Chapter 2-1800 Exhibit 1

Sample FINAL DECISION cover letter - Acceptance

Dear Claimant Name:

Enclosed please a Final Decision on your claim for compensation under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). The district office recommends acceptance of your claim for Burkitt’s lymphoma under both Part B and Part E of the Act.

I have enclosed the Acceptance of Payment form (EN-20), which is required before the Office of Workers’ Compensation Programs can issue payment to you. You must complete the form in permanent ink and there can be no cross outs or other marks. Do not use white out or correction tape. Any alteration of the form will result in it being rendered unusable for purposes of issuing payment. If you make a mistake or need another form, please contact the district office handling your claim. You must submit the form with an original signature. Faxes or another copied version of the EN-20 is not acceptable. A second copy of the form is attached in case a mistake is made. Only one form needs to be returned. Please check with your financial institution before returning the form to us to verify the routing number and your account number so that your money arrives promptly and to the correct account.

Please email the completed and signed original EN-20 to:

U.S. Department of Labor

DEEOIC, District Office

P.O. Box XXXX

City, State ZIP

Please be advised that the final decision on your claim may be posted on the agency’s website if it contains significant findings of fact or conclusions of law that might be of interest to the public. If it is posted, your final decision will not contain your file number, nor will it identify you or your family members by name.

Any future correspondence, inquiries, or telephone calls should be directed to the (District Office) district office. Thank you for your cooperation.

Sincerely,

Hearing Representative

Final Adjudication Branch

NOTICE OF FINAL DECISION

This decision of the Final Adjudication Branch (FAB) concerns the above claim for benefits under the Energy Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA or the Act), as amended, 42 U.S.C. § 7384 et seq. For the reasons set forth below, the claim for benefits under Part B and Part E of the Act for Burkitt’s lymphoma is approved.

STATEMENT OF THE CASE

On February 6, 2012, the claimant filed a Form EE-1 under the Act. He claimed that he developed non-Hodgkin’s lymphoma as a consequence of his employment at multiple Department of Energy (DOE) facilities.

In support of his claim, he submitted a Form EE-3 indicating that he was employed at the Hanford Plant in Richland, Washington from 1976 to 1987, and at the Savannah River Site (SRS) in Aiken, South Carolina from June 1984 to July 1985. A representative of DOE confirmed that he was employed at Hanford by the Bechtel Corporation, a DOE subcontractor, from December 6, 1982 to December 30, 1983, by the J.A. Jones Company, a DOE subcontractor, from January 27, 1987 to February 28, 1987 and by Kaiser Engineers Hanford, a DOE contractor, from March 1, 1987 to May 1, 1987. Also, union dispatch records and occupational medicine records provided by the DOE establish that the claimant was employed at Hanford by the Bechtel Corporation from June 2, 1977 to March 23, 1978. In addition, radiation exposure monitoring records provided by the DOE establish that he was employed at the SRS, a DOE facility, by B.F. Shaw Company, a DOE subcontractor, from November 26, 1984 to June 23, 1985.[1]

Also in support of his claim, the claimant submitted a hematopathology report, signed by Dr. Jonathan Roller, documenting a diagnosis of non-Hodgkin’s lymphoma on November 1, 2011. A subsequent oncology visit report from Dr. Thomas Jacobsen, dated February 27, 2012, confirms a specific diagnosis of Burkitt’s lymphoma, a form of non-Hodgkin’s lymphoma, based on the particular characteristics of the malignant lymphocytes.

On October 9, 2012, the Seattle district office issued a recommended decision to accept the claim for Burkitt’s lymphoma under Parts B and E of EEOICPA, finding that the claimant is a member of the Special Exposure Cohort (SEC) who was diagnosed with a specified cancer after beginning employment at a DOE facility. The district office also recommended that the claimant be awarded compensation in the amount of $150,000.00 under Part B, and medical benefits for the treatment of Burkitt’s lymphoma retroactive to February 6, 2012 under both Part B and Part E of the Act.

The claimant submitted a Form EN-16, dated October 16, 2012, declaring that he had neither filed a tort suit nor received any settlement or award from a claim or suit related to an exposure for which he would be eligible to receive compensation under the Act. He also declared that he had neither filed for nor received any state workers’ compensation benefits on account of the claimed illness. And finally, the claimant declared that he had neither pled guilty to nor been convicted on any charges of having committed fraud in connection with an application for or receipt of benefits under the Act or any other federal or state workers’ compensation law.

On October 22, 2012, FAB received the claimant’s written notification indicating that he waived all rights to file objections to the findings of fact and conclusions of law in the recommended decision.

Based on an independent review of the evidence of record, FAB hereby makes the following:

FINDINGS OF FACT

1. On February 6, 2012, the claimant filed a claim for benefits under the Act for non-Hodgkin’s lymphoma due to employment at DOE facilities.

2. The claimant was employed at Hanford, a DOE facility, by the Bechtel Corporation, a DOE subcontractor, from June 2, 1977 to March 23, 1978 and December 6, 1982 to December 30, 1983, by the J.A. Jones Company, a DOE subcontractor, from January 27, 1987 to February 28, 1987 and by Kaiser Engineers Hanford, a DOE contractor, from March 1, 1987 to May 1, 1987. In addition, he was employed at the SRS, a DOE facility, by B.F. Shaw Company, a DOE subcontractor, from November 26, 1984 to June 23, 1985.

3. The claimant was diagnosed with Burkitt’s lymphoma, a form of non-Hodgkin’s lymphoma, on November 1, 2011.

4. The claimant has neither filed a tort suit nor received any settlement or award from a claim or suit related to an exposure for which he would be eligible to receive compensation under the Act. He has neither filed for nor received any state workers’ compensation benefits on account of the claimed illness, and he has neither pled guilty to nor been convicted on any charges of having committed fraud in connection with an application for or receipt of benefits under the Act or any other federal or state workers’ compensation law.

Based on these findings of fact, FAB hereby makes the following:

CONCLUSIONS OF LAW

If a claimant waives any objections to all or part of the recommended decision, FAB may issue a final decision accepting the recommendation of the district office, either in whole or in part. 20 C.F.R. § 30.316(a) (2012). The claimant waived his right to file objections to the findings of fact and conclusions of law in the recommended decision.

Under Part B of the Act, an individual is a “covered employee with cancer” if that individual is a member of the SEC who contracted a specified cancer after beginning employment at a DOE facility. 42 U.S.C. § 7384l(9)(A).

On August 23, 2012, the Secretary of Health and Human Services designated the following class of employees for addition to the SEC in a report to Congress:

All employees of the DOE, its predecessor agencies, and their contractors and subcontractors who worked at Hanford in Richland, Washington, from July 1, 1972 through December 31, 1983, 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 SEC.

See EEOICPA Circular No. 12-16 (issued September 22, 2012).

The claimant was employed at Hanford by a DOE subcontractor for a period in excess of 250 work days between July 1, 1972 and December 31, 1983. Therefore, he is a member of the SEC. Also, Burkitt’s lymphoma is a specified cancer, provided the onset of the condition occurred at least five years after the initial exposure to radiation during covered employment. 20 C.F.R. § 30.5(ff)(5)(ii). The claimant began working at Hanford on June 2, 1977, and was diagnosed with Burkitt’s lymphoma on November 1, 2011. Therefore, he was diagnosed with a specified cancer over 5 years after beginning employment at a DOE facility.

Accordingly, the claimant is a “covered employee with cancer” under Part B in accordance with 42 U.S.C. § 7384l(9)(A), and his Burkitt’s lymphoma is an “occupational illness” in accordance with 42 U.S.C. § 7384l(15). As such, he is entitled to compensation in the amount of $150,000.00 and medical benefits under Part B, retroactive to February 6, 2012; the date of filing.

Further, since the claimant was employed by DOE contractors and subcontractors at covered DOE facilities during covered time periods, and given the acceptance of his Part B claim, that acceptance is treated for the purposes of Part E of the Act as a determination that he contracted his illness through work-related exposure to a toxic substance at a DOE facility. 42 U.S.C. § 7385s-4(a). As such, the FAB finds that the claimant is also a “covered DOE contractor employee” under Part E, and his Burkitt’s lymphoma is a “covered illness” under Part E. As a covered DOE contractor, the claimant is also entitled to medical benefits for his Burkitt’s lymphoma under Part E.

In summary, the claim for benefits under Part B and Part E of EEOICPA for Burkitt’s lymphoma is approved. The claimant is awarded $150,000.00 under Part B and medical benefits for the treatment of Burkitt’s lymphoma, retroactive to February 6, 2012, under Part B and Part E of the Act.

Washington, D.C.

__________________________

Name

Hearing Representative

Final Adjudication Branch