Addressee
Address
City, State, Zip
Dear
I am writing in reference to your claim for benefits under the Energy Employees Occupational Illness Compensation Program Act.
If you are not already aware, effective September 14, 2008, a class of workers at the Y-12 Plant in Oak Ridge, Tennessee, was designated as members of the Special Exposure Cohort (SEC) for the timeframe of March 1, 1943 through December 31, 1947. Our records indicate you have verified employment at Y-12 during this timeframe. Therefore, we are in the process of re-examining your case to determine if you qualify for benefits under the rules of this new SEC class.
In order to begin this process, I must first vacate our previous decision(s) and reopen your case. The attached Director’s Order explains the reason why the prior decision(s) is being vacated and your case reopened. Please read this Order very carefully. If any of the basic information has changed since your final decision was issued (such as medical condition(s) or employment dates), please contact this office immediately and ask for your assigned claims examiner. Your information will be incorporated into your case file and considered in our decision. Once we have completed our review of your file, a new recommended decision will be issued concerning your eligibility under this SEC designation.
If you have any questions about the Director’s Order, please feel free to call my office, toll free, at: (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
On {date} you were issued a final decision denying your claim for benefits under {Part B/E} of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA or the Act). A final decision may be reopened at any time on motion of the Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC). Because of new developments described in this Director’s Order, the {date} Final Decision under {Part B/E} of the Act is hereby vacated and your case is reopened under this provision.
BACKGROUND
{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 at the Y-12 Plant in Oak Ridge, Tennessee. Medical documentation established the claimed condition.
Under the Act, all cancer cases must be referred to the National Institute for Occupational Safety and Health (NIOSH), a division of the Department of Health and Human Services (HHS) in order to receive a dose reconstruction. A dose reconstruction allows the Department of Labor to run a program that provides a number called the probability of causation (PoC). Under Part B of the Act, a cancer is “at least as likely as not” related to employment at a covered facility if the PoC is 50% or greater. In your case, the PoC was calculated to be {XX.XX%}. As a result, on {date}, the district office issued a recommended decision denying the claim under Part B of the Act, because the PoC was less than 50%.
The recommended decision was forwarded to the Final Adjudication Branch (FAB) in accordance with our 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. {If there is also a claim for Part E- Explain the decision in the next paragraph.}
DISCUSSION
Under the Act, there is a provision that allows for payment of some cases regardless of a previous PoC. This provision becomes available when employees are included in a class of the Special Exposure Cohort (SEC). To be included as a member in a class of the SEC, the employee must be diagnosed with a specified cancer and meet all the employment requirements of the SEC class.
In order for certain classes of employees at a facility to be included in the SEC, individuals may submit petitions to NIOSH for review. NIOSH evaluates the petitions, and they determine whether a new SEC class will be added. Effective September 14, 2008, NIOSH added to the SEC a new class of employees who worked at Y-12 Plant. The designation states:
All employees of the Department of Energy (DOE), its predecessor agencies, and DOE contractors or subcontractors who worked at the Y-12 Plant in Oak Ridge, Tennessee from March 1, 1943 through December 31, 1947 for a number of work days aggregating at least 250 work days occurring either solely under this employment or in combination with work days within the parameters established for one or more other classes of employees in the Special Exposure Cohort.
CONCLUSION (Note: This paragraph is particularly important)
Based on the designation of this new class into the SEC, the district office has 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 for at least 250 work days at Y-12 during the designated years for the new classes in the SEC.}. This demonstrates that the employee performed work at Y-12 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.
If you disagree with the recommended decision, you will have 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