Summary: Advisory Board Meeting 1/20/19 – 1/21/19

The Advisory Board on Toxic Substances and Worker Health (ABTSWH) met in Paducah Kentucky on November 20^th -21^st.  Their job is to advise the Division of Energy Employees Occupational Illness Compensation (DEEOIC) on certain scientific and medical issues.

The meeting began with federal official, Doug Fitzgerald, introducing the new Board member, Dr. Rose Goldman.  John Vance, Director of Policy for the DEEOIC then updated the Board on program changes in the Procedure Manual and Site Exposure Matrix (SEM).  Two of the changes in the Procedure Manual were driven by recommendations from the Board.  Mr. Vance also discussed some new initiatives the Department of Labor (DOL) is working on, including setting up a dedicated medical benefits department that will encompass durable medical equipment, oxygen, medical supplies, home and auto modifications and home health care.  They currently have 19 staff members working on this with the expectation of hiring 11 more.

DEEOIC is also expanding their quality assurance program as the Government Accountability Office recommended in their March 2016 report to Congress entitled, DOL Generally Followed Its Procedures to Process Claims but Could Strengthen Some Internal Controls.  They will also be looking for instances of waste, fraud and abuse.

Vance also stated that the DEEOIC expects to reopen 280 claims for the new Y-12 Site Exposure Cohort (SEC) to see if they qualify, as well as 20 for the new West Valley Demonstration Project SEC.

The Secretary of Labor has not yet reviewed the more recent Board recommendations.

The public version of the SEM will be updated and available to the public around the end of the year.  Matrices will be added for Weldon Springs Raffinate Pits, Weldon Springs Quarry, and Uranium Mines, Mills, and Ore Buying Stations.  Additional toxins have been added to the SEM.

The big news from the Procedural Manual updates was that the DEEOIC has accepted the Board’s recommendation and will be allowing Industrial Hygienists to talk directly with claimants, when needed, to better understand a worker’s toxic exposures.  The standard for asbestos exposures has been expanded to include the years 1945-1995 and the exposure labor categories have been expanded.  Again, this was based on Board recommendations

The Medical Benefits section of the Procedure Manual has been updated as well, with clarification on letters of medical necessity and a way for home health care providers to assist claimants at doctor appointments.  Look for a summary of the changes to the Procedure Manual in the coming weeks.

There are also changes to the way lung conditions will be able to be searched in the new public SEM when it is released.  Many lung conditions will be found under pneumoconiosis.

Malcolm Nelson, DOL Ombudsman, presented the findings from his 2018 Report to Congress.  Some of the issues he raised were difficulties claimants have in navigating the program, problems arising with terminal claims, and a issues beryllium vendor employees have when they develop cancers that could be caused by beryllium, since they are not covered under Part E.

The Board discussed claims they had reviewed since the last meeting.  They discussed data on reopened claims and the Parkinson-related disease Working Group reported on their work to date.  There is much more to do in this complicated area.

The Board also noted that the DEEOIC’s internal claim audit identified that 28% of their contract medical consultants (CMC) impairment ratings needed improvement while only 1% of causation claims were found to be deficient.  The Board is concerned because they found more deficiencies in the causation cases they have reviewed.

As usual, the end of the first meeting day culminated in Public Comments.  The Board was very appreciative of the comments, especially those from Paducah workers.

The board worked on a recommendation to the DEEOIC on how to handle exposures in the SEM for jobs that would have had many of the same exposures across the Department of Energy (DOE) complex.

The next Board teleconference will be held in January or February and the in-person meeting will be held in April or May at a yet to be named location.  The Board acknowledged that most of the members’ terms expire July 2020 and would like to get as much accomplished before then.