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:
· Chapman Valve
· Dow Madison
· 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
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
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
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
Modified: Sep 11, 2012
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
INCIDENTS INVOLVING THIS TOXIC SUBSTANCE
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.