Chapter 2-0700 Exhibit 3

Establishing Causation for Hearing Loss

and Asbestosis

Asbestosis: A Claims Examiner is to accept Part E causation for asbestosis once the following three criteria are satisfied.

1. Medical: A medical diagnosis of asbestosis.

2. Employment: The employee is a covered DOE contractor employee at a covered DOE or RECA section 5 facility and in the course of employment was exposed to asbestos while at the DOE or RECA section 5 facility.

Asbestos existed at all covered DOE and RECA section 5 facilities. Using the Site Exposure Matrices (SEM), along with an examination of pertinent exposure data maintained in the case, a CE is to determine if there is a reasonable basis to conclude that the employee had exposure to asbestos. Additionally, the CE should reference EEOICPA Circular 15-05, “Occupational Exposure Guidance Relating to Asbestos,” for further guidance on asbestos exposure. If there is reason to doubt the employee’s exposure to asbestos because of the type of work performed, or other contradictory evidence, he or she is to request the following information from the claimant:

a. Contemporaneous medical evidence discussing the employee’s work history and exposure to asbestos at the covered facility. The presence of pleural thickening, interstitial fibrosis, neoplasia, or other medical findings characteristic of asbestosis also helps establish the relationship between employment and exposure;

b. Personnel or incident records disclosing exposure to asbestos; or

c. Persuasive affidavits from other employees, with reason to know, attesting to the employee’s asbestos exposure and other evidence such as independent studies of the facility or newspaper articles discussing asbestos exposure at the site.

Once the CE has collected all relevant exposure information, and he or she still cannot affirmatively conclude the extent or duration of employee’s exposure to asbestos, an Industrial Hygiene referral is to occur.

3. Exposure/Causation: Causation will be presumed when the case file contains evidence that the employee was exposed to asbestos for at least 250 aggregate workdays, and there was a latency period of at least 10 years between the start of covered DOE or RECA section 5 employment and the onset of asbestosis.

In a claim for an employee that does not meet the requirements of presumed causation because the evidence does not establish 250 days of asbestos exposure, or the latency requirement, the CE is to undertake development to obtain an opinion on causation from either the claimant’s treating physician or a Contract Medical Specialist (CMC).

Hearing Loss: Part E causation for hearing loss can be presumed without referral to National Office specialists if all three following conditions are satisfied:

1. Medical: The file contains a diagnosis of bilateral sensorineural hearing loss (conductive hearing loss is not known to be linked to toxic substance exposure).

2. Employment: The verified covered employment must be within at least one specified job category listed below

for a period of 10 consecutive years, completed prior to 1990. The labor categories are the following:

· Boilermaker

· Chemical Operator

· Chemist

· Electrician/Electrical Maintenance/Lineman

· Electroplater/Electroplating Technician

· Garage/Auto/Equipment Mechanic

· Guard/Security Officer/Security Patrol Officer (i.e., firearm cleaning activities)

· Instrument Mechanic/ Instrument Technician

· Janitor

· Laboratory Analyst/Aide

· Laboratory Technician/Technologist

· Lubricator

· Machinist

· Maintenance Mechanic

· Millwright

· Operator (most any industrial kind, the test being whether the operator position is one in which there is potential for solvent exposure)

· Painter

· Pipefitter

· Printer/Reproduction clerk

· Refrigeration Mechanic/HVAC Mechanic