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Below are the head notes for the FAB decisions and orders relating to the topic heading, Payment of Monetary Benefits. The head notes are grouped under the following subheadings: Beryllium sensitivity, Death of awardee, Exclusiveness of remedy, Forfeiture of entitlement to, Increase over basic survivor benefit amount payable under Part E, Maximum amounts payable, Overpayments, Relationship between Parts B and E, Requirements for, To survivors living at time of payment, and Withheld to recover debt. To view a particular decision or order in its entirety, click on the hyperlink for that decision or order at the end of the head note.

Beryllium sensitivity

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Death of awardee

  • Where evidence established that the employee died after applying for benefits under Part E but before receiving payment, the employee’s spouse who thereafter received the payment was obligated to return it for a redetermination of the correct amount to be paid to the employee’s survivors. EEOICPA Fin. Dec. No. 10078623-2009 (Dep’t of Labor, April 9, 2010).
  • Where the employee died before payment of an award of his 95% whole-person impairment under Part E was issued, the person who received the payment was required to return it to DEEOIC for a redetermination of the correct disbursement of the payment. Because the claimant’s spouse failed to return an improper payment or respond to communication from DEEOIC, the sum of $237,500.00 became a delinquent debt subject to appropriate collection actions including the reduction of potential future compensation and referral of the matter to the Department of the Treasury. EEOICPA Fin. Dec. No. 20190329-72990-5 (Dep’t of Labor, June 13, 2019).
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Exclusiveness of remedy

  • Where employee was awarded compensation under Part B in the amount of $150,000 for lung cancer, and subsequently filed claims for cancer of the pyriform sinus and colon, he was only entitled to additional medical benefits for those other cancers. An employee is only entitled to one lump-sum payment of compensation under Part B, regardless of how many occupational illnesses he may sustain. EEOICPA Fin. Dec. No. 2597-2002 (Dep’t of Labor, July 8, 2003).
  • Where covered employee was issued compensation under Part B in the amount of $150,000, claimant who later filed claim as surviving spouse of that same covered employee was not also entitled to compensation under Part B. EEOICPA Fin. Dec. No. 53272-2004 (Dep’t of Labor, March 31, 2004).
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Forfeiture of entitlement to

  • Claimant who previously pled guilty to making false statements in order to obtain federal workers’ compensation benefits forfeited her entitlement to benefits under EEOICPA and consequently was ineligible for survivor benefits under Part B. EEOICPA Fin. Dec. No. 105159-2010 (Dep’t of Labor, March 19, 2010).
  • It is the policy of DEEOIC that provisions of 42 U.S.C. §§ 7384s(e)(1), 7385s-1(2)(B) and 7385s-3(a) require that it redistribute in equal shares the pro rata share of survivor benefits forfeited by a potentially eligible survivor who was previously convicted of committing fraud in the application for or receipt of workers’ compensation benefits to his or her eligible siblings. This policy ensures that the full amount payable on account of the covered employee’s employment-related illness is received, if not by the covered employee, then by the employee’s living and eligible survivors. Based on this policy, FAB redistributed the pro rata share of a surviving child who had been convicted of committing fraud and paid it to his siblings, in equal shares. EEOICPA Fin. Dec. No. 20130604-16094-1 (Dep’t of Labor, February 28, 2014).
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Increase over basic survivor benefit amount payable under Part E

  • Surviving spouse of covered Part E employee who died as a result of his covered illness 16 calendar years before his normal Social Security retirement age was entitled to compensation in the increased amount of $150,000. The employee’s wages for each calendar year after his death through the calendar year of normal Social Security retirement age were assumed to be less than or equal to 50% of his average annual wage. Accordingly, the employee had an aggregate period of qualifying wage-loss of not less than 10 calendar years. EEOICPA Fin. Dec. No. 3831-2005 (Dep’t of Labor, August 10, 2005).
  • Where the employee died due to covered illnesses at age 54 and his normal retirement age (for purposes of the Social Security Act) was 65, surviving spouse was entitled to basic survivor benefits of $125,000.00 plus an additional $25,000 in survivor benefits under Part E, for total survivor benefits of $150,000.00. EEOICPA Fin. Dec. No. 10036412-2006 (Dep’t of Labor, June 13, 2007).
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Maximum amounts payable

  • Where survivor received $150,000 under Part B, $125,000 under Part E, and an additional $25,000 under Part E (based on deceased covered Part E employee’s qualifying calendar years of wage-loss due to renal cancer), no determination on the claim for benefits due to bone, lung, and brain cancers was made since claimant had already been awarded the maximum survivor benefits available under the Act. EEOICPA Fin. Dec. No. 9813-2007 (Dep’t of Labor, January 25, 2007).
  • Where the claimant previously received $200,000.00 in impairment benefits, and was otherwise entitled to wage-loss benefits of $165,000.00, the award of wage-loss benefits must be limited to $50,000.00 due to the $250,000.00 cap for Part E monetary benefits found in 42 U.S.C. § 7385s-12. EEOICPA Fin. Dec. No. 10014587-2006 (Dep’t of Labor, August 3, 2007).
  • To give the proper effect to both EEOICPA and the regulations, an employee’s potential Part E benefits are capped when the combination of impairment and/or wage-loss benefits reach the statutory maximum of $250,000, and this amount must then be coordinated with the state workers’ compensation benefits that the employee received (if appropriate) to arrive at the net lump-sum Part E benefit amount to be paid to the employee. EEOICPA Fin. Dec. No. 10032182-2006 (Dep’t of Labor, March 3, 2008).
  • The maximum amount payable for all Part E claims related to an individual employee is $250,000.00. In claims involving a tort suit recovery, the maximum amount payable under Part E is calculated based upon the amount of compensation payable prior to any tort recovery offset rather than the amount of compensation payable after any offset reduction. EEOICPA Order No. 20120607-12007-1 (Dep’t of Labor, July 12, 2012).
  • In cases under Part B where a covered employee is deceased at the time of payment and is survived by a spouse who is living at the time of payment, 42 U.S.C. § 7384s(e) provides that such payment shall be made to that surviving spouse. Children of a deceased covered employee may only receive such payment if there is no surviving spouse living at the time of payment. Thus, FAB concluded in this case that since the spouse of the deceased covered employee had already received a lump-sum payment of $150,000.00 under Part B, his surviving children were not also entitled to benefits under that Part. EEOICPA Fin. Dec. No. 20130322-1058-1 (Dep’t of Labor, October 8, 2013).
  • FAB could not award the “usual” figure of $217,500.00 for an 87% whole-person impairment rating because the claimant was also awarded $40,000.00 in wage-loss benefits under Part E.  Doing so would exceed the $250,000.00 maximum cap on Part E monetary benefits.  EEOICPA Fin. Dec. No. 20221201-48314-5 (Dep’t of Labor, December 13, 2022).
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Overpayments

  • Where employee died after applying for benefits under Part E but before receiving payment, and employee’s spouse thereafter received the payment but failed to return it, no benefits could be paid to the spouse on her subsequently filed survivor claim until the status of any overpayment resulting from her retention of the payment to her husband had been determined. EEOICPA Fin. Dec. No. 10078623-2009 (Dep’t of Labor, April 9, 2010).
  • A spouse who was paid survivor benefits under Parts B and E received an overpayment, because the affiant who claimed that he had worked with the deceased employee at a DOE facility retracted that statement and there was no other evidence of covered employment. EEOICPA Fin. Dec. No. 20121219-81137-1 (Dep’t of Labor, March 13, 2013).
  • After FAB issued a final decision in which it concluded that an overpayment occurred, it forwarded the claim to DEEOIC’s national office for further adjudication related to this overpayment. EEOICPA Fin. Dec. No. 20121219-81137-1 (Dep’t of Labor, March 13, 2013).
  • Where the employee died before payment of an award of his 95% whole-person impairment under Part E was issued, the district office incorrectly characterized the sum of $237,500.00 as an “overpayment.” Instead, the improper payment was a delinquent debt. If a non-claimant is in receipt of EEOICPA compensation and fails to return the money, it is a federal debt and not an overpayment. EEOICPA Fin. Dec. No. 20190329-72990-5 (Dep’t of Labor, June 13, 2019).
  • As set forth in 20 C.F.R. § 30.511(b), an overpayment exists if the compensation paid to an EEOICPA beneficiary exceeds the correct amount determined by the program.  Where a claimant was awarded $74,100.00, and this payment was later determined to be in error, the payment constituted an overpayment.  EEOICPA Fin. Dec. No. 20230602-58887-5 (Dep’t of Labor, August 15, 2023).
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Relationship between Parts B and E

  • Claimant receiving an award under Part B was automatically entitled to a determination under Part E that the DOE contractor employee’s occupational illness was contracted through work-related exposure to a toxic substance at a DOE facility. EEOICPA Fin. Dec. No. 12914-2002 (Dept. of Labor, February 8, 2005).
  • Where the surviving spouse was entitled to compensation under Part B due to the employee’s status as an atomic weapons employee and member of the SEC based on his work for General Atomics, and the employee also had verified employment as a DOE contractor employee at a DOE facility, it is the policy of DEEOIC that the provisions of 42 U.S.C. § 7385s-4(a) apply such that the spouse is entitled to a determination under Part E claim that the employee’s illness was contracted through exposure to a toxic substance at the DOE facility. EEOICPA Fin. Dec. No. 41882-2007 (Dep’t of Labor, December 21, 2007).
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Requirements for

  • Survivor found entitled to lump-sum payment under Part E based on Secretary of Energy’s acceptance of former Part D Physicians Panel determination that employee’s pulmonary fibrosis was due to exposure to a toxic substance at a DOE facility and medical evidence in the case record that this exposure contributed to the employee’s death. While the causes of death listed on the employee’s death certificate were cardiogenic shock and pneumonia, record included medical report finding that pulmonary fibrosis contributed to the employee’s death. EEOICPA Fin. Dec. No. 2029-2002 (Dep’t of Labor, January 10, 2005).
  • Because the survivor was entitled to the maximum allowable benefit under Part B of a lump-sum payment of $150,000 based upon the employee’s lung and bladder cancers, the FAB issued no determinations regarding other claimed medical conditions of the employee. EEOICPA Fin. Dec. No. 25528-2004 (Dep’t of Labor, September 30, 2004).
  • Where eight surviving children filed for benefits and were determined to be eligible to share an award under Part B, only those children who responded to requests for information on possible tort suits were paid their 1/8th shares. The remaining 1/8th shares of the award were held in abeyance pending submission of the requested information. EEOICPA Fin. Dec. No. 63743-2006 (Dep’t of Labor, November 21, 2006).
  • Where surviving spouse entitled to Part B lump-sum payment died prior to the date that the payment was electronically deposited in her account, the payment was reversed and the final decision awarding benefits to her was vacated. A new final decision was issued awarding benefits to the surviving children. EEOICPA Fin. Dec. No. 72762-2006 (Dep’t of Labor, December 2, 2005).
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To survivors living at time of payment

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Withheld to recover debt

  • FAB concluded that the claimant was an eligible survivor entitled to receive survivor benefits under Part E of EEOICPA for the death of the employee. However, no compensation was payable to the claimant because she had a delinquent debt in the amount of $237,500.00, a sum greater than the $125,000.00 award to which she was entitled. EEOICPA Fin. Dec. No. 20190329-72990-5 (Dep’t of Labor, June 13, 2019).
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