The language of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) can make it difficult to understand whether the illness you have been diagnosed with is a covered illness under the program. This article will explain eligibility and covered illnesses in a simplified manner so that you can get the answers you are looking for.
Are you or your family member an eligible worker?
In order to qualify, you have to be an eligible worker or the survivor of an eligible worker. An eligible worker is someone who became ill as a result of exposure to radiation or other toxic substances while employed at an Atomic Weapons Employer (AWE), the Department of Energy (DOE), or one of its contractors or subcontractors.
To see if the facility you or your family member worked for is an EEOICPA Covered Facility, click on this link to see a comprehensive list.
https://stephensstephens.com/areas-of-practice/eeoicpa/eeoicpa-facility-list/
If you don’t see your facility on this list, go to the search function (click on the 🔍at the top of the screen) and type in the name of the facility.
Part B Covered Illnesses
This is where things can get a little bit confusing, but it’s actually very straightforward.
In order to qualify for Part B coverage, you must have a diagnosis of one of the following:
- Cancer
- Chronic Silicosis
- Beryllium Sensitivity
- Chronic Beryllium disease
Resulting from covered employment during a specified time period.
What does this “specified time period” mean? Depending on the facility, the covered time period for employment differs. Again, click on the link above to see what the covered time period for your facility is.
There must be a determination that the illness developed after working at a covered facility, and that the illness is “at least as likely as not” related to that employment.
The “at least as likely as not” determination is made through a process called dose reconstruction, where radiation doses are estimated based on a scientific process.
If an employee is a member of the Special Exposure Cohort (SEC) and developed one of certain specified cancers, there is a presumption of causation and those claims do not undergo the dose reconstruction process.
To see the list of SEC Facilities, click here:
https://stephensstephens.com/areas-of-practice/eeoicpa/eeoicpa-sec/
To see the list of SEC specified cancers, click here:
https://stephensstephens.com/areas-of-practice/eeoicpa/sec-covered-illnesses/
But remember that all cancers are eligible, even those that do not receive the presumption of causation.
Part E Coverage Details
In order to qualify for Part E coverage, the claimant must establish the illness is due to exposure to a toxic substance during covered employment. Under Part E, toxic substances does not only mean radiation, but also includes any other toxic substance such as chemicals, solvents and metals.
Part E covers any condition found to be related to exposure to toxic substances at a covered facility. If your illness is not covered by Part B but was caused or contributed to by exposures to toxic substances during covered employment, it is covered under Part E. Examples of illnesses covered under Part E include: Chronic Obstructive Pulmonary Disease (COPD), Emphysema, asbestos related disease, Parkinsonism and Skin Cancer.
Impairment
If a covered illness has caused a decrease in the functioning of a body part or organ that affects the the workers’ Activities of Daily Living (ADLs), the employee is entitled to an impairment rating for compensation of $2500 for each one percent of whole body impairment.
Under Part E compensation of up to $250,000 is determined based on wage loss and impairment.
Wage Loss
Under Part E, an employee or the survivor(s) of an employee is entitled to wage loss compensation if the loss of wages was related to a covered illness. Wage loss is based on the total years the employee was unable to work as a result of the illness and is payable for years of lost wages that occur prior to regular social security retirement age. Total wage loss is either $10,000 or $15,000 for each year of lost wages.
For more information on wage loss, click here.
Questions? Contact us for a free evaluation.