Highlights from the 11/8 – 11/9 Advisory Board meeting

The Advisory Board on Toxic Substances and Worker Health held a two-day virtual meeting November 8-9, 2021.

Rachel Pond, Director of the Division of Energy Employees Occupational Illness Compensation (DEEOIC), and John Vance, Chief, Policy Branch, provided an update on changes to the program.

DEEOIC stopped the Quarterly Review audits. Instead, the audits of claims will be done on an ongoing basis. The audit will look at various stages of the claims process and will include

• Reviewing the claims examiners’ development and Recommended Decision.
• The work of the Final Adjudication Branch.
• The work of the Medical Benefits Branch.

DEEOIC will issue and publish quarterly reports on this review.

DEEOIC has eliminated all paper files. The documents have been transferred to electronic files. Living workers will have access to their electronic files this year with authorized representatives to have access next year. It will be longer for survivors to access the electronic files because DEEOIC will need to redact personal private information from the files.

DEEOIC continues to provide training seminars to staff, including training on Customer Service. This training addresses the proper way to talk to claimants and providers and civility in the workplace.

Mr. Vance provided a synopsis of the recent changes to the Procedure Manual (PM). Many were administrative updates, such as changing the title from Medical Director to Medical Officer. Others included updating the chapters on claims for impairment, and new chapters on medical benefits.

Dr. Steven Markowitz, the Board’s Chair, asked whether the Medical Director was still involved in reviewing impairment claims. Mr. Vance replied that the title is now Medical Officer and that he is no longer involved with impairment claims. According to the updated PM, the Medical Officer is now only responsible for determining whether a claim for an organ transplant or experimental treatment are warranted. There is still some confusion on the role of the Medical Officer since DEEOIC representatives also mentioned that they “are moving away from using the Medical Officer” and that he plays a small role in claim evaluations.  He will be used in “limited circumstances”.

DEEOIC accepted the Board’s recommendation to include disease related links from the International Agency on Cancer Research (IARC) and the National Toxicology Program. The Site Exposure Matrix (SEM) will be updated with the links and should be available on November 16, 2021.

There was a discussion on reports from the industrial hygienists (IH). Only two worker interviews with an IH have been requested by a claims examiner in the two years since this policy was adopted. Only the claims examiner can request that an interview be conducted. One board member noted that many IH reports state that the worker would not have been exposed to toxic substances over the legal limit and questioned those conclusions. Another member shared his experience as an IH stating that he conducted many interviews and was shocked that only one interview a year has been done. A member suggested that perhaps the new Occupational Health Questionnaire is capturing the necessary information. It was suggested that a pilot project be initiated to conduct more interviews to determine whether the interviews with the worker would provide more and better information on the exposures.

The Board is still without a support contractor, but it is likely that they will have one in the near future. Michael Chance, the Board’s Designated Federal Official, explained that the procurement process is slow and that the request is moving as quickly as possible. The Department of Labor is preparing to issue a Request for Proposal but needs some clarification from the Board on what the tasks and responsibilities of the contractor will be.

The Board decided to take a look at a sampling of claims which would represent approved and denied claims.  The types of claims that would like to review are,

• Claims for first responders and similar job categories.
• Claims containing IH reports.
• Claims for Impairment.
• Claims for Parkinson’s Disease.
• Part E cancer claims.

Board members who reviewed claims previously asked whether the claim files can be better organized or at least have an index so that the members can locate documents easily. The Board was informed that the files are arranged chronologically but DEEOIC would not be able to provide an index.

The transcript of the meeting will be posted to the Board’s page within 45 days and the minutes within 90 days.