Third-Term Advisory Board Submits Claim Adjudication Recommendations

The Advisory Board on Toxic Substances and Worker Health met virtually on November 5-6, 2020. The first day’s agenda provided an overview of the program.  This was especially helpful for the five new members who were named to the Board.

Representatives from the Division of Energy Employees Occupational Illness Compensation DEEOIC) provided a tutorial on the Site Exposure Matrices (SEM) database.  One Board member questioned why the SEM would delete chemicals which were previously  listed as being present in the SEM. DEEOIC explained that the SEM administrators continues to research the SEM and that if they find new evidence of that the substances were not present they will will update the SEM accordingly.

The Board also discussed the discrepancies in the SEM of exposure information for first responders such as security guards, health physics technicians and firefighters at facilities they audited.  The Board unanimously voted to provide the following recommendation,

The Board recommends that the Department develop and implement exposure presumption indicating that job categories at DOE sites whose workers likely worked throughout their individual sites had potential exposure to many or all listed toxic substances at those facilities.

This means that if DEEOIC accepts this recommendation workers whose job descriptions required them to patrol or respond to incidents, no matter which building was their “home base,” they would be presumed to have been exposed to any of the toxic substances listed in the SEM for their site.  DEEOIC would also investigate job categories other than those of security guards, firefighters, and health physics technicians and determine if those labor categories could also be presumed to be exposed to many or all toxic substances.  An industrial hygienists (IH) would need to determine the level, frequency, and duration of those exposures.

The Board also recommended that the toxic substances from the International Agency for Research on Cancer’s (IARC) 2A group of carcinogens be incorporated into the SEM.

Paragon Industries, the SEM administrator, provided a report and recommended that four additional labor categories be included in the presumption for exposure to asbestos.  Those labor categories are,

• Stationary Engineers
• Precision Instrument and Equipment Repairers
• Heating, Ventilation and Air Conditioning (HVAC) Mechanics, Installers, and Repairer
• Fire Fighters and Supervisors of Fire Fighters

The Board will continue to research other job categories which may be presumed to have asbestos exposure and created a Work Group to accomplish this.

The last recommendation the Board approved to be submitted to DEEOIC is that DEEOIC engage a third party to audit the reports submitted by contract medical consultants (CMC) and contract industrial hygienists (IH).  The Medical Director audits approximately 50 CMC reports a quarter and the Board has voiced concerns about these audits.  IH reports are not audited.

DEEOIC reported that they have begun using the revised Occupational Health Questionnaire (OHQ).  The revision incorporated recommendation made by the Board.  DEEOIC has received positive feedback from the Resource Centers about the new format.

A Board member asked if claimants who were previously denied would be able to redo their OHQ interview.  Ms. Rachel Pond, DEEOIC Director, stated that claimants can request a reopening of their claim because of the new OHQ format.

The final issue that was discussed by the Board is the recent development with the DEEOIC’s Medical Director’s involvement with impairment ratings performed by physicians who are independent from DEEOIC.  Ms. Pond sent a letter to the Board requesting assistance in clarifying certain tests,

DEEOIC has received conflicting medical input on whether certain functional measurements are an acceptable basis for assigning respiratory impairment. Based on the concerns communicated to the Board, DEEOIC acknowledges that there are competing interpretations of the Guides when it comes to how to use patient data in assigning a whole person impairment. The Guides oftentimes communicates broad discretion to physicians in how to reasonably calculate ratings based on the totality of available data.

The Board decided to form two Work Groups.  One will research and provide a response to Ms. Pond’s letter.  Another will review the documents provided to the Board, including the opinions from the Medical Director, and submit a report.