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Lung Cancer is one of the covered illnesses under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) as well as one of the 22 Specified Cancers under the EEOICPA Special Exposure Cohort (SEC) procedure.  That procedure establishes a relaxed causation standard and an efficiency procedure, in the place of the more rigorous standard Dose Reconstruction procedure, where a sufficiently accurate estimate of radiation dose cannot be calculated.  The absence of reliable historic radiation dose information (accurate dosimeter data for example) often requires the establishment of a Special Exposure Cohort (SEC) or a group of employees whose claims are subject to the streamlined procedure.  Because of the inability of the National Institute of Occupational Safety and Health (NIOSH), and its health physicists, to accurately estimate radiation dose, the Department of Labor (DOL) generally requires potentially qualified claimants to establish 250 days of site presence at the relevant facility and a one of the 22 specified cancers.  The list below is taken from the Department of Labor’s EEOICPA website and identifies the 22 specified cancers:

List of Qualifying Cancers for the SEC

In addition to having worked for a specified period of time at one of the SEC work sites, to qualify for compensation, a covered employee must also have at least one of the following types of cancer:

  • Bone cancer
  • Renal cancers
  • Leukemia (other than chronic lymphocytic leukemia) provided the onset of the disease was at least two years after first exposure
  • Lung cancer (other than in-situ lung cancer that is discovered during or after a post-mortem exam)
  • The following diseases provided onset was at least five years after first exposure:
    • Multiple myeloma
    • Lymphomas (other than Hodgkin’s disease)
    • Primary cancer of the:
      • Bile ducts
      • Brain
      • Breast (female)
      • Breast (male)
      • Colon
      • Esophagus
      • Gall bladder
      • Liver (except if cirrhosis or hepatitis B is indicated)
      • Ovary
      • Pancreas
      • Pharynx
      • Salivary gland
      • Small intestine
      • Stomach
      • Thyroid
      • Urinary bladder

NOTE: The Department of Labor has published EEOICP Final Bulletins to address various EEIOCPA issues. There are some bulletins that address information for some of the cancers listed above and some of the bulletins address how SEC claims are processed.

See http://www.cdc.gov/niosh/ocas/ocassec.html#cancers (last accessed December 1, 2013).

The important point with respect to lung cancer (as well as bone and kidney cancer) is the absence of a requirement that the cancer be diagnosed as primary lung cancer.  One of the characteristics of cancer that accounts, in part, for its characterization as malignant is its tendency to spread.  When cancer spreads that process is referred to as metastasis.  An interesting aspect of this spread, of metastatic cancer, is that when the cancer takes hold in another part of the body, the cancer in that part of the body is actually the same type of cancer as was found in the original or primary cancer site.  So prostate cancer that spreads to the lung is generally characterized as metastatic prostate cancer not lung cancer.  This is because the cancer in the lung is not simply lung cancer but more accurately prostate cancer in the lung.  Lung cancer that begins in the lung is referred to as primary lung cancer.  This becomes important in the Dose Reconstruction process because a Dose Reconstruction is only prepared for a primary cancer.  But within the Special Exposure Cohort procedure, lung cancer (as well as Renal/Kidney and Bone) is sufficient to afford membership in the cohort whether it is primary or secondary (i.e. metastatic).

One issue that tends to come up in the context of defining lung cancer for the purposes of the EEOICPA program is the treatment of mesothelioma which is a cancer of the lining of the lung.  Mesothelioma is not considered a specified cancer as it is not characterized as lung cancer by the Claims Examiners and Hearing Representatives in the Department of Energy Employee Occupational Illness Compensation (DEEOIC).

 

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