ORAU cries the blues
During the last NIOSH Advisory Board meeting, Stuart
Hinnefeld, Director of DCAS, reported on the impact sequestration has on NIOSH’s
duties for the program. He stated that
ORAU’s funding was cut by 20%. The
average decrease for government work was about 9%. So yeah, this was a pretty hefty cut in
funding.
Mr. Hinnefeld stated this decrease would delay dose
reconstructions and deliverables to the Board, such as SEC petition evaluation
reports. I’m not so sure about
this. During the heyday NIOSH, ORAU, the
Board and the Board’s contractor, SC&A, were juggling multiple SEC
petitions and other issues. For example,
in 2007 these sites were actively discussed and researched:
·
Blockston
·
Chapman Valve
·
Dow Madison
·
Fernald
·
Hanford
·
Linde
·
Nevada Test Site
·
Rocky Flats
·
Texas City
That’s just an example from 2007. Over the years, more than 100 SEC petitions have been submitted, discussed and decided upon http://www.cdc.gov/niosh/ocas/pdfs/abrwh/pres/2013/dc-secstatus0313fc.pdf. If all goes as planned during the Board’s July meeting, there may only be three SEC petitions that need to be reviewed. That’s at least a 66% decrease in SEC petition work. DEEOICP also anticipates a decrease in Part B claims filed in FY 2014, http://www.dol.gov/dol/budget/2014/PDF/CBJ-2014-V2-06.pdf.
Why would a 20% cut in funding to ORAU delay
anything if the workload is also decreased?
SC&A will also receive 10% less funding. However, they stated that by reassigning
their personnel they expect to be able to provide their reports to the Board in
a timely manner. ORAU can’t do the
same? They know they have fewer products
to submit to the Board. I don’t
understand why are they crying the blues.
Site Exposure Matrix Hacked
DEEOIC’s Site Exposure Matrix was hacked, http://bit.ly/130i8eM.
Of all the dang sites in the entire world
that could be breached, the hackers had to break into and compromise and hack the one database that was helping, granted only to a degree, achieve justice for workers. Thank
you very much (dripping with sarcasm), Hacker Person.
Obviously, Hacker Person did not realize the history behind this database. Otherwise they may have left it alone.
ANWAG suggested to DOL back in 2005 to develop
a database so that the claims examiners had a reference to determine if a certain
toxic substance was present at a facility, in a building, that could be
responsible for an illness or condition that a worker suffered or died
from. DOL did develop the database but
it was not accessible to the advocates, claimants or the claimants’ representatives. The advocates found this out and fought long
and hard to get this database posted in the public domain. If DOL was using this information to decide
claims, then the stakeholders needed to see what was in it. Due process and all of that.
Believe it or not, my very first reaction after reading the
above article was to contact DOL and ask if the report was true. I was actually expecting a response that the
article was mistaken and that all was well.
Instead, I received an immediate response (and I am very grateful for
that) advising me that DOL would check. When
I didn’t receive any information 20 minutes later, I decided to let everyone
that I thought would access the SEM know about the hack. The hack compromises all computers with
malware – not just DOL computers but also the general public's.
I did not hear anything from DOL the rest of the day. I emailed them again near the end of the day
and received an update. DOL took the SEM down and are conducting a
criminal investigation. Both IT specialists from DOL and Paragon Industries (managers
of SEM) are looking into the breach. They are doing forensic imaging to keep a
history in case the IG gets involved.
That’s great. I’m glad that DOL is taking this issue as
seriously as I and all the advocates are. I’m particularly thankful that DOL took down
the link to SEM quickly to prevent further infection.
I asked DOL
specific questions about the issue but they couldn’t answer earlier
tonight. Those questions are:
When was the SEM hacked?
When did DOL know the database was hacked?
Can it be fixed?
If so, when do you expect it to
be back online?
Were the claims examiners' computers affected?
Was any personal information compromised?
Other advocates
weighed in with their concerns. Some of
those questions are:
What specific security issues allow the
database to be hacked?
What has DOL done to correct these
security issues?
How many of the public may have been
affected by the hack?
What potential damage could have been done
to the public’s computers?
Has access to SEM been returned to the
claims examiners?
When will SEM will be available to the public again?
Everyone who has ever accessed SEM deserves an answer to these question. And the sooner DOL responds to these concerns the more confidence the stakeholders will have in the integrity of the database.
I am a little upset with DOL over this hacking incident. This is despite the fact that I am grateful to them for responding to my concerns – somewhat.
I do understand that they need some time to come to grips to what happened. But, I’m sorry. Shouldn’t checking the security of the database they spent millions of dollars on have been a priority?
And why didn't DOL acknowledge the hacking incident to the public until hours after I made an inquiry? Trust me, there's no ego involved here. I would have been just as happy to circulate a DOL notice that the SEM was hacked.
Let’s
hope there hasn’t been too much damage – to DOL or to the folks who use
SEM. Let’s hope they find the culprit.
Hacker
Person – you owe these sick and dying workers an apology. You have wronged them.
ANWAG Honors Nuclear Weapons Workers and their Families on Worker Memorial Day
President Obama proclaimed April 28, 2013 as Worker
Memorial Day http://www.whitehouse.gov/the-press-office/2013/04/26/presidential-proclamation-workers-memorial-day-2013
President Obama states,
Today,
our thoughts and prayers are with all those who have lost a loved one to a
workplace accident or work-related illness. But we owe them more than prayers.
We owe them action and accountability. While we cannot eliminate all risk from
the world's most dangerous professions, we can guarantee that when a worker
steps up to an assembly line or into a mine shaft, their country stands
alongside them, protecting their safety and their stake in the American dream.
I would like to join President Obama in remembering the
families of the nuclear weapons workers and honoring the workers who are ill or
have died from the result of daily exposure to the toxic soup they worked in to
keep America safe during the Cold War.
President Obama acknowledges that “Career-ending injuries
often led to poverty and starvation.” This
was and is applicable to some nuclear weapons worker families. People have lost homes because of the
illnesses. Spouses often would need to
work two and three jobs to make ends meet.
I remember when my husband first became ill and couldn’t work. I would
take my tip money from waitressing to the pharmacy and I would ask the
pharmacist, “Joe, how many of the prescription pills can I buy?”
These workers and their families now have a compensation
program that is intended to rectify the years of denial that the DOE facilities
were responsible for the workers’ illnesses and deaths. Unfortunately, the claims process is a far
cry to what Congress intended. I call
upon President Obama to honor the nuclear weapons workers by holding the
agencies responsible for EEOICPA accountable in their administration of the
program.
Why RECA Needs to be Reformed
I suppose I should have warned people who follow this blog – I only
write when I have something important to say or report.
Today, I have something encouraging to report. Senators Mark Udall, Tom Udall, Michael Bennet,
Mike Crapo, Jim Risch and Martin Heinrich and Congressman Lujan reintroduced
legislation that will reform the Radiation Exposure Compensation Act
(RECA). Until a few years ago, I didn’t
realize how important this reform, if passed, will be to the down winders and
uranium workers.
Those of you who have even an inkling of the history of the
nuclear bomb knows that the first test explosion was made at the Trinity site
in New Mexico. Onsite participants and
the communities downwind from that very first test were never included in the
original RECA legislation. Amazing! I was dumbfounded when I learned that. I don’t know how that site was overlooked 20
years ago but I’m glad that these people are no longer ignored.
This reform legislation also expands the down winder coverage to include Colorado, Utah and Idaho. This, too, makes sense.
Another section provides for epidemiological studies for the communities surrounding the sites where uranium was mined or processed. This one is a little personal for me. I live in a very rural county in Colorado where almost 14,000 people occupy 4,750.9 square miles. That turns out to be 3 people per square mile. There’s lots of open space up here. There was also a lot of uranium mining done in this county during the Cold War. Some have been reclaimed but others were left open to the elements for many years. Children would swim during the hot summer in the water that collected at the bottom of the mines. And I hear stories told about the number of brain cancer incidents in this county. I personally know of two people who have/had brain tumors. I’ve seen jars at the grocery stores asking to donate one’s change to help defer the costs of medical treatments for brain tumors. I would like to know if uranium is the reason for these tumors or if there is another culprit. And I'm sure other communities would like to know if their health was affected by uranium work.
Uranium workers are covered under EEOICPA. If a worker develops a cancer that is not currently covered under RECA, the claim will go to NIOSH for a dose reconstruction, just like claimants at a DOE or AWE site who are not members of the SEC will. This is a good thing. Unfortunately for the uranium workers, unlike DOE or AWE workers, they do not have the ability to file a petition to become a member of the SEC. An SEC member would automatically be covered without the need for a dose reconstruction if the worker contracted one of the 22 specified cancers. This legislation will correct this.
But the most important reform, in my opinion, is the change to the uranium workers. This legislation expands the coverage to workers past the 1971 cut-off date in the original legislation. America was still fighting the Cold War after 1971. DOE still needed uranium to build their bombs after 1971 and the miners, millers, transporters and core drillers provided that uranium after 1971.
In the original legislation, core drillers were never covered. The original RECA did not cover the same diseases for all labor categories. This reform rectifies that oversight.
This is a good example of bi-partisan legislation. The primary concern of the parties involved
is equitable justice for those exposed to radiological hazards. Many of those exposed had no idea of the
health risks associated with radiation.
It is my hope that the rest of Congress will agree that these reforms
are long past due and pass this legislation quickly.
DEEOIC 2014 Budget - Home Health Care, SEM and other observations
The administrative costs for EEOICPA have always bothered
me. DOL published their budget justification
to Congress for FY 2014 last week, http://1.usa.gov/14lJgbz
and sure enough I found a few items that concern me. They anticipate they will receive 12,480
claims next fiscal year. This is a
decrease of almost 9% from the 14,046 initial claims DEEOIC received for FY 2012.
So why is DEEOIC asking for a $3 million
increase? And why would they project
that the benefits paid out will be almost 13% less in 2014 than was paid out in
2012 if there is a only a 9% decrease in new claims filed? Shouldn’t the
decrease in benefits paid also be a 9% reduction? How do they arrive at the additional 4%
decrease?
Some might ask, what’s the big deal about a 4%
difference? I always try to put a human
face to numbers that involve this program.
That 4% represents 125 workers or their survivors who could qualify for
Part B lump sum benefits of $150,000.00 or 750 workers who could receive a 10%
impairment rating for their condition.
Another area of this budget that I find very unsettling is
DEEOIC’s apparent crack down on providing home health care for the approved
claimants. DEEOIC’s first concern is
that, “Home health care costs
have grown by 1,697 percent over the last seven years from…” (Page 18)
Uh, do you
think the rise in costs may be because these workers are sick and dying and
need this medical benefit?
Their other
concern is that these dying workers are receiving home health care for a year
or two. To me, that statistic reflects
that the health care provided at home allowed these dying workers to spend
another year watching the tulips bloom or celebrating another anniversary with
their spouse. What is wrong with
that? Many of these workers’ lives have
been cut short because the government allowed them to be poisoned during the
Cold War and refused to care for them until this program was enacted. Many of these workers had no idea what the
health effects were of the toxic soup they toiled in daily. The very least the government can do is to
provide them with the best care at the end of their life.
Ok, there
was one company who defrauded DEEOIC for $3 million. They were caught and rightfully
punished. I applaud the DOL Inspector
General for pursuing this. I’m all for checks and balances for providers. But, because of this one bad apple, is DEEOIC
going on a witch hunt with other home health care providers? That is not fair.
I found two
other types of fraud – and only two - from the Inspector General reports
perpetrated on DEEOIC. One was a
privately held pharmaceutical company who, in 2007, was fined and placed on
probation for “fraudulently marketing a prescription pain medication,
OxyContin, as less addictive, less subject to abuse and less likely to cause
withdrawal symptoms than other pain medications.” The cost of this fraud was $42 million to
DOL. The other fraudulent case was an
ACS employee was indicted for embezzling $260k from DEEOIC. ACS is the medical bill paying contractor for
DEEOIC.
I am glad these frauds were caught and punished. However, in my research not once did I see
DEEOIC state in their budget justification to Congress that they would evaluate all drug companies “to
ensure appropriate prescribed care as well as to provide additional capacity to
monitor for instances of fraud” or monitor ACS employees to make sure they were
not embezzling. Why is this provision to monitor home health care providers
specifically mentioned in the budget justification?
There are hundreds of home health care companies in the country. Are they
assuming that every home health care provider is overbilling the
government when caring for these dying nuclear weapons workers? Does DEEOIC
plan to determine the level of care a dying worker needs by utilizing a medical
consultant instead of relying on the worker’s personal physician? Will
DEEOIC strong arm the personal physician to reduce the level of care in order
to save money? What will be next? DEEOIC will decide that cancer treatments are
too expensive and institute an evaluation program for that benefit?
And why isn’t DEEOIC itself checking for potential waste of
taxpayer dollars with their own contractors?
For example, DEEOIC contracted with Paragon Technical Services for over
$12 million to manage the Site Exposure Matrix (SEM) database. This contract is about 7 years old and the
SEM is still not complete. DOE facilities are missing, workers who had the
potential of being exposed to a certain toxic substance is missing and even
some toxic substances themselves are missing from this database.
But let’s take a look a little closer to DEEOIC’s management
and the potential waste of a million dollars.
DEEOIC contracted with the Institute of Medicine to review SEM. IOM
reported to DEEOIC on SEM’s deficiencies last month. Instead of DEEOIC embracing IOM’s
recommendations to improve SEM, DEEOIC basically said, “Thank you very much for
your opinion. We’ll consider it.” A more detailed analysis can be found here http://bit.ly/12aAZ6G
I hope Congress asks why DEEOIC needs $3 million more
dollars when they are processing less claims.
I hope Congress asks DEEOIC if the reason for finally initiating, after
7 years, “the process of developing a
new measure in FY 2013 to evaluate home health care cases to ensure appropriate
prescribed care as well as to provide additional capacity to monitor for
instances of fraud” has more to do with cutting benefits to the workers than it
does for finding fraudulent billings.
I hope Congress asks why DEEOIC did not catch the many problems with SEM. And I hope that Congress asks why DEEOIC will
only consider and not adopt IOM’s recommendations to improve SEM.
President Obama's Budget Proposal and EEOICPA
I apologize for not posting for a week. I’ve been working on an EEOICPA-related
project that has taken up all of my time. Stay
tuned for that in the next few days.
I took a look at President Obama’s budget proposal and –
good news! – It does not appear that the proposal affects EEOICPA.
The reason for that may be because EEOICPA provides lump sum
compensation and the legislation does not provide for a Cost of Living increase
to the benefits. Unfortunately, this budget proposal will affect the workers at the DOE nuclear
weapons facilities who are ill because they were exposed to toxic substances. This is
especially true if they were denied compensation under EEOICPA or were only approved
for a fraction of the compensation available.
President Obama’s proposal recommends that the annual increases to Social Security Disability Insurance be calculated using the Chained Consumer Price Index, or Chained CPI.
Like statistics, understanding accounting is not one of my assets. I decided to research this issue and found this article, “Chained CPE and You: A Primer”, http://www.theatlanticwire.com/politics/2013/04/what-is-chained-cpi/64083/ which explains the issue in layman's term.
So while I am thankful that the President’s budget did not directly affect the approved or potentially approved claimants under EEOICPA, I am dismayed that the budget does affect DOE workers who are too ill to work and depend on Social Security benefits.
I
know too many of these workers. Some
have been cut down in their prime because they were exposed to a toxic soup of
chemicals and radioactive materials on a daily basis. These workers have lost their
livelihood. All would much rather be working
and providing for their families.
There has to be a common sense answer to the financial
crisis we face. But the one solution to
the problem that must be taken off the table is the one that penalizes the most
vulnerable, especially the ones who worked to defend this country.
DEEOIC and the IOM report - Part 2; Claims Examiners not allowed to check PubMed etc. for scientific research
Deb Jerison did such a great job on her Radioactive Daughter
blog, http://eecap.org/EECAP_blog.htm,
comparing IOM’s report, http://bit.ly/XgHjJd, with DOL’s response, there are
only a few issues I’d like to discuss.
IOM made quite a few recommendations on how to improve the
structure of the SEM database. IOM
reported some structural deficiencies in navigating the SEM. A few of IOM’s findings are:
·
The lack of ease to access the SEM database from
DEEOIC’s webpage
·
Users cannot perform a “universal” search for
job categories or toxic substances.
·
No specifics are shown as to what information
has been added when the SEM is updated
·
Labor categories are not always linked to site
buildings or to toxic substance exposures
·
SEM is not capable of assessing complex
exposures and chemical mixtures
·
SEM fails to incorporate DOE worker
epidemiological studies
·
Haz-Map http://hazmap.nlm.nih.gov/index.php
is the sole source in the SEM for linking a disease with a toxic substance.
I will not revisit each and every point IOM reported in its
review. The report is easy to read and
self-explanatory, especially for someone who is not familiar with the program. I
agree with 99.9% of IOM’s recommendations.
The only one I am concerned about is their suggestion that the SEM
incorporate routes and levels of exposure.
It was rare that the weapons facilities monitored for substances other
than radioactive materials and beryllium. I imagine routes of exposure can be figured
out, with the help of the workers, but exposure levels? How does one calculate how much
trichloroethylene was absorbed daily when a worker degreased his hands while
degreasing a part?
DEEOIC’s response to the report is alarming. The first three bullets can be easily
corrected, even the “universal” search.
I do understand DEEOIC’s view that each site was unique but the SEM does
have a universal list of toxic substances present at each site. Why not research the feasibility of this
recommendation? I understand that if the
cost was prohibitive DEEOIC might have some concerns. But to summarily dismiss it seems a bit
harsh.
The IOM strongly recommended (as did GAO) that an external
advisory panel be formed. Instead of
embracing this idea, DEEOIC stated in their response they would reach out to
other agencies “to determine whether there are possibilities for collaboration
or information gathering as a starting point.”
Why? So that they will still
control the science used in adjudicating claims?
The reason I say this is because of what I read on page 59
of the IOM report. I have to tell you, I
was not aware of this and was shocked.
While more comprehensive
information about the health effects associated with a toxic substance is
available from Haz-Map (for example, skin designations), the DOL explicitly
instructs the claims examiners to use only Haz-Map information that is included
in the SEM. The Claims Examiner Manual
states:
The occupational disease links in SEM are imported
from the widely accepted and well rationalized medical science database call
Haz-Map, a database of the National Library of Medicine (NLM). While the NLM database, Haz-Map, is often
utilized in other circumstances as a resource, the claims examiner
must never use Haz-Map as a development or adjudicatory tool. Only SEM is acceptable for use in case file
development and adjudication. It is
unacceptable to base a decision, particularly a remand order, on any
information contained in Haz-Map beyond the established links populated
directly into SEM. Haz-Map
serves many purposes for the public and medical professional fields and will
often cite suggestive research that it has not accepted as a basis for finding a
demonstrable link between a given substance and an occupational illness. (DOL,
2012b)
The emphasis is mine.
I know this is complicated.
Welcome to EEOICPA! This might
make it easier to understand - SEM only uses selected information contained in
Haz-Map. So what are these links located
in Haz-Map that only cites suggestive research?
They are sites like Pub-Med (http://www.ncbi.nlm.nih.gov/pubmed/), ATSDR
(http://www.atsdr.cdc.gov/), and Tox-Net (http://toxnet.nlm.nih.gov/). All of these sites are U.S. Government sites. And these research sites are off limits to
the claims examiner when deciding a claim????
Why? Is it because the CE might
find relevant scientific evidence that would support that a toxic substance
could contribute or aggravate a disease or condition instead of just causing it,
as the SEM Haz-Map links tend to provide?
Another area I found concerning can be found on page 56 of
the report:
The “Special Health Effects” field
contains health information based solely on “established relationships between
toxic substance exposure and occupational diseases as reported by the National
Library of Medicine (NLM) on its Haz-Map website (http://Haz-Map.nlm.nih.gov)” (DOL 2012c).
Although DOL relies on the Haz-Map database for toxic
substance-occupational disease links, NLM does not establish those causal associations
as might be implied from that statement.
I don’t know about you, but I resent this misdirection by
DEEOIC.
The IOM report does a great service for the claimants under
EEOICPA. It shines the light on the
deficiencies of the SEM and Haz-Map.
Their recommendation for an external advisory board to review the SEM
should be accepted. But I want to take
that recommendation one step further. I
think this panel should also be responsible for reviewing of DEEOIC’s Final Rules, Bulletins,
Circulars and Procedure Manuals to ensure that DEEOIC is following not just the letter of the law but
also the Congressional intent of the law.
DEEOIC and the IOM report - Part 1
I promised in my 3/27/13 my blog that I would have a more
detailed summary out on Institute of Medicine’s (IOM) report on their review of
the DEEOIC’s Site Exposure Matrix (SEM).
I thought it would be pretty straightforward by hitting the highlights
of the report and explaining what it means to those who don’t have intimate
knowledge of the program. Deb Jerison,
author of the Radioactive Daughter Blog http://eecap.org/EECAP_blog.htm , and
I also thought that we could split the topics up to make it easier on us and,
more importantly, get the message out quicker.
That’s still the plan.
But things got a bit more complicated because DEEOIC issued their
response to IOM’s report on Friday – two days after the report was released to
the public http://1.usa.gov/YlmSdH . I realize that IOM would have presented the
report to DEEOIC first, since DEEOIC asked them to review the SEM. But I never expected such a quick response. They
even beat us to our press release on the IOM’s report! Here’s our second draft of the press release
that was within hours of being released.
ANWAG APPLAUDS IOM’S
REVIEW OF DOL’S SITE EXPOSURE MATRIX
March 30, 2013
Contact: Deb Jerison,
Energy Employees Claimant Assistance Project 937-767-2890
Faye
Vlieger, Cold War Patriots 509-736-0922
Terrie Barrie, Alliance of Nuclear Worker Advocacy Groups 970-824-2260
Kennewick, WA – The
Alliance of Nuclear Worker Advocacy Groups (ANWAG) is pleased with the
recommendations made by the National Academy of Sciences Institute of Medicine
(IOM) from their review of the Department of Labor’s Division of Energy
Employees Occupational Illness Compensation Program’s (DEEOIC) Site Exposure
Matrix (SEM) http://bit.ly/XgHjJd.
DEEOIC contracted
with IOM to review the SEM to ensure that the links between exposure to toxic
substances and disease utilizes the best available science. The SEM is a database which shows the types
of toxic substances present at a Department of Energy nuclear weapons facility,
the job categories of the workers who may have been exposed to the substances
and the health effects that can be the result of the exposure. SEM is used as a tool by the DEEOIC claims
examiners to adjudicate compensation claims.
SEM relies solely on Haz-Map for information on the health effects of
toxic substances.
“This is very
comprehensive and well thought-out report with many recommendations will
greatly help claimants when implemented,” stated Deb Jerison Executive Director
of EECAP. “I was especially happy to see
they agreed with the Government Accountability Office and the advocates on the
need for an independent advisory board. Many of the tasks for the new
independent advisory board were spelled out nicely in the report.”
“Cold War
Patriots appreciates that IOM has listened to the concerns of the advocates and
claimants regarding the inconsistencies in Haz-Map and the SEM,” added Faye
Vlieger, Advisory Committee Member for CWP.
“We await DOL's response on how the IOM's recommendations will be
implemented.”
“I am
grateful that DEEOIC took the initiative to request IOM to review the SEM,”
stated Terrie Barrie, ANWAG Founding Member.
“I look forward to DEEOIC’s active support of legislation to form this
independent advisory board that Congress may introduce.”
IOM believes “that
establishing a formal oversight and review process for the Haz-Map database and
using a weight-of-evidence approach are critical for both maintaining and
expanding the Haz-Map database for its use in SEM.”
ANWAG looks forward to
Congress’s quick introduction and passage of legislation that will create this
independent advisory board.
# # #
We pulled the press release because we read DEEOIC’s
response.
So what Deb and I will do is write frequent posts for the
next few days that should cover the advocates’ perspective on the IOM report
and DEEOIC’s response.
Today, my blog will concern the history of the SEM from an
advocates’ perspective. I think that in
order to understand the issue, you need to know the background.
Way back in 2005, ANWAG, and other private citizens and
organizations whose purpose is to see that the workers who became ill from
toxic exposures at the DOE nuclear
weapons facilities, submitted comments on DEEOIC’s Interim Final Rules. One of ANWAG’s suggestions involved the
exposure matrix now known as SEM. We
naively thought that SEM could be utilized by the claims examiner (CE) in the
following manner.
A claim comes in with a worker suffering from chronic
bronchitis. The claimant lists a host of
toxic chemicals he was exposed to during his 10 year position as a welder at
Hanford. These chemicals include
aluminum, oil mists, iron oxide, vanadium and obviously welding fumes. The CE would first verify that the worker was
employed at Hanford for the years claimed as a welder. Then the CE would search SEM to determine if
the toxins were present at the site during the time of employment. If they were, the CE would then search the
SEM to see if exposure to any of these materials would have caused, contributed
or aggravated the chronic bronchitis. If
a link was found the claim would be paid.
To the advocates, that made the best sense to administer the
compensation program because we all knew that very little monitoring, if any at
all, was performed for chemical exposure at the sites. This approach would not set a precedent. Heck,
workers rarely had a fully complete radiation exposure assessment, let alone
having a daily record of how much nickel dust they were breathing. The system would be similar to the Radiation
Exposure Compensation Program.
In 2007, DEEOIC announced that they contracted with Dr. Jay
Brown, developer of Haz-Map, to utilize that database for use in the SEM http://1.usa.gov/166nNyw. At first, this seemed like an ok idea. Many of the advocates searched Haz-Map first
when arguing claims. We understood that
this database’s assessment was what toxic substance could cause a disease but
Haz-Map also listed other sites such as Pub-Med and Toxnet that could show
scientific studies that could provide evidence that would meet the standard
that a toxic chemical was a significant factor in contributing to or
aggravating a disease.
Little by little word was seeping out that DEEOIC developed
the database and that the CEs were using this to decide claims. SEM documents
were included in case files but the database the CEs used was not what was
available to the public. The advocates
pushed back about the due process issue and in 2010 DEEOIC, with the assistance
from DOE, DEEOIC published the “expanded” SEM.
The database is actually pretty cool. You can search the facility for which
chemicals are/were located in which building; which job categories would be the
most likely to be exposed and any major incidents involving the chemical or the
building. But then we realized the
database is not complete or up to date.
Check out my 3/26/13 blog for the latest example of job categories not
listed in the SEM.
Despite DEEOIC’s assurance that the SEM was only one tool
that the CEs used to adjudicate claims, we began to realize that SEM was being
used to deny claims. Our concerns were
confirmed in this 2009 ProPublica report, “Plan to Pay Sick Nuclear Workers
Unfairly Rejects Many, Doctor Says” http://bit.ly/YkEFBG. Dr. Eugene Schwartz was DEEOIC’s medical director. He pointed out the problems with the
SEM. In this article Dr. Schwartz
stated, “The program needs scientific oversight. I was told they’re not going to do that –
repeatedly.”
Unfortunately, that still seems to be
the case with DEEOIC. IOM made repeated
references to the need of an independent advisory panel to oversee the
SEM. INDEPENDENT. DOL’s response? They left out the word “independent” and
merely call it “expert panel”. DEEOIC
states they will “evaluate options for developing” a peer review process of the
information contained in SEM and Haz-Map and lists a variety of avenues to
pursue. The IOM report lays out their
idea of the types of experts who should be on the independent panel. IOM suggested that workers and worker advocate
representatives be included. DEEOIC
ignores that particular suggestion.
I don’t get that warm fuzzy feeling that DEEOIC is going to embrace the IOM report. I think they plan to keep the status quo. In fact, Rachel Leiton admitted as much when she addressed the advocates in November 2012. (4:35 mark http://www.youtube.com/watch?v=cDN3R0Bw1XY&feature=plcp).
Institute of Medicine's Report the review of DOL's Site Exposure Matrix now out!
Eighteen months ago, DEEOIC contracted with the National Academy of Sciences' Institute of Medicine (IOM) to review DEEOIC's Site Exposure Matrix. This data base is one of the tools used by DEEOIC's claims examinters to decide whether a toxic substance was responsible for a disease developed by a worker at the Department of Energy's nuclear weapons facility. IOM published their report today http://bit.ly/XgHjJd
I've only read it thru once. The one thing that struck me is that IOM also recommends that an independent board is needed to ensure that the best science is used when adjudicating claims.
I will have a more complete summary of this report posted in a few days. But I wanted to make sure that the many followers of this blog is aware the report has been released.
DEEOIC suspends due process - again!
I check DOL’s webpage for new information a couple of times
a week. Today I saw that they posted a
new Final Bulletin titled “Systemic Review of Denied Part E Claims” http://1.usa.gov/YAL8ej. I was ecstatic. I was ready to break out the champagne, balloons
and ticker tape. Yes! Yes! DEEOIC has finally come around and realized
that some Part E claims have been erroneously denied. I envisioned the day when
I could stop working on this issue and concentrate on the fun things in life
like sitting on a tropical isle under palm trees sipping on a Mai Tai.
Then I read the bulletin.
No! No! No! DEEOIC,
you were so very close to doing the right thing. What happened? You could have come out looking like the
knight in shining armor. Instead you
take the same path to forgo the basic rights given every citizen of the United
States by violating due process for EEOICPA claimants.
Allow me to explain my interpretation of this Final Bulletin
and how the average denied claimant will still not receive the true justice
deserved.
DEEOIC will prepare a list of cases that need to be reviewed
for updated scientific levidence between exposure to toxic substances and the
resulting diseases. If the claims
examiner (CE) finds such a linkage in the Site Exposure Matrix (SEM) the claim
is to be forwarded for a medical opinion to determine whether it is at least as likely as not that exposure to
a toxic substance at a DOE facility was a significant factor in aggravating,
contributing to, or causing the illness.
If the CE is suspicious that the worker may have been exposed, the claim
can be forwarded to the DEEOIC industrial hygienist for an opinion.
What is wrong
with this picture is that the claimant has absolutely no idea that this process
is going on. In fact, the claimant may
never know their file has been reviewed because the bulletin says the only time
DEEOIC will reopen the claim on its own is if either the medical consultant or
the industrial hygienist confirms that it is likely that exposure to the toxic
substance was responsible for the disease.
Therefore, the claimant is denied the opportunity to present his/her
case and offer expert opinion before DEEOIC seeks out their experts.
Additionally,
if a claimant requests a reopening of the claim, it is possible that DEEOIC
will deny the petition to reopen because they already have their expert’s
opinion that the exposure was not responsible for the disease.
DEEOIC is
deciding the case without giving the claimant the due process guaranteed by the
Constitution.
But, believe it or not, it gets worse. DEEOIC will be issuing Final Circulars periodically
when the SEM has been updated with new scientific knowledge which links a
disease with toxic substances. For
example, the Final Circular on bladder cancer, http://1.usa.gov/ZpfQA2,
explains that exposure to four toxic chemicals may result in bladder
cancer. This bulletin recommends that
the claims examiner review the claims that have been denied and determine if
the employee worked in a “labor category
associated with regular, routine exposure to the substance for a full working
year as a baseline for favorable determinations under this Circular.”
Tonight, I
decided to check the Rocky Flats SEM to see exactly what it showed for the presence
of o-Toluidine(one of the
four toxic substances responsible for bladder cancer) and which labor categories
would have been exposed. Guess what?
The SEM doesn’t list any job categories
at Rocky Flats which would have been exposed to this chemical!
Site: Rocky Flats Plant
Toxic Substance: o-Toluidine
|
IDENTIFICATION |
CAS: 95-53-4 Aliases: o-Aminotoluene; 2-Aminotoluene; 1-Methyl-2-aminobenzene;
2-Methyl-1-aminobenzene; o-Methylaniline; 2-Methylaniline; ortho-Toluidine;
Orthotoluidine; 2-Toluidine; CH3C6H4NH2 Category:
Other Materials |
|||
|
PROPERTIES |
Physical: Light-yellow
liquid that becomes reddish-brown on exposure to air and light. Chemical: Soluble in alcohol and ether; very
slightly soluble in water. Combustible. |
|||
|
SPECIFIC HEALTH EFFECTS |
The following diseases were associated with exposure to
this substance in the NLM Haz-Map website as of January 11, 2013
|
|||
|
NLM
Haz-Map REFERENCES (derived from records
maintained by National Library of Medicine) |
Title: NLM Haz-Map - o-Toluidine (not a
DOL website) |
|||
|
RECORD HISTORY |
Modified: Sep 11, 2012 |
|||
|
RELATED
ITEMS IN SITE EXPOSURE MATRIX
|
||||
|
BUILDINGS WHERE TOXIC
SUBSTANCE WAS PRESENT |
|
|||
|
SITE
PROCESSES/ACTIVITIES POTENTIALLY INVOLVING THIS TOXIC SUBSTANCE |
|
|||
|
LABOR
CATEGORIES POTENTIALLY INVOLVING THIS TOXIC SUBSTANCE |
none listed |
|||
|
INCIDENTS
INVOLVING THIS TOXIC SUBSTANCE |
none listed |
|||
So does this mean that Rocky Flats claimants who were denied for bladder cancer will be again denied because the SEM doesn’t list which type of worker could have been exposed to this chemical?
I have a better idea.
Let’s use the Veteran’s Administration or the Radiation Exposure Compensation
Act model. If a toxic substance was
present on site then the worker was exposed.
If the science links the exposure to a disease, then the claimant gets
compensated. It’s a simple and a logical
course of action for anyone who understands the workings of a nuclear weapons
facility.
While I think the bulletin and circular is DEEOIC’s attempt
to get ahead of the IOM’s review of the SEM, my interpretation is that this
provides and additional argument that
DEEOIC needs an advisory board.
