Something shady is afoot with DEEOIC. Surprise!
DEEOIC stands for the US Department of Labor’s Division of Energy Employees Compensation. They are responsible for compensation workers from the Department of Energy’s nuclear weapons facilities if they developed an illness as a result of an exposure to a toxic substance, including radiation.
It’s been a long time since I’ve heard complaints about claims being delayed, years in fact. So, it caught my attention when three authorized representatives (AR) contacted me. The first one was a few months ago but the next two were just last week.
The explanations provided for the majority of the delayed claims was because the responsible claims examiner simply dropped the ball or for some other reason that the claim fell through the cracks. It happens, I guess.
But one AR shared with me a troubling account of what happened with one claim.
The claim was filed by surviving children in November of 2018. Nothing was done on the claim despite the AR’s multiple inquiries to the District Office (DO). The AR understood that this claim was transferred to four different claims examiners in the DO.
In August of 2019, the AR was assured that the claim would receive the personal attention of the District Director’s staff. Again, when nothing happened the AR contacted the DO. The AR was then informed that the case was sent to a different DO the end of March 2020!
Needless to say, the AR was not happy especially since there was no notification from DEEOIC to the claimant or AR about this transfer.
The AR pressed the issue and learned that this claim will not be decided until the end September of 2020 – almost 2 years after the claim was filed. The reason? DEEOIC decided that this claim did not merit immediate attention. Instead, DEEOIC determined that this claim had “basically, the least important priority”.
DEEOIC even has a name for this type of delaying claims. A claim delayed under this circumstance is referred to being in the “Frozen Universe”. That designation is as morbid as the previous training manual where a fictitious claimant was identified as Freddie Kruger.
If that isn’t enough to get you upset, the AR was told that DEEOIC has an internal document titled, EEOICPA Operational Document - which lists the manner in which the status of the claims are assigned, and the time frames to complete the claims process - has been given names such as "Frozen Universe".
Apparently, DEEOIC now decides when a claim gets processed regardless of the age of the claim. “Oh, you’re only the children of a worker who died from being poisoned at work. Your claim isn’t important enough to work on right now. Go to the back of the line.”
That’s outrageous! It’s a slap in the face of every surviving child who experienced the death of their parent attributable to an occupational disease. DEEOIC has no right to delay a claim because they think the claim is not important enough.
The only claims that should have priority is for a worker who is terminal. DOL has a process in place for those claims and for the most part it works well.
The other major problem is that this is an internal document and the neither the claimants nor the ARs have access to it. This has been a long-standing issue with the advocates. In fact, the Advisory Board on Toxic Substances and Worker Health (ABTSWH) made a recommendation to have these internal policy memos be provided to the public in a “…database searchable by topic area.” It was a great idea but DEEOIC shot it down.
For almost 20 years there has been serious issues with DEEOIC’s implementation of the Energy Employees Occupational Illness Compensation Program Act of 2000, as amended. They are in desperate need of rigorous oversight. Advocates and claimants alike had hoped this would happen when Congress established ABTSWH in 2015. When the Advisory Board on Radiation and Worker Health (ABRWH), which advises the National Institute for Occupational Safety and Health (NIOSH), votes on whether to accept or reject NIOSH’s position on an issue NIOSH accepts ABRWH’s decision. That doesn’t happen with DEEOIC.
And that must change. This example of the Frozen Universe is a fine example why DEEOIC needs to be reigned in; be held accountable for their policies; and be completely transparent with their policies.
The Department of Labor’s Division of Energy Employees Occupational Illness Compensation (DEEOIC) still has not responded, either directly or by publishing emergency policies, to ANWAG’s letter of March 10, 2019 or the subsequent emails I submitted, including this one sent yesterday.
It was brought to my attention this morning that Medicare now allows telehealth and will provide the same payment to medical providers for a telehealth visit at the same rate as they would for in-person visits.
Knowing that DEEOIC follows many of the of the Medicare guidelines I want to inquire when DEEOIC will implement this policy. This will reduce the trips to a physician's office just to have a prescription filled or authorization for therapies, etc.
In addition, despite Medicare's exemption of home health care agencies from telehealth, it may be beneficial for some of our less injured workers to be able to telehealth with their in-home health providers. Including home health care workers in the telehealth ability would protect more people without the claimants losing this important benefit.
I look forward to your earliest response,
To summarize, ANWAG requested that DEEOIC issue emergency policies to,
- Allow some patients to obtains more than a 30-day supply of prescription medications.
- Expedite claims for consequential illnesses due to a covered disease.
- Relax the need for an in-person meeting with a treating physician to obtain reauthorization of therapies and home health care.
- Allow telehealth visits between all medical providers.
All of these suggestions will protect the sick worker as well as free up the medical providers to treat the more serious patients.
The silence from DEEOIC is deafening. As I jokingly told a good friend and fellow advocate, I would be happy if they just posted the title of Douglas Adams' fourth book of the Hitchhiker’s Guide to the Galaxy, “So Long and Thanks for All the Fish”. That would at least be some kind of acknowledgement.
DEEOIC should re-read their mission statement,
Our mission is to protect the interests of workers who were injured or became ill on the job, or their families, by making timely, appropriate, and accurate decisions on claims and providing prompt payment of benefits to eligible claimants. (emphasis added)
Seven days ago, the Alliance of Nuclear Worker Advocacy Groups (ANWAG) sent this letter to the Department of Labor (DOL) requesting that the Division of Energy Employees Occupational Illness Compensation (DEEOIC) allow some workers to receive more than a 30 day supply of covered prescription medications.
Since Janet Michel or I have received an acknowledgement of the letter, I emailed the Director of DEEOIC yesterday afternoon, requesting an update.
I do hope all is well with you. I've had a couple of people ask about the emergency circular ANWAG requested last week. Could you give me an update on the status of this request?
Also, one AR suggested today that certain consequential disease claims could be expedited. For instance there was a claimant who had a transplant of the body organ covered by DEEOIC. The anti-rejection medications are not yet approved and the out-of-pocket expense is very high.
Another individual contacted me later and made another suggestion. I submitted that via email this morning but also copying the Director of OWCP, the Ombudsman, the Chair of the Advisory Board and the Deputy DEEOIC Director.
I can only imagine how busy you are, but I want to bring another issue to your attention for your consideration.
It was suggested special consideration be given during this national emergency would be a good idea to either extend the authorization period for home health care, therapies and durable medical equipment or at least waive the face-to-face physician visit if the physician provides a prescription.
It is dangerous to have a chronically ill and high-risk patient going to the physician’s office during this time. Something like this would reduce the risk to the patient and reduce the burden on an already strained health care system. Taking this action through at least August 1st makes sense because the work to get a patient authorized or reauthorized starts about 45-60 days before the actual authorization date.
I would be happy to speak with you to discuss this and other issues if that would be more expedient.
This is not a time to by super-critical of an agency who is responsible to provide the care to the Department of Energy nuclear weapons workers who sacrificed their health to protect our country. Nonetheless, I'm disappointed that DEEOIC has not acknowledged the requests. Their silence is disconcerting.
Normally, when ANWAG sends a letter we receive a reply around thirty days later via U.S. Mail which adds days to receiving the response. But this isn’t a normal situation. Lives, literally, depend on swift action DEEOIC to assure that their claimants receive the necessary equipment and medical attention without placing them in further jeopardy.
Apparently, emergency changes to policies can be issued. In a December 30, 2019 letter to the Chair of the Advisory Board on Toxic Substances and Worker Health, DOL Deputy Director stated that the reason DEEOIC will only provide changes to the Board a mere ten days before publication is that, “…it is imperative that new procedures be put in place as quickly as possible…”
If ever there was a time to implement new procedures quickly it is now. ANWAG does understand there are levels of the internal processes to review the policy changes, but they should be expedited.
ANWAG urges DEEOIC to break the silence and immediately let the covered workers know how they plan to ease some restrictions during this national health emergency. Transparency will alleviate some of the worry these workers are experiencing.
Over the years I have had people come to me to let me know that their petition to reopen their claim was denied by the Department of Labor’s Division of Energy Employees Occupational Illness Compensation (DEEOIC). But it was highly unusual to have three claimants approach me for assistance within ten days of each other.
Because of this Deb Jerison of the Energy Employees Claimant Assistance Project (EECAP) and I decided to issue this survey, https://bit.ly/2Ijw4eL, to determine how widespread this problem is.
DEEOIC allows claimants to submit a petition to reopen a claim at any time. A claim can be reopened if the claimant has new evidence to present or if there is a change in policy or the Site Exposure Matrix.
I worked many years with one claimant who has tried unsuccessfully to have his company designated as a Department of Energy (DOE) covered facility. When DEEOIC denied the claim he filed a complaint in federal court. The court ruled in favor of DEEOIC and the appeals court upheld the decision. The appeals court’s decision noted that the claimant did not provide any DOE contracts as evidence to support the idea that DOE had proprietary interest in the facility.
The contracts were obtained through a Freedom of Information Act Request and submitted as new evidence to reopen the claim.
DEEOIC denied the petition to reopen the claim. The claimant went back to court. Unfortunately, the court said it does not have the jurisdiction to review the denial of a petition to reopen a claim. So there is no recourse to file a federal lawsuit because DEEOIC refused to reopen a claim.
There also doesn’t appear to be a mechanism to reopen a claim if pertinent evidence already in the file is ignored, as happened with two of the claimants who reached out to me.
Before ANWAG can go any further it will be important to understand how many claimants are affected. I would appreciate anyone who had a petition to reopen a claim denied to complete the poll. All responses will remain anonymous.
Again, to take the survey, click here https://bit.ly/2Ijw4eL