Attention: This bulletin has been superseded and is inactive.
EEOICPA BULLETIN NO. 17-01
Issue Date: October 5, 2016
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Effective Date: October 5, 2016
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Expiration Date: October 4, 2017
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Subject: Processing Part E Survivor Election of Benefits Claims.
Background: Under Part E of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), if a covered Part E employee dies after filing a claim but before payment is received, and if the employee’s death was caused solely by a non-covered illness, any eligible survivor has an “election of benefits” option. The survivor may elect to receive monetary compensation (wage-loss and/or impairment benefits) that the employee would have received had he or she not died prior to payment. It is not necessary for the employee to have filed a claim specifically for wage-loss or impairment benefits in order to have the election of benefit option available. As long as the employee filed a Part E claim, claims for impairment and wage-loss benefits are assumed.
The Federal (EEOICPA) Procedure Manual (PM) contains language that interprets the regulations and statute to preclude a survivor from receiving compensation under the election of benefits option if the employee had received any monetary compensation for either impairment or wage-loss benefits prior to death. However, based on recent litigation, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) is aligning the eligibility requirements regarding the Part E survivor election of benefits with the district court’s interpretation. Accordingly, the fact that the employee may have previously received monetary compensation in the form of either impairment or wage-loss benefits prior to death no longer voids the election of benefit option.
DEEOIC is issuing this Bulletin to notify staff of a procedural change and it will update the PM to reflect this new procedure.
References: 42 U.S.C. § 7385s-1(2)(B); 20 C.F.R. § 30.509; and Federal (EEOICPA) Procedure Manual, Chapter 2-1200.
Purpose: To provide policy guidance regarding eligibility requirements pertaining to the survivor election of benefits option under Part E of the EEOICPA.
Applicability: All staff.
Actions:
1. When an election of benefits is available, the CE contacts the survivor via telephone or letter advising the survivor of the option to receive the benefits that the employee would have received had he/she not died prior to receiving payment. One a claimant makes his or her election in writing, the CE proceeds with a review of the claim. If interacting by phone, the CE obtains a verbal response and follows with written confirmation of the survivor’s option.
2. Once the claimant’s election is documented in the case record, the CE proceeds to award the survivor the impairment and/or wage-loss benefit the employee would have received. In assessing any payable lump-sum compensation to the survivor, the CE has to assess an impairment or wage-loss claim using established procedures as outlined in the PM (Refer to PM Ch. 2-1300, Impairment Ratings & PM Ch. 2-1400, Wage-Loss Determinations).
3. Under the election, lump-sum compensation is payable to a qualifying survivor up to the aggregate maximum amount of compensation payable under Part E.
4. A survivor cannot exercise the election of benefit option unless the evidence establishes that the employee’s death occurred solely because of a non-covered illness.
Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual.
RACHEL P. LEITON
Director, Division of Energy Employees
Occupational Illness Compensation
Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, and District Office Mail and File Sections.