Here at Stephens & Stephens, LLP, we are continually studying the Energy Employees Occupational Illness Compensation Act (EEOICPA), from every angle, in order to understand all facets of the Act. This includes not only the Act itself, but the entire process of Atomic Weapons Employment that produced the somewhat less than ideal working conditions that led to the Act’s passage in the first place.
To that end, we have recently completed a complete Facility List of all 382 sites currently covered by the Act, with links to individual pages that describe each site’s location, activities, type (Atomic Weapons Employer [AWE], Department of Energy [DOE], Beryllium Employer [BE], etc.), EEOICP claims statistics, and time frames when the sites were active. As is the nature of the beast, these pages can be variously either incredibly detailed or somewhat vague, depending on currently available open sources of information.We have also provided a List and relevant pages for work sites that fall under the Special Exposure Cohort (SEC) provision of the Act.
The site descriptions, however, can constitute a ponderous collection of details that would require even the most devoted student of the realm to spend copious amounts of time learning everything from nuclear physics to geography to territorial rights in order to fully comprehend, all of which likely involves more time and patience than most possess.
However, the Nuclear Age we live in was maturing in tandem with the Video Age we are now also fully immersed in at literally every turn. Further, we have entered a time when vast amounts of formerly classified information concerning the Manhattan Engineering District (or MED, which created the bombs dropped on Hiroshima and Nagasaki) and the subsequent Cold War are becoming freely available.
Therefore, it seemed only both reasonable and logical to include all available video documentation to our growing Library of data concerning the EEOICPA. The videos cover everything from the construction (and occasional demolition) of various sites to detailed documentation of nuclear bomb testing in Alaska, the Pacific Ocean, and Nevada to eminent physicist Richard Feynman’s highly amusing recollections of working with Oppenheimer at Los Alamos National Laboratory. Other videos can serve to simplify complex nuclear science into language and images that make them understandable without becoming mired in minutiae. Still others document interviews with former Workers and their struggles with both certain Facilities and the Act.
In keeping with our fundamental aim of keeping as much information as possible both freely accessible and easily available, we have embedded the videos on their respective pages and linked to all of them on our Video Page, extended to complement Hugh’s concise explanation of the Act itself.
Please visit our collection of EEOICPA Site Videos for a fascinating view into the inner workings of nuclear annihilation.
In our continuing effort to make as much information about the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) as possible freely available and readily accessible, we have added a page to our site that includes a list of our previously blogged videos and links to each video for further perusal. The page can be found at this link, or in the menu above under Areas of Practice > Energy Employees Occupational Illness Compensation Program Act (EEOICPA).
Do you need an attorney for an Energy Employees Occupational Illness Compensation Program Act (EEOICPA) claim?
Perhaps you or someone you love has been diagnosed with cancer or another illness after working at a Department of Energy (DOE) or an Atomic Weapons Employer (AWE) facility. Did someone work in the manufacture or testing of nuclear weapons and become ill thereafter? Perhaps you have just learned about the Energy Employees Occupational Illness Compensation Program (EEOICP) and you are trying to determine whether you have a claim. Or you recently learned of the Radiation Exposure Compensation Act (RECA) and you are trying to understand the difference between RECA and EEOICPA.
Perhaps your claim under EEOICPA or RECA has been denied or your EEOICPA claim has been accepted and you need to understand the impairment rating or the wage loss process. Or your EEOICPA claim has been accepted and you want to learn about health care coverage or reimbursement of expenses or travel and the available health care and home care benefits.
Call or email us at the numbers and addresses below as we can assist you with these matters.
As lawyers we can also address the other issues that accompany these claims. We can make sure that you become aware of your rights under State and Federal Workers Compensation laws and Social Security Disability (SSD) and Supplemental Security Insurance (SSI) programs. State Workers Compensation statutes have deadlines after which a claim cannot be timely filed. Similarly, Social Security Disability (SSD) rights are extinguished after periods of unemployment. EEOICPA compensation has special status and is exempt from certain types of taxation, should be segregated from other funds and should not be considered “resources” for purposes of certain housing assistance and other government programs. Medical bills and insurance can be overwhelming, especially for those already struggling with an illness or that of a spouse or parent. While there are those who would counsel that a lawyer is not necessary in the EEOICPA or RECA claim filing process, a lawyer can often be helpful and it is difficult to know in advance whether a lawyer would have helped with your claim or in some other capacity. We believe these claims represent a significant financial event in the life of a claimant and should be handled by a licensed professional. Sometimes mistakes in the claim process can be fixed after the fact and sometimes they cannot. For example, a claimant who qualifies for both RECA and EEOICPA benefits loses the right to claim the more advantageous EEOICPA benefits if he or she accepts RECA benefits. These are sad situations that cannot be repaired after the fact. Some claimants spend the compensation on medical bills, old and new, until they have nothing left when alternatives could have been explored. Certain insurance policies have limits, deductibles or “holes” that can be managed where an EEOICPA claim has been accepted. Finally, the Dose Reconstruction Process is almost incomprehensible for even the more educated among us. We have studied that process and have successfully overturned poorly prepared Dose Reconstructions.
While there are those who would suggest that lawyers are expensive and charge more than so-called “professional” advocates or representatives, that is simply not true. The fees charged by lawyers are limited by the EEOICPA and RECA statutes themselves. Lawyers are bound by the same limits on fees that bind unlicensed advocates and representatives. Lawyers are also held to a higher ethical standard imposed by the state bar and licensing authority and generally good ones carry professional liability insurance for the protection of their clients.
While there are unlicensed advocates and representatives who practice in the EEOIC program, under the Federal Employees Compensation Act (FECA) which provides compensation to federal workers and which is also administered together with the Longshore and Harbor Workers Compensation Act (LHWCA) and the Black Lung Compensation Act (BLCA) by the Department of Labor’s (DOL) Office of Workers Compensation Programs (OWCP), RECA claims administered by the U.S. department of Justice (DOJ) cannot be handled by unlicensed advocates or representatives.
Whether you have just learned about these programs or you have just finished your fourth impairment rating, give us a call or send us an email. We will answer your questions and put you on our mailing list to keep you up to date with developments in the program. We can be reached at (800) 548-4494 or (716) 852-7590. You can also reach Hugh Stephens on his cell phone at (716) 208-3525. Call anytime. We are managing claims 24 hours a day, 7 days a week, 365 days a year. You can also send us an email at firstname.lastname@example.org or email@example.com. We are happy to help and hope to hear from you soon.
U.S. Department of Energy Former Worker Medical Screening Program (FWP)
Section 3162 of the Defense Authorization Act for Fiscal Year 1993 requires the U.S. Department of Energy (DOE) to establish and carry out a program in order to identify and evaluate DOE employees subject to significant health risks as a result of their exposure to hazardous or radioactive substances while employed at a DOE facility. 50 U.S.C. § 2733 (2013).
The Act also requires that the DOE provide a process to:
- Identify hazardous and/or radioactive substances that DOE employees may have been exposed to during their employment at a DOE site;
- Identify those DOE employees who may have been exposed to such hazardous and/or radioactive substances;
- Determine the number, scope, and frequency of the medical evaluations that are to be provided to exposed employees;
- Make available the evaluations and tests to the exposed employee;
- Maintain the privacy of the exposed employees; and
- Ensure that employee participation is voluntary.
Id. at § 2733(b)(1). In addition to providing evaluations, tests, and results to the exposed employees, the Act requires the DOE to collect and assemble the information to assist in preventing the exposure and illness in current and future DOE employees. Id. at § 2733(b)(5).
The purpose of FWP is to provide voluntary medical screenings to assist DOE employees in the early detection of illnesses or conditions potentially related to their employment at a DOE facility. Not only does this provide the DOE employee with information on the status of their health, but also the DOE gains valuable information about the trends on the health effects of exposure to hazardous or radioactive substances and how to reduce those effects for future employees.
In order to remain objective, the FWP uses independent occupational health experts to administer the medical screening programs. U.S. Department of Energy, Office of Environment, Health, Safety & Security, “Former Worker Medical Screening Program,” available at http://energy.gov/ehss/services/worker-health-and-safety/former-worker-medical-screening-program. The FWP is administered through both regional screening projects, with clinics in communities near DOE sites, and nationwide screening projects, with a vast network of clinics nationwide. Id.
Nationwide Screening Projects
The National Supplemental Screening Program (NSSP)
The National Supplemental Screening Program (NSSP) provides free medical screenings to eligible Department of Energy (DOE) employees. It is operated by Oak Ridge Associated Universities (ORAU) and its partners, including National Jewish Health (NJH), Comprehensive Health Services, Inc. (CHS), Axion Health, and the University of Colorado Denver. National Supplemental Screening Program (NSSP), available at http://www.orau.org/nssp/default.htm.
The NSSP provides free medical screenings to detect health issues resulting from exposure to hazardous substances and radiation while employed at a DOE facility. Eligible employees are entitled to a customized medical screening based on their work history and work site risks. In addition, special examinations are available for employees who have been exposed to beryllium (i.e. the BeLPT test), asbestos, radioactive substances, or lasers. In addition to the initial medical screening, rescreening is authorized by the DOE every three years. Initially, this rescreening was only allowed for beryllium sensitivity testing but now includes all medical testing. National Supplemental Screening Program (NSSP), “Screening Exam,” available at http://www.orau.org/nssp/nssp-screening-exam.html. Like an initial screening, rescreening is entirely voluntarily and eligible employees may elect to repeat all, some, or none of the tests available.
Former DOE employees, contractors, or subcontractors who may have been exposed to radiation and/or worked with hazardous substances are eligible for free medical screening so long as they worked at one of the covered facilities: Argonne National Laboratory, Fermi National Laboratory, or Princeton Plasma Physics Laboratory. National Supplemental Screening Program (NSSP), “Am I Eligible?” available at http://www.orau.org/nssp/am-i-eligible.html.
Former production workers are eligible if they worked at Hanford, Kansas City Plant, Pinellas Plant, Rocky Flats, or Savannah River Site. Id. Because the medical providers included under these Former Worker Programs are limited, a worker who does not meet the criteria of one of the regional FWP, as discussed below, may be referred to the NSSP if he or she no longer lives in the vicinity of a regional FWP. Id.
Building Trades National Medical Screening Program (BTNMSP)
The Building Trades National Medical Screening Program (BTNMSP) is a national screening program conducted by the CPWR – Center for Construction Research and Training in conjunction with the University of Cincinnati Medical Center, Duke University Medical Center, and Zenith American Solutions, Inc.
Like the other screening programs, the BTNMSP provides free medical screening to eligible DOE employees. First, employees will undergo a comprehensive work history interview to help determine whether they have been exposed to hazardous and/or radioactive substances. Building Trades National Medical Screening Program, “Program Benefits,” available at https://www.btmed.org/benefits.cfm. Next, eligible employees are given a free medical screening examination. Id. The screening may help with the early detection of health problems and will also be used for informational purposes to better protect the health of current and former DOE employees. Id.
To be eligible under the BTNMSP, the employee must have performed construction work, either as a contractor or subcontractor, at any time in the past for the Atomic Energy Commission (AEC) or a DOE site associated with the research or production of nuclear weapons. Building Trades National Medical Screening Program, “Who Is Eligible?” available at https://www.btmed.org/eligible.cfm. In addition, the employee must have potentially been exposed to a health hazard, such as radiation, beryllium, asbestos, silica, mercury, cadmium, nickel, lead, uranium, plutonium, and etcetera or think that he or she has developed serious health problems as a result of his or her DOE employment. Id.
Covered DOE Sites
To be eligible under the BTNMSP, the employee must have performed construction work at one of the following sites:
- Hanford Nuclear Reservation
- Argonne National Laboratories (West)
- Idaho National Laboratory
- Amchitka Island Nuclear Explosion Site
- Rocky Flats Plant
- Waste Isolation Pilot Plant
- Kansas City Plant
- Mallinckrodt Chemical Company
- Weldon Spring Site
- Paducah Gaseous Diffusion Plant
- Piqua Organic Moderated Reactor
- Mount Plant
- GE Evendale
- Fernald Feed Materials Center
- Oak Ridge Reservation (K-25, X-10, Y-12)
- Savannah River Site
- Brush Luckey
- Battelle Laboratories (King Avenue and West Jefferson)
- Ashtabula (Reactive Metals Extrusion Plant)
- Shippingport Atomic Power Plant
- Brookhaven National Laboratory
- National Energy Technology Plant
- Portsmouth Gaseous Diffusion Plant
- Huntington Pilot Plant
- Pinellas Plant
Regional Screening Projects
Worker Health Protection Program (WHPP)
The Worker Health Protection Program (WHPP) provides free medical screening for former and some current employees at thirteen participating Department of Energy (DOE) facilities. The WHPP seeks to detect work-related illnesses at an early stage and assist employees in determining whether a current health condition is the result of their exposure to hazardous materials while employed at a DOE facility. The program is funded by a contract with the DOE and is led by the Queens College of the City of New York, in collaboration with the United Steel Workers (USW), Atomic Trades and Labor Council (ATLC), and the former Fernald Atomic Trades and Labor Council (FATLC). The Worker Health Protection Program, available at http://www.worker-health.org/index.html.
The WHPP provides medical screening examinations for chronic lung diseases, kidney disease, liver disease, and hearing loss. The tests that accompany the physical examination include:
- Spirometry, used to diagnose chronic obstructive pulmonary disease (COPD) and other chronic lung conditions;
- Chest x-ray;
- Audiometry, used to diagnose hearing loss;
- Urinalysis, used to diagnose kidney disease;
- Blood test;
- Beryllium sensitivity test (BeLPT) for eligible employees who were possibly exposed to beryllium as a result of their employment at a DOE facility;
- Low-dose CT scan, used to diagnose lung cancer, for eligible former Nevada Test Site, Mound Plant, and Fernald Plant employees as well as current and former Oak Ridge National Laboratory, Y-12 Plant, and Gaseous Diffusion Plant employees; and
- Medical and occupational exposure questionnaires.
While only available to eligible workers, a beryllium lymphocyte proliferation test (BeLPT) is used to determine whether a former employee has developed an allergic reaction or sensitivity to beryllium or is at risk for developing Chronic Beryllium Disease (CBD). The Worker Health Protection Program, “Beryllium Testing,” available at http://www.worker-health.org/berylliumtesting.html. In the event that an employee receives abnormal results from his or her BeLPT test, he or she is eligible to participate in follow-up medical tests, which are used to diagnose CBD. CBD can be compensated under Parts B and/or E of the Energy Employee Occupational Illness Compensation Program Act (EEOICPA).
To obtain free medical screening under the WHPP, an employee must first be deemed eligible. If a former employee was employed at one of the participating DOE sites, listed below, for thirty days or more, he or she is eligible for free medical screening. In the event that the former employee was employed at Nevada Test Site, Lawrence Livermore National Laboratory, Lawrence Berkeley National Laboratory, or Sandia National Laboratories, the period of employment must be one year or more. While the program only covers former employees for a majority of the DOE facilities, current employees at the Paducah or Portsmouth Gaseous Diffusion Plants are also eligible for free screening. The Worker Health Protection Program, “What We Do,” available at http://www.worker-health.org/whatwedo.html.
Covered DOE Sites
The participating DOE facilities under the WHPP include:
- Sandia/CA National Lab in Livermore, CA;
- Lawrence Livermore National Lab (LLNL) in Livermore, CA;
- Lawrence Berkeley National Lab (LBNL) in Berkeley, CA;
- Nevada Test Site in Las Vegas, NV;
- Idaho National Laboratory (INL) in Idaho Falls, ID;
- Mound Plant in Miamisburg, OH;
- Fernald Plant in Harrison, OH;
- Paducah Gaseous Diffusion Plant in Paducah, KY;
- K-25 Complex in Oak Ridge, TN;
- Y-12 Plant/Oak Ridge National Laboratory (ORNL) in Oak Ridge, TN; and
- Portsmouth Gaseous Diffusion Plant in Piketon, OH.
The WHPP contracts with medical facilities to provide free medical screenings near all of the covered DOE facilities. A list of participating medical facilities is provided at http://www.worker-health.org/whatwedo.html.
Pantex Former Worker Program
Former employees, who are at risk for illness due to their exposure to hazardous and/or radioactive substances while employed at Pantex Plant in Amarillo, TX, are entitled to a free medical screening. The program is administered by Drexel University School of Public Health and the University of Texas Health Science Center at Tyler. U.S. Department of Energy, Office of Environment, Health, Safety & Security, “Pantex, Former Production Workers Screening Projects,” available at http://www.energy.gov/ehss/pantex-former-production-workers-screening-projects.
Medical Exam Program for Former Workers from Los Alamos and Sandia National Laboratories
The Medical Exam Program for Former Workers from Los Alamos (LANL) and Sandia National Laboratories (SNL) was established to determine whether the health of former employees from either DOE facility was affected due to their employment and exposure to hazardous substances.
The Medical Exam Program for former LANL employees focuses on exposure to asbestos, beryllium, lead, noise, radiation, and solvents. John Hopkins Bloomberg School of Public Health, “Medical Exam Program,” available at http://www.jhsph.edu/research/affiliated-programs/medical-exam-program-for-former-workers-at-los-alamos-national-laboratory/. The Medical Exam Program for SNL employees focuses on the same substances as well as silica.
The initial medical screening includes an exam and selected tests, depending on which substances the employee was exposed to. Employees are eligible for a rescreening every three years if they had past exposure to asbestos and/or beryllium. Id.
To be eligible for a free medical screening exam, former LANL employees must have worked at the LANL site anytime after 1943, been significantly exposed to one of the substances listed above, and been employed by the University of California, Zia, Pan Am World Services, Johnson Controls International, Johnson Controls of Northern New Mexico, or another subcontractor. Id.
To be eligible for a free medical screening exam, former SNL employees must have worked at the SNL site anytime after 1949, been significantly exposed to one of the substances listed above, and been employed by Z-Division Sandia Laboratories, Sandia Corporation (Western Electric), Sandia Corporation (Lockheed Martin), or Sandia National Laboratories (SNL).
Former Worker Medical Screening Program for Line 1/Division B Iowa Army Ammunition Plant and Ames Laboratory
The Former Worker Medical Screening Program provides free medical screenings to all employees of Line 1/Division B of the Iowa Army Ammunition Plant from 1949 to 1975 and Ames Laboratory in Ames, IA. The program is administered by the University of Iowa College of Public Health. The University of Iowa College of Public Health, “Former Worker Medical Screening Program (FWP),” available at http://cph.uiowa.edu/IowaFWP/line1/screening.html.
The Former Worker Medical Screening Program provides free medical screenings to eligible employees, which include a chest x-ray, a Pulmonary Function Test (PFT), a Beryllium Lymphocyte Proliferation Test (BeLPT), and general laboratory tests. Id. For those living in Iowa, medical screenings are offered in Burlington, Mt. Pleasant, Iowa City, or Ames. Id. For those not residing in Iowa, the Former Medical Screening Program refers employees to the NSSP. Id.
DISCLAIMER: The material presented in this blog post is meant for informational purposes only. It is not intended as professional advice and should not be construed as such. Transmission of this information is not intended to create, and receipt does not constitute, an agreement to create an attorney-client relationship with Stephens & Stephens, LLP or any member thereof. If specific legal assistance of advice is needed, the services of a competent legal professional should be sought. – See more at: http://www.stephensstephens.com/category/our-eeoicpa-blog/#sthash.xK48Y8dA.dpuf
Medical Benefits Provided By the United States under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA)
Under the Energy Employees’ Occupational Illness Compensation Program Act (EEOICPA), employees of Department of Energy facilities, atomic weapons employers, or beryllium vendors who develop one of the covered cancers or illnesses may be entitled to up to $400,000 in compensation, as well as medical benefits, from the U.S. Department of Labor. Under the EEOICPA, medical benefits include “services, appliances, and supplies prescribed or recommended by a qualified physician” which are likely to “cure, give relief to, or reduce the degree or the period of the accepted illness.” 42 U.S.C. § 7384t(a) (2000). These services often include home health aide services and in-home skilled nursing care as well as the rental or purchase of Durable Medical Equipment (DME). DME often includes hospital beds, wheelchairs, and other equipment used in the home to aid in better quality of living.
Once a claim for an “accepted” illness is filed and approved with the U.S. Department of Labor under either Part B or Part E of the EEOICPA, a claimant is entitled to reimbursement of his or her medical expenses directly relating to that accepted illness. Before a claimant can receive these medical benefits, including services such as home health care, the expenses must first be authorized by the Division of Energy Employees Occupation Illness Compensation (DEEOIC). Prior to obtaining such services, the claimant’s DEEOIC District Office Claims Examiner must pre-approve the services. Division of Energy Employees Occupational Illness Compensation, U.S. Department of Labor, “Home Health Care Services and the EEOICPA,” available at http:///www.dol.gov/owcp/energy. The claimant must present medical evidence from a treating physician confirming the claimant’s need for care. Id. The treating physician must supply a “Plan of Care,” which is a letter of medical necessity or a written explanation of the care required by the claimant. Id. The “Plan of Care” must describe the level of care required (i.e. skilled nursing care or home health aide care), the frequency of care required (i.e. the number of hours per day), and the time period for which the claimant will require home health care. Id. Once a claimant’s home health care is approved by the DEEOIC, the claimant may choose any licensed medical provider to provide medical assistance. While some medical providers are enrolled in the Energy Employees Occupational Illness Compensation Program (EEOICP) and therefore are paid for their services directly by the DEEOIC, if a claimant chooses a provider that is not enrolled, the claimant can seek reimbursement for his or her expenses by filing a Form OWCP-915 with the U.S. Department of Labor. To determine if a provider is enrolled in the EEOICP, a medical provider database is provided at http://owcp.dol.acs-inc.com.
What Benefits are Covered?
Once a claimant is approved for medical benefits under the EEOICPA, the following benefits are covered:
- Prescription drugs
- Doctor co-pays, if applicable (co-pays are no longer required once medical care is approved)
- Medical travel
- Oxygen supplies
- Home health care
- Durable medical equipment (DME)
- Housing modifications
- Vehicle purchase
- Hospice care
- Organ and stem cell transplant
- Nursing home
- Assisted living
- Extended care facilities
- Medical alert systems
- Health facility and spa membership
- Chiropractic services
- Illness screening service
- Home exercise equipment
- Psychiatric treatment
Nuclear Workers Institute of America, EEOICPA Health Benefits, available at http://nuclearworkers.org/eeoicpa-health-benefits/.
To be reimbursable under the EEOICPA, medical assistance must be furnished by medical officers, hospitals, and physicians that are designated or approved under the Program. 42 U.S.C. § 7384t(b). In addition to the above medical benefits, “personal care” services, whether or not those include medical services, are reimbursable under the EEOICPA as long as they are deemed medically necessary and are provided by home health aides, licensed practical nurses, or similarly trained individuals. 20 C.F.R. § 30.403 (2012). Personal care services include assistance with housekeeping, meal preparation, grooming, bathing, and etcetera. Many family members seek to assist with the personal care of the claimant. The family member must be trained and certified in order to make services reimbursable under the EEOICPA. Certain health care providers can assist with the training necessary for family members to obtain certifications.
Issues that Claimants Face
One of the biggest issues that claimants face in obtaining reimbursement for medical services under the EEOICPA is the requirement that the services be reauthorized every six months. Initial approval for medical services requires that the physician responsible for treating a claimant for an accepted illness submit a “Plan of Care.” Division of Energy Employees Occupational Illness Compensation, U.S. Department of Labor, “Home Health Care Services and the EEOICPA,” available at http:///www.dol.gov/owcp/energy. The “Plan of Care” includes a letter of medical necessity or an explanation of the care needed to treat the accepted illness. Id. In addition, a claimant must have received a recent physical examination, defined as “a face-to-face encounter between the requesting physician and the DEEOIC approved patient, within 60 days prior to the submission of a home health care authorization request.” Id. Following the physical examination, the physician must submit a detailed report that documents the results of the examination. Id. To obtain reauthorization every six months, the claimant must submit updated medical information and a new face-to-face evaluation within sixty days of reauthorization. Id. Failure to do so results in the denial of the reauthorization and the ineligibility of the claimant to obtain reimbursement for his or her medical expenses, including the rental or purchase price of DME. This places a burden on claimants to follow a strict timeline and attend frequent doctor’s appointments in order to retain medical benefits under the EEOICPA. It is not unusual for a primary physician to become impatient with these requirements. It is sometimes useful to have a physician who has experience with the EEOICP and is willing to write the necessary reports every six months.
A second issue that arises is the personal care of a claimant by a family member. As previously stated, personal care services are reimbursable so long as provided by a home health aide, licensed practical nurse, or a similarly trained individual. 20 C.F.R. § 30.403. Typically, family members are not trained in satisfaction of the regulations and therefore, cannot be paid for providing care. While the regulations still allow a trained individual to provide personal care, often it is preferable for a claimant to be cared for by a family member, typically a spouse or a child. Because a family member that has not been trained cannot be paid for their services, that often raises additional financial issues. Some home health care providers have addressed this issue by providing training to family members of claimants. This allows family members to provide the necessary care to a claimant while getting paid for it, lessening the burden on claimants and their families as well as home health care providers.
To address some of these issues, the Office of Workers’ Compensation Programs (OWCP), which is responsible for administering the EEOICP, is set to publish proposed regulations in April 2015. The regulations will focus on enhancing the OWCP’s ability to efficiently provide appropriate medical care for beneficiaries, explaining the increased automation of the medical authorization and billing process, and modernizing the process that OWCP uses to investigate whether medical providers are engaging in appropriate activity and the steps it takes to exclude those medical providers in the event that they engage in harmful activity.
Medical Providers Enrolled in the EEOICP
Medical providers enrolled in the EEOICP are paid directly by the DEEOIC for their services, whereas those providers that are not enrolled in the EEOICP must be paid by the claimant, who may then seek reimbursement for his or her medical expenses by filing an OWCP-915 Form with the Department of Labor. Some of the home health care providers enrolled under the EEOICP include Victory Medical Solutions, Professional Case Management, Critical Nurse Staffing, Four Corners, Remain at Home Health Care, Trusted Ally Home Care, and United Energy Workers Health Care.
Many of these home health care companies provide free in-home nursing care to eligible claimants, including health status assessments, assessments of the claimant’s ability to carry out typical daily activities, communication with the claimant’s physician and pharmacy, and assistance with tasks of daily living, such as bathing, walking, and meal preparation. In addition, one provider in particular, Four Corners, provides training to family members so that they can become certified and provide personal care to the claimant.
To learn more about medical benefits under the EEOICPA, please contact Hugh Stephens of Stephens & Stephens, LLP at (716) 852-7590, (716) 208-3525, or via email at firstname.lastname@example.org. You can also learn more by visiting our website at www.stephensstephens.com.
We hope that you all have had a wonderful 2014!
A comprehensive outline of 2014’s activity concerning the EEOICPA at Stephens & Stephens can be read here.
We hope it will be informative for you.
In the final video of our series dedicated to keeping the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) understandable and accessible, Hugh continues his explanaion of the claims filing process by discussing some of the proofs and forms required to submit a claim. He also describes how the process generally plays out and how long it should be expected to take, while taking into account various obstacles that may arise along the way.
The tenth video of our EEOICPA series, in which Hugh gives an explanation of the Energy Employees Occupational Illness Compensation Program Act claims filing process and discusses some of the standard forms involved, can be seen below:
EEOICPA videos: Energy Employees Occupational Illness Compensation Program Act in a Nutshell (video 9)
In video number nine of our Energy Employees Occupational Illness Compensation Program Act (EEOICPA) series, Hugh thoroughly recounts the history of the Act. He then explains how certain atomic weapons workers who are suffering from various illnesses such as Silicosis, Chronic Beryllium Disease (CBD), and various cancers may be compensated under the Act after it has been determined that their employment at any of over three hundred Department of Energy (DOE) and Atomic Weapons Employer (AWE) sites across the country is at least as likely as not to have caused their illness(es).