Energy Employees Occupational Illness Compensation Program

1. Energy Employees Occupational Illness Compensation Program Joint Outreach Task Group Program Overview February 2016

2. Today’s Agenda Housekeeping Information DOL overview of EEOICPA – Parts B and E Department of Energy, including BTMed and ORAU Former Worker Screening programs Ombudsman for EEOICPA Question and Answer session Opportunity to meet with agency representatives, including NIOSH representative

3. Important Information • Emergency Exits • Restrooms • Photographs & Videotaping • Cell Phones • Q&A • Slide Presentation will be available on DOL web site: http://www.dol.gov/owcp/energy/ • Working meeting – agency reps available to meet with individuals

4. The EEOICPA • Administered by the Labor Department’s Division of Energy Employees Occupational Illness Compensation (DEEOIC) • Provides lump-sum compensation and medical benefits to current and former nuclear weapons workers • Survivors of qualified workers may also be entitled to benefits

5. Administration of the EEOICPA • Agencies: • Department of Labor (DOL) • Department of Energy (DOE) • Department of Health and Human Services • National Institute for Occupational Safety and Health (NIOSH) • Department of Justice (DOJ)

6. Eligibility – Two Paths

7. Employee Eligibility 6

8. Eligibility – Medical Part B • Cancer • Chronic Beryllium Disease • Chronic Silicosis • RECA Section 5 awardees Part E • Any condition related to toxic substances 7

9. Eligibility – Survivors Part B • Spouse • Adult Children • Grandchildren • Grandparents Part E • Spouse (death related) • Children (<age 18, <age 23 if full time student) • Medically incapable of self support 8

10. Benefits 9

11. Means of Verifying Employment DOE – Earnings Records Oak Ridge Institute for Science and Education (ORISE) Corporate Verifiers SSA Wage Data Other Sources Affidavits Records/documents created by state/federal agencies 10

12. Part B: Dose Reconstruction & Probability of Causation (PoC) • Part B Cancer Cases and Dose Reconstruction • NIOSH • Level and extent of occupational radiation dose • PoC • Scientific calculation of likelihood that radiation exposure caused cancer • NIOSH Computer System • PoC - 50% or greater for award

13. Part B: Special Exposure Cohort (SEC) Presumption of causation - cancer Employment Covered in class defined by NIOSH Work day requirement – 250 work days “Specified” Cancer 22 cancers named in law No need for dose reconstruction 12

14. Part B: Adding New SEC Classes • NIOSH designates new SEC classes • 4 statutory SEC classes; plus • As of December 31, 2015, HHS has designated 115 additional SEC classes • DOL administers SEC cases • No role in designation

15. Part E: Causation Exposure to toxic substances Causation standard different than under Part B Includes aggravation, contribution DOL Tools: Occupational History Questionnaire (OHQ) Site Exposure Matrices (SEM) DAR records Former Worker Medical Screening Program (FWP) work history interviews Other Sources: Affidavits/facility records 14

16. Site Exposure Matrices (SEM) Website • Toxic substances present at DOE and RECA Section 5 Facilities • Information gathered from a variety of sources • Scientifically established links between certain toxic substances and certain illnesses • Available at http://192.104.4.234/

17. Part E: Employee Impairment • % permanent whole person impairment due to covered illness • AMA’s Guides to the Evaluation of Permanent Impairment, 5th Edition • $2,500 awarded for each % of impairment

18. Part E: Employee Wage Loss • Decreased capacity to work due to an accepted medical condition • Employee Compensation: • Any year <50% of pre-disability annual wage = $15,000 compensation • Any year > 50% but <75% of pre-disability annual wage = $10,000 compensation

19. Application – Claimant Responsibilities

20. DOL Responsibilities

21. EEOICPA Compensation • $12.2 Billion Total Compensation • $5.88 Billion Part B • $3.66 Billion Part E • $2.66 Billion Medical Data as of February 15, 2016

22. Florida Compensation • $249.5 Million Total Compensation • $154.5 Million Part B • $68.9 Million Part E • $26.1 Million Medical Data as of February 15, 2016

23. Covered Facilities Website https://ehss.energy.gov/Search/Facility/findfacility.aspx * Includes all covered facilities in Florida

24. Claimant Resources • 11 Resource Centers Nationwide • Savannah River Resource Center toll free number: (866) 666-4606 • 4 District Offices locations • Jacksonville District Office toll free number: (877) 336-4272 • DEEOIC web site www.dol.gov/owcp/energy/ • General program information • SEM website • Forms • Sample decisions

26. District Office Jurisdictional Map

27. Department of Energy Support to the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) and the Former Worker Medical Screening Program (FWP) Office of Environment, Health, Safety and Security February 2016

28. DOE Responsibilities • Respond to DOL and NIOSH requests for information related to individual claims (employment verification, exposure records). • Provide support and assistance to DOL, NIOSH, and Advisory Board on large-scale research and site characterization projects through records research and retrieval efforts at various DOE sites. • Conduct research, in coordination with DOL and NIOSH, on issues related to covered facilities designations.

29. Individual Records • Claimants often worked at multiple DOE sites, for multiple contractors and subcontractors, and in different jobs or divisions over a career. • Records packages that DOE provides to DOL and NIOSH can be hundreds of pages long.

30. Former Worker Medical Screening Program

31. FWP Background Program serves all former Federal, contractor, and subcontractor workers from all DOE sites Mission: • Identify and notify former workers at risk for occupational disease. • Offer them medical screening that can lead to treatment. • Provide information and assistance about medical follow-up and compensation. • Use findings to strengthen safety and health protection for current and future workers.

32. Former Worker ProgramContacts • National Supplemental Screening Program (NSSP) • Production and in-house workers • 1-866-812-6703 or • http://www.orau.org/nssp/ • Building Trades National Medical Screening Program (BTMed) • Construction and subcontractor workers • 1-800-866-9663 or www.btmed.org

33. Building trades national medical screening program(BTMED)February 2016

34. overview • Started in 1996 • Covers DOE construction/sub contractor workers • Completed 32,660 medical exams • (500 in Florida) and 2,200 CT scans • • 99% satisfaction rating! www.btmed.org

35. Covered sites

36. BTMed Network Provider Locations

37. Medical Services (200+ medical providers) • Occupational and medical history • Physical exam • Chest X-ray • Blood test (including GHP, BeLPT) • Spirometry • Hearing test www.btmed.org

38. Medical Findings • Abnormal chest x-rays in 18%, • Abnormal pulmonary function in 40%, • Evidence of hearing loss in 64%. • Beryllium sensitization in about 1.5% • 17 lung cancers www.btmed.org

39. Did you work construction at a DOE site? www.btmed.org/1-800-866-9663

40. National Supplemental Screening Program Oak Ridge Associated Universities February 22-24, 2016

41. National Supplemental Screening Program (NSSP) • Oak Ridge Associated Universities manages the NSSP, and with its partners: • National Jewish Health • University of Colorado-Denver • Comprehensive Health Services, Inc. • Axion Health provides free medical examinations to Department of Energy former workers on a nation-wide basis

42. National Supplemental Screening Program (NSSP) • Provides an integrated health model • Occupational and Non-Occupational health conditions • Exposure-based medical examinations • > 2,000 medical centers used • Medical exams performed in all 50 states, Canada, and Puerto Rico • NSSP - 99% participant satisfaction rating

43. NSSP Meets the Needs of DOE Former Workers LEGEND  CHSi Facilities Total: 2,091

44. NSSP through 01/31/2016 Enrolled (All Sites) - 17,020 Examined Initial Exam - 15,074 1st 3-Year Rescreening - 2,287 2nd 3-Year Rescreening - 286

45. NSSP through 01/31/2016 Enrolled (Pinellas) - 683 Examined Initial Exam - 635 1st 3-Year Rescreening - 145 2nd 3-Year Rescreening - 13

46. Occupational Medical Conditions

47. Non-Occupational Medical Conditions

48. NSSP Key Points • Demonstrated the importance of using a holistic integrated approach to former worker wellness. • Identified occupational health conditions in 40.5% of those screened. • Also identified 85.8% of participants with significant and often newly identified addressable health conditions that were non-occupational.

49. THE OFFICE OF THE OMBUDSMAN FOR EEOICPA February 2016 Orlando & Tampa, FL

50. EEOICPA and THE OFFICE OF THE OMBUDSMAN History: • October 2000 – Congress enacted EEOICPA • Part B administered by Department of Labor • Part D administered by Department of Energy • October 2004 - Congress repealed Part D and established Part E. • Part E administered by the Department of Labor