Summary: Advisory Board Meeting April 15-16, 2020

Board agrees to finalize recommendations to DEEOIC before their term expires

The Advisory Board on Toxic Substances and Worker Health, which advises the Department of Labor’s Division of Energy Employees Occupational Illness Compensation (DEEOIC) held a virtual meeting April 15-16, 2020.

The Chair, Dr. Steven Markowitz, asked Michael Chance, the Designated Federal Official, to summarize a conversation they had on April 2, 2020 along with Doug Pennington, DEEOIC Deputy Director. The subject of the call was the years long request by the Board to obtain a support contractor to assist with their statutory responsibilities.

The Board feels it is necessary for them to have a contractor to be able to carry out its work. They currently do not have the capacity to properly oversee the quality of the work by Industrial Hygienists and Contract Medial Consultants as legislated by Congress.

Mr. Chance explained that it is unlikely that the Board’s request will be granted next year since the budget for fiscal year 2021 has been submitted and the cost related to the support contractor was not included. He added that the Board must define the mission of the contract, the tasks to be performed and the hourly rates for the personnel. This will then be submitted to the Secretary of Labor for his consideration. Mr. Chance warned that with the “huge crunch on government resources” the Board needs to “…develop a working business case to illustrate the need for funds and that they need to demonstrate a ‘compelling reason’ why the Secretary should allocate funds to the Board instead of to other Labor offices competing for the same, limited financial resources.”

Mr. Chance also reminded the Board members who wish to continue to serve to submit their paperwork no later than May 1, 2020.

The term for this Board ends July 15, 2020. They will work on providing the requested information and hope to have it ready for the full board’s vote during the meeting at the end of June 2020.
DEEOIC provided updates to the Board on changes to the program. These include:

• Medical benefits costs are rising due to the claimant population aging and developing more consequential diseases.
• DEEOIC made changes to the case assignment process. Instead of assigning cases to District Offices bases on the DOE site, DEEOIC will distribute cases to even out the workload among the District Offices. Each District Office will have a point of contact so that claims examiners can call with questions about a site which the District Office previously adjudicated. The claims examiners will also have access to a library which the District Offices accumulated for specific sites. DEEOIC will have a weekly review of decisions to ensure a robust review process.
• The Board was informed of how DEEOIC is coping with the COVID-19 pandemic. The explained the changes for reauthorizing home health care and durable medical equipment. DEEOIC will allow teleconference for these authorization with the provision that a registered nurse or physician’s assistant was present in the claimant’s home during the video conference. DEEOIC also offered that the personal physician must weigh the risk of exposing the claimant to COVID-19 versus the medical care the claimant needs.
• DEEOIC stated that they will be flexible with time limits to respond for additional information. They are also working on other impacts the pandemic may have on the claims’ process.
• DEEOIC will cover workers accepted under the program if they contract COVID-19 as long as their physician provides a fully rationalized report linking the development of the virus to the covered condition.
• The Board had recommended that DEEOIC review Exhibit 18-1 for the contradictory statement involving smoking history and the presumption for COPD which DEEOIC accepted. DEEOIC agreed and will remove Exhibit 18-1 from the Procedure Manual.

Department of Energy stated that they are not fully staffed and cannot verify employment quickly and that this may delay the claims’ process.

The Board and DEEOIC have been discussing ways to improve the Occupational Health Questionnaire (OHQ). The Board agreed with the changes DEEOIC made to the document but will recommend that:

• DEEOIC add a question that would trigger the worker’s memory.
• Send a copy of the OHQ to the worker before the interview or send a shortened version of the OHQ to the claimant or brochure of what to expect in the interview.
• Work with the Ombudsman’s office on this project.

Dr. Mikulski presented his findings to the Board on causative agents for Parkinsonism/Parkinson Disease. The Board will review the current research and hope to make a recommendation to improve DEEOIC’s adjudication of Parkinsonism/Parkinson Disease before the end of the Board’s term in July.

Dr. Berenji reviewed the IARC 2A chemicals that might be incorporated into the Site Exposure Matrix. These chemicals are probable human carcinogens. While the group of IARC identified chemicals that are listed as carcinogenic to humans are currently incorporated into the SEM, the probable carcinogens are not. Director Pond verified that the chemicals listed in the SEM are causative only and not chemicals which aggravate or contribute to covered illnesses.

On February 12, DEEOIC asked the Board to assist them by providing the certification requirements for B Readers (x-ray technicians). Dr. Goldman reported that the certification is administered by NIOSH and that a list of qualified B Readers is available on the NIOSH website, although these may be out of date. The Board passed a resolution providing DEEOIC with information on the B Readers Certification.
The Board feels it is necessary for them to have a contractor, as legislated, to be able to carry out its work. They currently do not have the capacity to properly oversee the quality of the work by Industrial Hygienists and Contract Medial Consultants as legislated by Congress. DEEOIC explained that this is impossible because they have already done their budget through 2021.

The Board’s work plan for the next three months is:

• Finalize the recommendation on Parkinsonism
• Finalize recommendation to include IARC 2A toxic substances into the Site Exposure Matrix.
• Review post 1995 claims denied for lung cancer. This can only be accomplished if DEEOIC provides the Board with the claims the Board requested in November 2019.
• Develop the document required by DOL to justify the Board’s need for a support contractor.
• Further investigate the discrepancies of the Gaseous Diffusion Plants exposures to security guards.