Talk to Terrie: Filing for Consequential Diseases

Many workers who have been approved by the Department of Labor’s Division of Energy Employees Occupational Illness Compensation Program (DEEOIC) know that if they develop a disease that is the result of the treatment for the originally covered disease, that condition can also be covered by DEEOIC. These are known as consequential diseases.

But for those who are not familiar with this, allow me to explain further why it’s too your benefit to file a claim.

Consequential diseases can be, for instance, the result of side effects from medications prescribed for treatment of the covered disease. A friend gave me permission to share his experience with filing for a consequential disease. He worked at a company that was designated as a Beryllium Vendor under the program. He developed chronic beryllium disease (CBD) and was compensated under Part B. Beryllium Vendor employees are not eligible for claiming other diseases, such as cancer or silicosis, under the statute nor can they apply for medical or financial compensation under Part E.

It is commonly accepted that steroids prescribed to treat CBD can result in the development of heart disease. He developed heart disease and was approved for heart disease as being the consequence of the prescription medication he used for CBD. Sadly, he then developed cancer. He learned that one side effect of the medication he takes for his heart condition can result in the development of the cancer he has. He showed his physician the medical studies. After reviewing several medical studies, his physician concluded, absent any other contributing factor such as smoking, that the heart medication was likely to have caused, contributed to, or aggravated the development of the cancer.

DEEOIC reviewed the physician’s rationalized letter, the medical studies, and the medical history and agreed that the medication used for a covered disease was responsible for the development of the cancer. My friend now has full medical coverage for the cancer. This means he has no out-of-pocket expenses or deductibles for any treatment or surgeries for the cancer. If he was a DOE a Beryllium Vendor employee, he would also be eligible to file for increased impairment and wage loss, if any.

Consequential conditions can also be claimed. For instance, you are at your doctor’s office to renew your prescription for the originally covered condition. Upon leaving, you trip on a step, fall and break your ankle. Treatment for the broken ankle can be covered.

The physicians’ letters are a key piece of evidence in a claim for consequential diseases. The DEEOIC Procedure Manual offers some guidance about what information the opinion should contain:

• A description of the patient’s covered disease and the medical treatment the claimant has been prescribed to treat the disease.
• A description of the consequential disease being claimed.
• How the consequential disease is the result of any treatment for the originally covered disease.
• Citations from relevant and credible medical studies.
• Office notes, diagnostic testing, or other relevant medical evidence.

To file a claim for consequential disease the worker must complete and submit form EE-1 (Survivors must use form EE-2). The Procedure Manual also recommends that,

Ideally, the claimant should concurrently send a written statement identifying the specific nature of the consequential condition claimed, along with a signed EE-1/2. A signed EE-1/2 is required, because it provides notice to the claimant of his or her responsibilities in filing for benefits under the Act.

Forms EE-1 and EE-2 cannot be uploaded through the portal.  They must be either mailed to:

U.S. Department of Labor
OWCP/DEEOIC
PO Box 8306
London, KY 40742-8306

Or dropped off or faxed to a Resource Center.

If you have further questions or need assistance, please contact our Help Center at 1-888-837-7390.