Address
City, State, Zip
Dear
I am writing regarding your claim for benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA).
The Department of Health and Human Service’s National Institute for Occupational Safety and Health (NIOSH) has determined that chronic lymphocytic leukemia (CLL) is a radiogenic cancer. As such, effective March 7, 2012, all claims for CLL are eligible for radiation dose reconstruction under the EEOICPA. While this may not result in an acceptance of your claim, it is necessary to return your case to NIOSH to allow for a dose reconstruction and a calculation of the probability of causation on your claim for cancer.
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 the dose reconstruction has been completed, a new recommended decision will be issued concerning your eligibility under the EEOICPA.
If you have any questions about the Director’s Order, please feel free to call my office, toll free, at: (xxx) xxx-xxxx.
Sincerely,
{Name of District Director}
District Director
EMPLOYEE: [Employee Name]
CLAIMANT: [Claimant(s) Name]
FILE NUMBER: [Last 4 Digits of 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 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 EEOICPA is hereby vacated and your case 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-1 or 2] (Claim for [Survivor] Benefits under the EEOICPA) under Part B [and/or E, as appropriate] on {date}. It was asserted that the employee {employee name} developed {cancer type} as a result of employment at the {site/facility}. Medical documentation established the claimed condition.
Under the Act, most 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, a value of zero percent was assigned to your claim for chronic lymphocytic leukemia (CLL). 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 EEOICPA, claims for CLL were assigned a zero percent probability of causation value. Because of a change to the regulations governing the calculation of probability of causation, all claims for CLL are eligible to receive radiation dose reconstruction to determine whether their cancer was at least as likely as not caused by radiation exposure at a covered DOE facility.
CONCLUSION (Note: This paragraph is particularly important)
Based on recent guidance that allows for a dose reconstruction on claims for CLL, it is necessary to reopen your claim. Your claim is being referred to NIOSH for a dose reconstruction (or rework of the dose reconstruction) to include CLL. Upon receipt of the dose reconstruction from NIOSH, a new recommended decision will be issued on your claim for benefits under Parts B and E of the EEOICPA.
If you disagree with the recommended decision, you will have the opportunity to file an objection and request an oral hearing or 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