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6 Elements of a Successful EEOICPA Claim: Tips for Linking Your Illness to Your Work Exposure

November 2, 2022

November 2, 2022

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It’s no secret that the process for qualifying for benefits under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) and garnering a coveted white medical benefits card can be long and complicated. According to statistics released by the DOL, only about 47% of the roughly 337,000 EEOICPA claims that have been filed as of 8/21/22 have been approved. While certain classes of workers with specific diseases have a higher probability of proving eligibility, the waiting and uncertainty can still be unnerving for most claimants.

The key to qualifying is linking your illness to your work exposure. Here are six things to keep in mind when filing a claim. Each of these criteria is considered by the U. S. Department of Labor (DOL) when reviewing claims:

  1. Your diagnoses. The whole process starts with you experiencing health problems—the type that cause you to eventually seek help from a doctor or other medical provider. This could be anything from difficulty breathing to tingling in your toes to a severe rash. You need to see a doctor who can make a clinical diagnosis of your problem. This is a critical step that cannot be overlooked. You can’t just be sick; you must be diagnosed.

There are currently more than 5,000 different illnesses that are considered “covered conditions” under EEOICPA. Some of the more common EEOICPA illnesses include: chronic beryllium disease (CBD), chronic obstructive pulmonary disease (COPD), emphysema, silicosis and skin cancer.

Some diagnoses, such as CBD or silicosis, are almost sure to guarantee your eligibility, because they are known as presumptive illnesses. This means they are presumed to have been caused by your exposure to radioactive materials while working. People who worked even one day at a covered DOE facility and are diagnosed with CBD will likely be compensated if they file a claim, since it is presumed the only place they could get CBD is at a nuclear weapons or beryllium facility.

Other illnesses under Part B are cancers, which require more proof established through a process called dose reconstruction, which is conducted by the National Institute for Occupational Safety & Health (NIOSH). This analysis will calculate the likelihood that you contracted cancer due to your workplace radiation exposure. If your dose reconstruction is 50% or more, you are likely eligible for benefits. For certain classes of workers, a Special Exposure Cohort (SEC) may apply, which make qualification far easier.

The threshold of proof for Part E claims in the program is that it is “at least as likely as not” that exposure to a toxic substance at a DOE facility caused, contributed to, or aggravated the worker’s illness or death.

  1. Where you worked. For many claimants, you must prove that you worked at one or more DOE covered facilities in the U.S. Currently there are more than 350 EEOICPA-covered facilities across the country where workers are eligible for a U.S. DOL white medical benefits card. By visiting the website, you can search to see if your facility or facilities are included on the approved list. Your place of employment can be verified through pay stubs and tax returns.
  2. When you worked. Dates of employment will often have a determinant effect on the success of your claim. For some specific work sites, Special Exposure Cohorts, or SECs, are established to make it easier to qualify for some cancer claims for workers who worked there during specific timeframes.

Your length of employment is often correlated to your length of exposure, so longer employment could increase your likelihood of qualifying, although there have been cases of workers being approved for benefits even if they only worked one day at a covered facility where they had high exposure.

  1. Your job function. The type of work you performed matters, as different jobs brought workers into contact with different radiation, toxins and exposure levels. Job responsibilities play a key role in the success of your claim. Job titles imply the type and amount of exposure you had. For applicants who worked at multiple sites over their careers, this section of the application can become more complicated, as some titles automatically suggests a higher probability of causation.
  2. Incidents or accidents. If there was a radiation or toxic release of some kind or an incident that created a higher level of exposure than normal during your time of employment, this could strengthen the merits of your claim. One example is the Church Rock uranium mill in New Mexico which experienced one of the largest releases of radioactive material on U.S. soil in July 1979.
  3. Type of toxins or radioactive materials on site. Your risk of and level of illness is directly related to the toxic or radioactive materials to which you were exposed while working. The U.S. DOL maintains the Site Exposure Matrices (SEM), a database of covered sites and the toxic substances that were present at those sites. This website also contains information regarding scientifically established links between toxic substances and recognized occupation illnesses. Under EEOICPA regulations, the SEM may be used to provide “probative factual evidence” that a toxic substance was present at a DOE covered facility. SEM is a useful tool for workers trying to determine their level of exposure. It can be viewed at sem.dol.gov.

Regardless of your situation, the best starting point for filing a successful EEOICPA claim is a call to our Cold War Patriots Outreach Help Center. We’ll get answers to your questions and direct you to key resources that you need. Bests of all, Cold War Patriots never charges a fee.

You’ve sacrificed your health to provide for our national security.  Now it’s our turn to help you.

Give us a call today at (888) 903-8989.