The EEOICPA was passed in 2000. It provides compensation to workers who became ill as a result of their employment manufacturing nuclear weapons in the USA, as well as their spouses, children, and grandchildren.
Are you eligible for compensation? If you or a family member worked at any of the Atomic Weapons Employer (AWE) and Department of Energy (DOE) Covered Facilities listed on this website and became ill, you may be entitled to compensation of up to $400K plus medical benefits. Call EEOICPA Counsel Hugh Stephens at 1-855-548-4494 or fill out our free claim evaluation, We can help even if you’ve already filed, even if your claim was denied!
In these pages, we present general definitions of Illnesses covered by the Act, followed by specific references to the disease from the EEOICPA Procedure Manual, Bulletins, and Final Decisions of the Final Adjudication Board to clarify how these maldies might relate to the Energy Employees Occupational Illness Compensation Program Act.
Small Intestine Cancer
Below we have collected specific references to small intestine cancer from the DEEOIC Procedure Manual, Bulletins, and Final Decisions, to illustrate how this illness is viewed under the EEOICPA.
Small Intestine Cancer
Definition of small intestine cancer: A rare cancer that forms in tissues of the small intestine (the part of the digestive tract between the stomach and the large intestine). The most common type is adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). Other types of small intestine cancer include sarcoma (cancer that begins in connective or supportive tissue), carcinoid tumor (a slow-growing type of cancer), gastrointestinal stromal tumor (a type of soft tissue sarcoma), and lymphoma (cancer that begins in immune system cells).
Also called: Duodenal cancer, Ileal cancer, Jejunal cancer, Small intestine cancer
Your small intestine is part of your digestive system. It is a long tube that connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet or having Crohn’s disease, celiac disease, or a history of colonic polyps can increase your risk.
Possible signs of small intestine cancer include
- Abdominal pain
- Weight loss for no reason
- Blood in the stool
- A lump in the abdomen
Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and show whether it has spread.
Surgery is the most common treatment. Additional options include chemotherapy, radiation therapy, or a combination.
NIH: National Cancer Institute
uu. Specified Cancers are listed in Section 30.5(ff) of the regulations. An employee must be diagnosed with one of these specific types of cancer to be considered eligible for benefits as a member of the Special Exposure Cohort (SEC). The list of specified cancers, which is derived from section 4(b)(2) of the RECA Amendments of 2000, is as follows:
(5) The following diseases, provided onset was at least five years after first occupational exposure:
(c) Primary cancer of the:
(vi) Small intestine;
e. Other Diseases. For the following diseases, onset must have been at least five years after initial exposure during qualifying SEC employment:
(3) Primary cancer of the:
(f) Small intestine;
2. RECA Background.
c. Section 4 of RECA.
(b) Covered Illnesses: Leukemia (other than chronic lymphocytic leukemia), multiple myeloma, lymphomas (other than Hodgkin’s disease), and primary cancer of the thyroid, male or female breast, esophagus, stomach, pharynx, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary bladder, brain, colon, ovary, liver (except if cirrhosis or hepatitis B is indicated), or lung.
03-11 Additional cancers considered as primary cancer
EEOICPA BULLETIN NO.03-11
Issue Date: November 19, 2002
Effective Date: November 19, 2002
Expiration Date: November 19, 2003
Subject: Additional Cancers Considered as Primary Cancers
Background: 20 CFR 30.5 (dd)(6) states that specified cancers are “the physiological condition or conditions that are recognized by the National Cancer Institute under those names or nomenclature, or under any previously accepted or commonly used names or nomenclature.” The Department of Labor (DOL) forwarded a list of six medical conditions to the National Cancer Institute (NCI) for their review and classification to determine which conditions could be considered as cancers under the EEOICPA. The six medical conditions sent to NCI were:
myelofibrosis with myeloid metaplasia;
polycythemia vera with leukocytosis and thrombocytosis;
polycythemia rubra vera;
carcinoid tumors or carcinoid syndrome; and
monoclonal gammopathies of undetermined significance.
On October 8, 2002, DOL received a letter from Dr. E. G. Fiegal, the Acting Director of NCI’s Division of Treatment and Diagnosis, detailing NCI’s evaluation of the above mentioned six medical conditions.
According to Dr. Fiegel, NCI recognizes myelofibrosis with myeloid metaplasia, polycythemia vera with leukocytosis and thrombocytosis, polycythemia rubra vera, and myelodysplastic syndromes as reportable cancers. These hematological conditions are not reportable as leukemia, non-Hodgkin’s lymphoma, or multiple myeloma, but have distinct categories (except in the case of polycythemia rubra vera and polycythemia vera with leukocytosis and thrombocytosis, which share the same category). One of the functions of bone is to manufacture blood cells in the bone marrow. Accordingly, myelofibrosis with myeloid metaplasia, polycythemia rubra vera and its variant polycythemia vera with leukocytosis and thrombocytosis, and myelodysplastic syndrome(s) should be considered as bone cancer for purposes of having a “specified cancer” as a member of the Special Exposure Cohort, since all are malignancies of the bone marrow.
Carcinoid syndrome and monoclonal gammopathies of undetermined significance are not currently recognized as malignant conditions by NCI. Consequently, these conditions should not be considered as cancers.
Carcinoid tumors, except of the appendix, are recognized as malignant conditions by NCI and should be considered to be primary cancers of the organs in which they are located. If the organ is one on the specified cancer list, the carcinoid tumor may be considered as a specified cancer. Carcinoid tumors are found in greatest amounts in the small intestine and then in decreasing frequency in the appendix, rectum, lung, pancreas and very rarely in the ovaries, testes, liver, bile ducts and other locations.
Reference: Energy Employees Occupational Illness Compensation Program Act of 2000, As Amended, 42 U.S.C. § 7384 et seq., Section 7384l(17); interim final rule 20 CFR Part 30, Section 30.5 (dd); and a letter from Dr. E. G. Fiegal, NCI, to R. Leiton, DOL, dated October 8, 2002.
Purpose: To notify District Offices of the classification of six additional medical conditions as primary cancers for eligible SEC claimants under the EEOICPA.
Applicability: All staff.
The CE should consider: (1) myelofibrosis with myeloid metaplasia; (2) polycythemia rubra vera; (3) polycythemia vera with leukocytosis and thrombocytosis; and (4) myelodysplastic syndrome(s) to be bone cancer, which is a specified primary cancer per EEOICPA Section 7384l(17)(B).
2. Carcinoid tumors, except of the appendix, are recognized as malignant conditions by NCI. If the organ is one on the specified cancer list, the CE should consider the carcinoid tumor as a specified cancer (per EEOICPA Section 7384l(17)).
3. Carcinoid syndrome and monoclonal gammopathies of undetermined significance are not currently recognized as malignant conditions by NCI. Consequently, these conditions should not be considered cancers by the CE. If no other medical conditions are claimed that qualify the employee as having a covered condition, the claim should be denied.
The CE must look for any other cases of the medical conditions discussed above that could make the claimant eligible for benefits, either as a member of the SEC or through dose reconstruction. A preliminary review of the ECMS is underway to determine which cases may have already been denied or sent to NIOSH. That list will be forwarded to each District Office under separate cover. Using that list, the District Office must pull any cases for review in accordance with this bulletin. If modification orders are required, the District Office should send the case to the National Office.
The CE must continue to distinguish these medical conditions from bone or other specified cancers, as appropriate, using the appropriate ICD-9 codes on all paperwork and in ECMS.
For the conditions to be considered as bone cancers, the ICD-9 code for a myeloid metaplasia is 289.8, polycythemia rubra vera and its variant polycythemia vera with leukocytosis and thrombocytosis is 238.4, and myelodysplastic syndrome is 238.7. The ICD-9 code for malignant neoplasm of the bone is 170.
Carcinoid tumors, except of the appendix, should be recorded by the organ of the specified cancer. For example, the CE should use the ICD-9 code of 170 for a carcinoid tumor in the small intestine.
Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual
PETER M. TURCIC
Director, Division of Energy Employees
Occupational Illness Compensation
Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, District Office Mail & File Sections
EEOICPA Fin. Dec. No. 10012834-2006 (Dep’t of Labor, February 21, 2007)
NOTICE OF FINAL DECISION
This is the decision of the Final Adjudication Branch (FAB) concerning your claim for compensation under the Energy Employees Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or the Act), 42 U.S.C. § 7384 et seq. For the reasons stated below, your claim for benefits under Part E of the Act is accepted.
STATEMENT OF THE CASE
On September 10, 2003, the FAB issued a final decision which concluded that your father was a member of the Special Exposure Cohort based on his employment at the Portsmouth Gaseous Diffusion Plant (GDP), a Department of Energy (DOE) facility, and that he was diagnosed with colon cancer after beginning that employment. For those reasons, the FAB concluded that you, as a surviving child, were entitled to compensation under Part B.
On March 13, 2003, you filed a DOE F 350.2 (Request for Review by Physicians Panel) based on colon cancer having been caused by your father’s work at a DOE facility. A copy of your father’s death certificate shows that his death was due to metastatic mucinous adenocarcinoma. A copy of your father’s autopsy report indicates that colon cancer had metastasized to the peritoneum, omentum, intestines, stomach and liver.
You submitted a copy of your birth certificate which shows that your date of birth is April 23, 1947. A copy of your father’s death certificate shows that he was born on August 16, 1922, and died on November 26, 2002, and that he was widowed at the time of his death.
The Social Security Administration (SSA) provided an itemized statement of earnings for the period of January 2000 to December 2004 which shows that you had no earnings reported for that period. A letter from the Department of Veteran Affairs (DVA), Cleveland Regional Office, dated April 21, 2006, shows that you are entitled to receive benefits at the 100% rate, effective December 1, 1997, and that such entitlement continued to the date of this letter. Copies of DVA Rating Decisions, dated March 23, 1995 and April 29, 1997, show that you were found to be permanently and totally disabled from December 30, 1975, and that post-traumatic stress disorder (PTSD) was found to be totally disabling from March 9, 1994.
On January 10, 2007, the district office issued a recommended decision which concluded that because your father was a DOE contractor employee who was entitled to compensation under Part B of the Act, it was established that he contracted a covered illness through exposure to radiation at a DOE facility. The recommended decision also concluded that his death was at least as likely as not aggravated, contributed to, or caused by that radiation. The district office found that, at the time of your father’s death, you were incapable of self-support. For those reasons, the district office concluded that you, as his surviving child, are entitled to $125,000.00 under Part E.
On January 22, 2007, the FAB received written notification that you waive any and all objections to the recommended decision. After considering the recommended decision and all the evidence in the case file, the FAB hereby makes the following:
FINDINGS OF FACT
1. You filed a claim for benefits on March 13, 2003.
2. By final decision dated September 10, 2003, the FAB determined that your father was employed at a DOE facility and was entitled to compensation under Part B for an occupational illness, colon cancer, which was diagnosed after the beginning of that employment.
3. Your father died on November 26, 2002, due to metastatic mucinous adenocarcinoma which had originated in the colon.
4. You are a surviving child of [Employee], and were incapable of self-support at the time of his death.
Based on the above-noted findings of fact in this claim, the FAB hereby makes the following:
CONCLUSIONS OF LAW
The term “covered child” means a child of the employee who, at the time of the employee’s death, was under the age of 18 years, or under the age of 23 years and a full-time student who was continuously enrolled in an educational institution since attaining the age of 18 years, or incapable of self-support. See 42 U.S.C. § 7385s-3(d)(2). You were 54 years old at the time of your father’s death. Based on information provided by SSA and DVA, you had not been paid wages for at least the period of 2000 to 2004 and you were found to be totally (100%) disabled due to PTSD and other disabling conditions since at least March 9, 1994 and continuing until the time of your father’s death on November 26, 2002.
Based on the final decision of September 10, 2003, I have determined that, as provided by 42 U.S.C. § 7385s-4(a), colon cancer (resulting in metastatic mucinous adenocarcinoma) was contracted by your father through exposure to a toxic substance at a DOE facility. The evidence of record establishes that his death was at least as likely as not aggravated, contributed to, or caused by that exposure. For those reasons, I conclude that, as his surviving child, you are entitled to $125,000.00 as provided by 42 U.S.C. § 7385s-3(a)(1).
Tracy Smart, Hearing Representative
Final Adjudication Branch