Addressee
Address
City, State, Zip
Dear Mr./Mrs./Ms. Claimant:
I am writing in reference to your claim for benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). The Final Adjudication Branch (FAB) issued a Final Decision on {date}, denying your claim for compensation.
The regulations governing the EEOICPA allow the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC) to review decisions issued by the FAB. It is within the Director’s discretion to vacate such decisions as necessary. In the exercise of the Director’s discretion over the reopening process, the Director has delegated authority to each of the four District Directors in the DEEOIC to reopen cases under certain limited circumstances. The authority granted to the District Director is restricted to claims based upon employment between January 1, 1957 and December 31, 1983 with the Nuclear Materials and Equipment Corporation (NUMEC) in Apollo, Pennsylvania.
Effective December 29, 2007, a class of workers at Apollo NUMEC were designated as members of the Special Exposure Cohort (SEC) for the timeframe January 1, 1957 and December 31, 1983. In this case, there is potential eligibility for inclusion as a member of that SEC. Accordingly, the attached Director’s Order vacates the above-noted final decision and reopens your claim for cancer. Your claim will be adjudicated accordingly and a new recommended decision will be issued in full accordance with all current statutory, regulatory and procedural directives.
If you have any questions about the Director’s Order, please fell free to call this district office at our toll-free number of (xxx)xx-xxxx.
Sincerely,
{Name of District Director}
District Director
EMPLOYEE: [Employee Name]
CLAIMANT: [Claimant(s) Name]
FILE NUMBER: [File Number]
DOCKET NUMBER: [Insert Docket Number]
DIRECTOR’S ORDER
The Energy Employees Occupational Illness Compensation Program Act (EEOICPA or the Act) Regulations at 20 C.F.R. § 30.320 state that a final decision, or any other decision issued by the Final Adjudication Branch (FAB), may be reopened at any time on motion of the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC). The Regulations further state that the case may be reopened without regard to whether new evidence or information is presented or obtained, and that the decision whether or not to reopen a case is solely within the discretion of the Director of the DEEOIC.
Pursuant to the authority granted by 20 C.F.R. § 30.320 and for the reasons set forth below, the {date} Final Decision under Part B and/or Part E of the Act is hereby vacated and your case reopened.
{Provide a concise and accurate synopsis of the claim’s history. Some sample paragraphs are provided here, though these should be altered to tailor-fit the specifics of the case.}
The evidence of record shows that {claimant name} filed Form EE-2 (Claim for Survivor Benefits under the EEOICPA) under Part B (and/or E, as appropriate) on {date}. It was asserted that {employee and relationship} developed {cancer type} as a result of employment with the Nuclear Materials and Equipment Corporation (NUMEC) in Apollo, PA, an Atomic Weapons Employer. Medical documentation established the claimed condition.
The case record was referred to the National Institute for Occupational Safety and Health (NIOSH), a division of the Department of Health and Human Services (HHS). NIOSH was directed to prepare an occupational radiation dose reconstruction to determine the probability of causation (PoC) that the cancer is “at least as likely as not” related to
employment at a DOE covered facility. Under the EEOICPA, the PoC for a claimed cancer must be 50% or greater to be accepted as a covered illness. Based upon the dose reconstruction report prepared by NIOSH, the district office calculated the PoC to be {XX.XX%}.
On {date}, the district office issued a recommended decision denying the claim under Part B and/or Part E of the Act, finding the PoC did not substantiate the claim of a covered employee with cancer as defined in 42 U.S.C. § 7384n(b). The recommended decision was forwarded to the FAB in accordance with EEOICPA procedures for an independent assessment and issuance of a final decision.
On {date}, the FAB issued a Final Decision, affirming the recommended decision to deny the claim. The FAB concluded that the evidence of record did not change the outcome of the claim; i.e., based on the PoC, it was not “at least as likely as not” that the claimed illness was related to employment at the covered facility.
As defined in 42 U.S.C. § 7384q, the term Special Exposure Cohort (SEC) refers to a class of employees at an DEEOIC-covered facility who were likely exposed to radiation at that facility but for whom it is not feasible to estimate with sufficient accuracy the radiation dose they received. To be included as a member of a SEC, the employee must be diagnosed with a specified cancer, and as defined in 42 U.S.C. § 7384l(14), be either a DOE employee, contractor employee, or atomic weapons employee who meets certain requirements.
As defined in § 7384q, new sites may be designated as members of the SEC, and effective December 29, 2007, a new class of employees who worked at NUMEC in Apollo, PA were added to the SEC. The designations by the National Institute for Occupational Safety and Health (NIOSH) state:
Atomic Weapons Employer employees who were monitored or should have been monitored for exposure to ionizing radiation while working at the NUMEC in Apollo, Pennsylvania from January 1, 1957, through December 31, 1983, for a number of work days aggregating at least 250 work days or in combination with work days within the parameters established for one or more other classes of employees in the SEC.
Based on the designation of these new classes into the SEC, the district office reviewed the file and finds there is sufficient evidence to warrant reopening of this claim. The evidence of record shows that the employee worked {describe evidence that shows the employee worked at NUMEC in Apollo during the designated years for the new classes in the SEC.}. This demonstrates that the employee performed work at Apollo NUMEC for at least 250 work days within the designated time period for the SEC class. Moreover, the evidence establishes the employee was diagnosed with, {type of cancer} a SEC-specified cancer.
Therefore, the above findings indicate potential eligibility as a member of the SEC. Accordingly, the Final Decision pursuant to Part B and/or Part E is hereby vacated and the case is reopened so that a new recommended decision can be issued
Should the claimant disagree with the recommended decision, he/she will be afforded the opportunity to file an objection and request an oral hearing or a review of the written record.
{city of district office}
{Name of District Director}
District Director
CERTIFICATE OF SERVICE
I hereby certify that on a copy of the Director’s Order was sent by regular mail to the following:
Addressee
Address
City, State, Zip
{Name of District Director}
District Director