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EEOICPA OFFICE OF THE OMBUDSMAN. April 25, 2017 Albany, OR. General Information. Emergency Exits Restrooms Cell Phones Photographs and Videotaping Slide presentation is available on the Ombudsman web site: http://www.dol.gov/eeombd. What I am going to cover:.
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EEOICPA OFFICE OF THE OMBUDSMAN April 25, 2017 Albany, OR
General Information • Emergency Exits • Restrooms • Cell Phones • Photographs and Videotaping • Slide presentation is available on the Ombudsman web site: http://www.dol.gov/eeombd
What I am going to cover: • Overview of the Office of the Ombudsman • EEOICPA Part B • EEOICPA Part E • Questions
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.
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.
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
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
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)
Wah Chang Type of Facility: AWE 1971-1972 & Residual Radiation 1973 – March 1, 2011 Coverage: Part B – cancer only
Wah Chang Special Exposure Cohort All Atomic Weapons Employer employees who worked in any building at the Wah Chang facility in Albany, Oregon, for the operational period from January 1, 1971 through December 31, 1972, 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 May 29, 2011).
Albany Research Center Type of Facility: DOE Remediation 1987 – 1993 Coverage: Remediation – Part B & Part E for remediation workers only. Type of Facility: DOE 1995 - present Coverage: DOE – Part B only (cancer, CBD, beryllium sensitivity)
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
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
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)
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)
SEC Petition Process • NIOSH receives SEC petitions and makes recommendations as to whether a petition should be approved by Congress. • Any DOE, DOE contractor, subcontractor, AWE employee or their survivors can file a SEC petition. • Labor organizations representing or formerly representing such workers can file a SEC petition. • A petition must explain the basis for believing records and information available are inadequate to estimate the radiation doses incurred by members of the proposed class with sufficient accuracy. • Petition forms and information can be found online at https://www.cdc.gov/niosh/ocas/how2add.html#forms
General Part E – EligibilityWho 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 a continuous full time student, or • Any age if incapable of self support
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).
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 while employed at a covered 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).
Part E – Employee Benefits • Medical benefits for the covered illness(es), including home health care benefits. • Impairmentcompensation for permanent impairment for 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 condition. (Must be claimed). • There is a cap of $250,000 on Part E claims. However, no monetary cap on medical benefits.
Part E - Benefits • Survivors Benefits – 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)
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
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 from your claims examiner 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 from your claims examiner at any time. Your request must be in writing.
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.)
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.
Assistance The following DEEOIC Offices can also be contacted for assistance. HanfordResource Center 303 Bradley Blvd., Suite 104 Richland, WA 99352 Toll free: 888-654-0014 Fax: 509-946-2009 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
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