EEOICPA OFFICE OF THE OMBUDSMAN

1. EEOICPA OFFICE OF THE OMBUDSMAN August 11, 2016 Idaho Falls, ID

2. What I am going to cover: • Overview of the Office of the Ombudsman • EEOICPA Part B • EEOICPA Part E • Slide presentation is available on the Ombudsman web site: http://www.dol.gov/eeombd

3. OFFICE OF THE OMBUDSMAN • EEOICPA passed by Congress in 2000. • October 2004 legislation also created the Office of the Ombudsman. • The Office of the Ombudsman is independent from the offices within the Department of Labor that administer EEOICPA. • In 2010, Congress expanded the authority of the Office to include Part B of the EEOICPA. • In 2014, the Congress extended the authority of the Office through October 28, 2019.

4. OFFICE OF THE OMBUDSMAN Our Duties: Provide information on the benefits available under the EEOICPA. Make recommendations regarding the location of resource centers for the acceptance and development of claims – there are currently 11 resource centers. Submit an annual report to Congress detailing: a) The number and types of complaints, grievances and requests for assistance received during the year, and b) An assessment of the most common difficulties encountered by claimants during the year.

5. OFFICE OF THE OMBUDSMAN Limitations – The Office cannot: • Rule or make decisions on claims • “Make” DEEOIC reverse or change a decision • Request that Congress revise the Act • Take DEEOIC to court • Lobby Congress • Act as an advocate

6. OMBUDSMAN ASSISTANCE • When the Office receives complaints, grievances, and requests for assistance: • We respond to inquires from claimants, attorneys, lay representatives, congressional staff and others • We explain, review and discuss aspects of the EEOICPA claims process • We answer questions and provide other assistance to individuals encountering difficulties with claims pending with DEEOIC • We discuss your concerns in our annual report to Congress

7. OMBUDSMAN ASSISTANCE • Outreach efforts and initiatives include: • Sponsoring town hall meetings • Participating in DEEOIC sponsored town hall meetings and traveling resource centers • Offering opportunities for individuals to speak one-on-one with Ombudsman staff • Coordinating efforts with the Joint Outreach Task Group (JOTG)

8. EEOICPAPart B Overview

9. Idaho National Laboratory Location: Scoville, ID Type of Facility: DOE Dates of Operation: 1949 – Present

10. Argonne National Laboratory - West Location: Scoville, ID Type of Facility: DOE Dates of Operation: 1949 – 2005

11. General Part B Eligibility – (Who is covered?) Employee Eligibility: • DOE Employee • DOE Contractor or Subcontractor • Beryllium Vendors • Atomic Weapons Employer • Approved Section 5 RECA claims Survivor Eligibility: • Eligible Spouse • Children • Parents • Grandchildren • Grandparents

12. General Part B Eligibility • Illnesses covered under Part B: • Cancer • Chronic beryllium disease (CBD) • Chronic silicosis (only for employees who worked during the mining of test tunnels related to an atomic weapon at a DOE facility in Nevada or Alaska) • Beryllium sensitivity

13. General Part B Eligibility • Cancer Claims are determined by: 1)NIOSH Dose Reconstruction - 50% or greater probability of causation (PoC) that the cancer was caused by radiation exposure at a covered facility. OR 2).Special Exposure Cohort (SEC) employment and a diagnosis of one of the 22 specified cancers. (Fast track)

14. INL Special Exposure Cohort All employees of the DOE, its predecessor agencies, and their contractors and subcontractors who worked at the Idaho National Laboratory (INL) and were monitored for external radiation at INL (e.g., having at least one film badge or TLD dosimeter) during the period from March 1, 1970, through December 31, 1974, and were employed for a number of work days aggregating at least 250 work days, occurring either solely under employment during the period from March 1, 1970, through December 31, 1974, or in combination with work days within the parameters established for one or more other classes of employees in the Special Exposure Cohort. (Effective July 3, 2016).

15. ANL-WestSpecial Exposure Cohort All employees of the DOE, its predecessor agencies, and their contractors and subcontractors who worked at the Argonne National Laboratory-West during the time period from April 10, 1951, through December 31, 1957, 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 Special Exposure Cohort. (Effective July 3, 2016).

16. Part B - Benefits • For any cancer, CBD, and chronic silicosis - $150,000 (lump sum) + medical benefits for the approved condition(s) • For Beryllium Sensitivity – only medical monitoring • For approved Section 5 RECA claims - $50,000 + medical benefits for the approved condition(s)

17. Practical Information - File a claim for any/all cancers, i.e., skin - File a new claim for any/all new cancers - Claim can be reopened any time - Make sure you have reported any/all potentially covered employment to DOL - Review your Occupational History Interview for completeness/accuracy

18. EEOICPAPart E Overview

19. General Part E – Eligibility(Who is covered?) Employee Eligibility • DOE Contractors • DOE Subcontractors • RECA Section 5 Uranium miners, millers, and ore transporters Survivor Eligibility • Spouse • Child – who at the time of the employee’s death was: • Under age 18, or • Under age 23 and enrolled as a continuous full time student, or • Any age if medically incapable of self support

20. Part E - Covered Illness • What is a Covered Illness? Any illness (or death) where it is “at least as likely as not” that exposure to a toxic substance(s) at a covered DOE or Section 5 RECA facility, during a covered time period, was a significant factor in aggravating, contributing to, or causing the employee’s illness (or death).

21. Part E - Burden of Proof Evidence Required: Medical evidence to establish a covered illness. (Proof of a confirmed medical illness is needed – description of symptoms is not sufficient). Evidence of exposure to a toxic substance during a period of covered employment at a DOE or Section 5 RECA facility. Evidence of an established scientific link associated to a specific toxic substance(s) significant enough to have caused, contributed to, or aggravated the claimed diagnosed illness (or death).

22. Program Presumptions • A presumption is an inference that can be drawn from a set of facts or evidence. • It can be disproven, but not without facts or evidence to the contrary. • DOL has published presumptions for certain illnesses. - Examples include: • Hearing loss (PM Chapter 2-700, Exhibit 3) • Asbestosis (PM Chapter 2-700, Exhibit 3) • COPD (Bulletin 16-02) • Asthma (Bulletin 16-01)

23. Practical Information - You can access and search the DOL Site Exposure Matrices (SEM) database of toxic substances online at http://www.sem.dol.gov/. - You may search the SEM database by your work facility; onsite buildings; labor category; disease; work process; or incidents. - You may print and share this information with your doctor to assist you in proving your case.

24. Practical Information • DOL may have your claim reviewed by a specialist (CMC, IH, Toxicologist, Referee) & you should be provided a copy of the report with your Recommended Decision. • You can request a copy of any specialist report at any time, even before your decision. Your request must be in writing. • You can request a copy of your file or part of your file at any time. Your request must be in writing.

25. Part E – Employee Benefits(Claims filed by the Worker) • Medical benefits for the covered illness(es), including home health care benefits. • Impairmentcompensation for permanent impairment as a result of the accepted covered illness(es). (Must be claimed). • Wage loss compensation based upon the years of reduced or lost wages, prior to your normal Social Security retirement age, due to the accepted covered illness(es). (Must be claimed). • There is a cap of $250,000 on Part E claims. However, no monetary cap on medical benefits.

26. Part E - Benefits • Survivors Benefits for Approved Part E claims: • Lump sum compensation of $125,000 (plus wage loss if applicable) • Wage Loss – Survivors may also be eligible for additional compensation for wage loss if: • The employee accrued between 10 and 19 years of wage loss due to the approved condition. ($25,000) • The employee accrued 20 years or more of wage loss due to the approved condition. ($50,000)

27. Practical Information If claim accepted for medical benefits, you can: • Confirm your provider is enrolled or find enrolled providers online by clicking on Provider Search at http://owcp.dol.acs-inc.com/portal/main.do. • You must notify DOL in writing of change in health care provider. • If your accepted covered illness or treatment for the illness causes a new illness or injury, you can file a claim for consequential illness/injury. (You must file a claim form.)

28. How to submit documents to DOL • Mail to central mailroom in London, KY • Fax to your claims examiner in local district office or FAB office • Take to local Resource Center and have them send to DOL • Upload to Energy Document Portal – https://eclaimant.dol-esa.gov. • You may request extension of time to submit documents to DOL. Must be in writing.

29. Part B and Part E Claims The following DEEOIC Offices can also be contacted for assistance. Idaho Resource Center Exchange Plaza 1820 East 17th St., Suite 250 Idaho Falls, ID 83404 Toll free: 800-861-8608 Seattle District Office DOL, DEEOIC Central Mail Room P.O. Box 8306 London, KY 40742-8306 Toll free: 888-805-3401 FAX: 206-224-1216

30. ONLINE RESOURCES • DEEOIC - http://www.dol.gov/owcp/energy/ • DEEOIC Procedure Manual - http://www.dol.gov/owcp/energy/regs/compliance/PolicyandProcedures/UnifiedProcedureManual.htm • DEEOIC Final Bulletins and Final Circulars - http://www.dol.gov/owcp/energy/regs/compliance/PolicyandProcedures/FinalBulletinshtml.htm and http://www.dol.gov/owcp/energy/regs/compliance/PolicyandProcedures/finalcircularshtml.htm • EEOICPA (the Act) - http://www.dol.gov/owcp/energy/regs/compliance/law/EEOICPAALL.htm • Federal (EEOICPA) Regulations - http://www.dol.gov/owcp/energy/regs/compliance/law/FinalRuleInRegister.pdf

31. Affiliated EEOICPA Agencies • Department of Labor’s Division of Energy Employees Occupational Illness Compensation (DEEOIC) • Department of Energy (DOE) • DOE Former Worker Programs • National Institute for Occupational Safety and Health (NIOSH) • Department of Justice (DOJ) – adjudicates RECA claims • Advisory Board on Toxic Substances and Worker Health

32. Ombudsman Contact Information Mail: U.S. Department of Labor Office of the Ombudsman for EEOICPA 200 Constitution Ave., N.W. Room N-2454 Washington, D.C. 20210 Toll Free: 1-877-662-8363 Fax: (202) 693-5899 Email:ombudsman@dol.gov Website:www.dol.gov/eeombd