Board Advising the DEEOIC holds first public meeting of 2021

The Advisory Board on Toxic Substances and Worker Health held a virtual meeting April 22-23, 2021. Mr. Christopher Godfrey replaced Julia Hearthway as the Department of Labor’s (DOL) Director of the Office of Workers’ Compensation Programs on January 20, 2021.  He addressed the Board and acknowledged the importance of their work and promised to be respectful and responsive to the board.  He also said that he enjoyed learning about the program from Rachel Pond, the program’s director and that she is a terrific administrator.

Michael Chance, the Board’s Designated Federal Official, notified the Board that their charter expires in June.  He does not foresee any issues extending the charter for another two years.  He also told the Board that their long-standing request for a support contractor has been finally approved.  Hopefully, a contractor will be provided before the end of the fiscal year.

Ms. Pond and Mr. John Vance, Chief of the Policy Branch, provided the Board with the program’s highlights since November 2020,

• Instead of the Annual Quarterly Review of the claims process, DOL is implementing a quality process to ensure that claims are processed in accordance with the procedure manual.
• They are working on having the claimants’ case file available online. This will replace the need for claimant or authorized representative to request the file in writing from the claims examiner (CE).
• DOL is still experiencing delays for records requests from the Department of Energy (DOE) and Social Security Administration due to COVID-19.

Ms. Pond also said that the new case assignment process of randomly assigning claims to the District Offices was proceeding.  She assured the Board that each office has a Point of Contact that CEs can reach out to for explanations of specific sites.  One Board member questioned this policy noting that DOE sites are complex and have quirks that other similar sites may not have.

The Board made a recommendation that the Site Exposure Matrix should include disease links from the International Agency for Research on Cancer’s (IARC) 2 A  group.  Carcinogens from Group 2A have limited evidence in humans for cancer but could satisfy the legal standard that a toxic substance contributed or aggravated a disease.  The Board recommended that 11 carcinogens be added to SEM.

DOL requested that the board provide them with guidance on covered conditions which are impacted by Covid-19.  The board recommended that Covid-19 disease that impacts a covered condition be covered under EEOICPA.  The formal recommendation and rationale will be sent to DOL shortly.

The Asbestos Working Group recapped their recommendation on asbestos presumptions.  The Board felt that research shows that certain job categories should be added to DOL’s list of asbestos related job categories.  These jobs are Chemical Engineers, Health and Safety Engineers, and Mechanical Engineers.  The board did a detailed analysis based on malignant mesothelioma since it is specific to asbestos and found those three jobs had substantially elevated Proportionate Mortality Rate (PMR).  The board requested that DOL re-consider adding these job titles.  The formal recommendation and rationale will be sent to DOL shortly.

DOL asked the Board to weigh in on whether the Six Minute Walk test was a valid test for lung impairment.  The board provided a report which demonstrated that it was the best available method of estimating a person’s maximal oxygen uptake other than direct measurement of oxygen uptake and a valid, reliable, and robust method in determining impairment.

The Board discussed other issues having to do with impairment ratings.  The board noted that there seemed to be a high percentage of errors demonstrated by DOL’s internal audits of contract medical consultants (CMC).  No audit was done in 2020 as DOL is in the process of setting up a new auditing procedure.

The Board questioned what triggered an impairment rating to be brought to the Medical Director’s attention for an opinion on whether the rating is in accordance with the AMA Guides.  Mr. Vance said that any questions a CE has about the rating first goes to the Policy Branch.  The Policy Branch will then determine whether the question should go to the Medical Director.

The Board is asking for the numbers of impairment ratings as part of claims over the past two years; how many impairment ratings the OWCP Medical Director has reviewed and disputed (not as part of the quarterly report process); how many physician impairment raters are involved in these reviews; and what actions the CMC contractor is taking to improve impairment ratings.  The Board also noted that overseeing the Chief Medical Officer and the CMCs is a purview given them in their charter.

The Board is unsure if the fall meeting will be held by teleconference, in-person, or by a combination of the two.  If the meeting is held in person, the next populous site would be the Nevada Test Site.

For more information on the presentations, recommendations and public comments please visit the Board’s website.