the DOL web site can be accessed to obtain the most recent information.

The state component of OICP administered by DOE assists DOE contractors in filing claims for state workers’ compensation benefits for an illness caused by exposure to a toxic substance in the course of employment at a DOE facility. OICP directed DOE to establish a program to assist workers in this effort. HHS appoints panels of independent physicians with expertise in occupational illnesses to review medical and exposure records of claimants. The review process is completed within 30 days from the date of filing to determine if the illness was indeed caused by toxic exposure at a DOE site. If the physician panel recommends in favor of the claimant, OWA reevaluates the claim and makes a final determination.

DOE will assist workers or survivors whose claims were approved in filing a state workers’ compensation claim. Eligible persons under the state component of OICP include past or present DOE contractors who worked at a DOE facility and survivors of eligible employees. Federal employees, atomic weapons employees, beryllium workers and employees at other facilities are not covered under this part of the program. Diseases caused by workplace toxic exposures are covered under the state component of OICP, such as heavy-metal poisoning, asbestosis, liver disease, nervous system disorders, non-cancerous respiratory problems, kidney disease and certain reproductive disorders.

Hearing loss, primary depression, carpal tunnel syndrome and lower back pain will not be reviewed by physician panels. Draft proposed guidelines for physician panels have been posted in the Federal Register. When the final rules have been published, DOE will begin the negotiation process with various states to conclude state agreements.

Discussion.
Dr. Crawford noted that OICP criteria for doses are large compared to epidemiological studies of DOE workers. Efforts should be made to comply with international guidelines for occupational exposure. The potential exists for OICP to set a precedent for doses that is inconsistent with established data. Dr. Kirr confirmed that this concern has been raised on numerous occasions and is currently being addressed by NIOSH. Ms. Guess cited a recent newspaper article that reported that most SRS claimants have not received compensation.

Dr. Kirr acknowledged that only one affected SRS worker has been paid under OICP to date. The delay is caused by the fact that any cancers caused by exposure at SRS must be evaluated by NIOSH. More than 200 SRS claims are currently being processed in terms of forwarding health physics data to NIOSH and finalizing the claims. Since NIOSH has now established its protocols and procedures for the dose reconstruction component of the claims process, Dr. Kirr anticipated that SRS workers will begin receiving compensation in late summer 2002. However, payments on claims under the state component of OICP will most likely not begin for the next six months. Final rules for physician panels must first be approved and published and agreements with states must then be developed.