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Leukemia: Covered by the Special Exposure Cohort

Leukemia, one of the 22 Specified Cancers covered by the Special Exposure Cohort (SEC) classes of the Energy Employee Occupational Illness Compensation Program (the Program or EEOICPA), is a type of blood cancer that begins in the bone marrow.

Did you know that a diagnosis of chronic lymphocytic leukemia (CLL)—one of the most common forms of leukemia—instead of small lymphocytic lymphoma (SLL) could have major coverage implications?

We work to compensate workers and their survivors who have developed certain illnesses, including leukemia, as a result of exposure to radioactive and toxic substances. If you think you may be eligible, please sign up for a free claim evaluation today.

Leukemia: Four Most Common Forms

The various forms of leukemia are divided into two categories: acute and chronic. Acute leukemias develop much more quickly than other forms and occur when a large number of leukemic cells are produced and remain in the bloodstream for a longer-than-normal period of time. Chronic leukemias develop over time and are characterized by a slow production of leukemic cells. These cells exist in the bloodstream, but are not abundant enough to initially inhibit the proper functionality of normal cells.

Listed below are the four most common forms of leukemia:

  1. Acute lymphocytic leukemia (ALL): ALL affects the lymphocytic type of white blood cells. It is most common in children.
  2. Acute myeloid leukemia (AML): Often referred to as acute non-lymphocytic leukemia, AML affects the myeloid type of white blood cells, red blood cells, and cells that produce platelets. Children and adults have an equal risk of developing this leukemia.
  3. Chronic lymphocytic leukemia (CLL): Like ALL, CLL affects the lymphocytic type of white blood cells and is most common in adults over the age of 55.
  4. Chronic myeloid leukemia (CML): Like AML, CML affects the myeloid type of white blood cells, red blood cells, and cells that produce platelets. This type of leukemia is most common in adults.


Lymphoma is another type of blood cancer that occurs when the lymphocytic white blood cells, also known as lymphocytes, behave abnormally. This abnormal behavior is most commonly characterized by a rapid division of cells and an increased life span. Like with leukemia, these cells overcrowd healthy cells and prevent them from functioning properly. Unlike leukemia, lymphoma can develop not just in the bone marrow, but in the lymph nodes, spleen, blood, or other organs. Symptoms of lymphoma include—but are not limited to—swollen lymph nodes and enlarged spleen, causing abdominal pains, fever, sudden weight loss, fatigue, and loss of appetite.

There are dozens of forms of lymphoma, but they are all categorized as either Hodgkin’s or non-Hodgkin’s. In Hodgkin’s lymphomas, the abnormal lymphocytes present are cells known as a Reed-Sternberg cell. In non-Hodgkin’s lymphomas, Reed-Sternberg cells are not present. Non-Hodgkin’s lymphomas are significantly more common than Hodgkin’s lymphomas. Some of the most common non-Hodgkin’s lymphomas are:

  1. Diffuse large B-cell lymphoma (DLBCL): DLBCL is the most common lymphoma, accounting for one out of every three cases of lymphoma in the United States. DCBCL is an aggressive lymphoma, but responds well to treatment. This lymphoma typically originates in a lymph node inside the body (chest or abdomen), or a lymph node one can feel (neck or armpit).
  2. Follicular lymphoma: This lymphoma accounts for one of every five lymphomas in the United States and is a slow-growing lymphoma. Over time, some follicular lymphomas can develop into aggressive large B-cell lymphomas.
  3. Small lymphocytic lymphoma (SLL)” SLL is a less common lymphoma that affects the lymphocytes, much like CLL described above. SLL originates in the lymph nodes and spleen and is generally incurable, although it can be managed effectively, allowing those afflicted to live many years after a diagnosis.
  4. Mantle cell lymphoma (MCL): MCL accounts for about five percent of lymphomas in the United States. MCL is typically widespread in the lymph nodes, spleen, and bone marrow. It is typically a slow-growing lymphoma that does not respond to treatment as well as aggressive lymphomas do.

Because both lymphoma and leukemia affect the bloodstream, they often share common characteristics, including symptoms and the way in which they manifest themselves in the body.

One leukemia and one lymphoma in particular exhibit such similar characteristics that they are often considered the same disease: chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). CLL and SLL both affect the same lymphocytes. They are essentially the same disease; however, the major difference is the primary location where the cancer occurs. CLL occurs when the cancerous cells are located in the bloodstream and bone marrow, while SLL occurs when these cells are mostly located in the lymph nodes. However, it is common in both CLL and SLL for cancer cells to exist in the bloodstream, bone marrow, lymph nodes, and spleen.

Part B: EEOICPA and Leukemia

A diagnosis of CLL versus SLL has major implications for claims for compensation under Part B of the EEOICPA Program. Under Part B of the Program, certain atomic energy workers and their survivors are entitled to compensation of $150,000 based on their inclusion in the (SEC).

An SEC class is issued by the National Institute of Occupational Safety and Health (NIOSH) when they determine that they do not have enough adequate data and information to perform a dose reconstruction with sufficient accuracy at a given facility during a given time period. As a result, workers who were employed by the Department of Energy, its contractors, or subcontractors, and atomic-weapons employers who worked for at least 250 days at these facilities during these time periods, are compensated without the need to have a dose reconstruction performed. The last criteria for inclusion as a member of an SEC is having one of 22 specified cancers. One of the cancers excluded from this list is CLL, whereas SLL is included.

Therefore, a diagnosis of CLL versus SLL could mean the difference between compensation of $0 instead of $150,000. For those diagnosed with CLL, we highly recommended that you ask your doctor about the potential for an additional diagnosis of SLL.

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