Sample Letter to Claimant Granting Medical
Benefits for Unaccepted Reverse Consequential Condition
(Medical Treatment of Underlying Primary Cancer)
[Date]
Case ID: [number]
Employee: [name]
[Claim Name]
[Street Address]
[City, State, Zip]
Dear [name]:
The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) regulation at 20 CFR § 30.400(a) states the following with regard to payment of medical bills for an unaccepted condition: “In situations where the accepted occupational illness or covered illness is a secondary cancer, such treatment may include treatment of the underlying primary cancer when it is medically necessary or related to treatment of the secondary cancer.”
Accordingly, payment for medical treatment of your primary cancer [identify cancer] is covered when medically necessary or related to the treatment of your accepted secondary cancer. However, payment for medical treatment of your primary cancer under these circumstances does not constitute a determination by the Office of Workers’ Compensation Programs that the primary cancer is an accepted illness under the EEOICPA.
For reimbursement of medical bills, I have enclosed form OWCP-915 (Claim for Medical Reimbursement). Carefully read and follow the instructions on the back of the form to ensure reimbursement of those bills.
Where to Send Your Reimbursement Form:
Send a copy of this authorization letter, the completed itemized Form OWCP-915, and any required receipts to our bill processing agent. For your convenience, I have enclosed a pre-addressed envelope and an extra copy of this authorization letter. Mail your information to:
Energy Employees Occupational
Illness Compensation Program
P.O. Box 8304
London, KY 40742-8304
If you have any questions, you may contact the district office at [phone number].
Sincerely,
[Examiner Name]
Examiner
Enclosure: OWCP-915 (Claim for Medical Reimbursement)