The Energy Employees Occupational Illness Compensation Program Act (EEOICPA)

Changes from August 5, 2020 to January 13, 2021

This page shows textual changes in the document between the two versions indicated in the dates above. Textual matter removed in the later version is indicated with ~~red strikethrough~~ and textual matter added in the later version is indicated with blue.

The Energy Employees Occupational Illness
~~August 5, 2020~~January 13, 2021
Compensation Program Act (EEOICPA)
Scott D. Szymendera
During the Cold War, thousands of Americans worked in the development and testing of the During the Cold War, thousands of Americans worked in the development and testing of the
Analyst in Disability Policy Analyst in Disability Policy
nation’s nuclear weapons stockpile. Some of these workers were exposed to radiation, beryllium, nation’s nuclear weapons stockpile. Some of these workers were exposed to radiation, beryllium,

silica, and other toxic substances that may have contributed to various medical conditions, silica, and other toxic substances that may have contributed to various medical conditions,
including different types of cancer. Enacted in 2000, the Energy Employees Occupational Illness including different types of cancer. Enacted in 2000, the Energy Employees Occupational Illness

Compensation Program Act (EEOICPA, Title XXXVI of P.L. 106-398) provides cash and Compensation Program Act (EEOICPA, Title XXXVI of P.L. 106-398) provides cash and
medical benefits to former nuclear weapons arsenal workers with covered medical conditions and to their survivors.medical benefits to former nuclear weapons arsenal workers with covered medical conditions and to their survivors.
Part B of EEOICPA provides a fixed amount of compensation and medical coverage to Department of Energy (DOE) Part B of EEOICPA provides a fixed amount of compensation and medical coverage to Department of Energy (DOE)
employees and contractors, atomic weapons employees, and uranium workers with specified medical conditions, including employees and contractors, atomic weapons employees, and uranium workers with specified medical conditions, including
cancer. Workers with certain radiogenic cancers can access EEOICPA Part B through one of two pathways: dose cancer. Workers with certain radiogenic cancers can access EEOICPA Part B through one of two pathways: dose
reconstruction and the Special Exposure Cohort (SEC). Under dose reconstruction, the worker’s individual work history and reconstruction and the Special Exposure Cohort (SEC). Under dose reconstruction, the worker’s individual work history and
radiation exposure is evaluated to determine the probability that the worker’s cancer was caused by his or her exposure to radiation exposure is evaluated to determine the probability that the worker’s cancer was caused by his or her exposure to
ionizing radiation. Under the SEC, workers from the same worksite can petition to be included in the SEC based on the site’s ionizing radiation. Under the SEC, workers from the same worksite can petition to be included in the SEC based on the site’s
work and exposure history. All members of the SEC with covered cancers are eligible for Part B benefits. work and exposure history. All members of the SEC with covered cancers are eligible for Part B benefits. ~~Approximately~~App roximately
70% of EEOICPA Part B cancer cases are awarded benefits via the SEC rather than dose reconstruction. 70% of EEOICPA Part B cancer cases are awarded benefits via the SEC rather than dose reconstruction.
Part E of EEOICPA operates similar to a traditional workers’ compensation program. It pays variable cash benefits based on Part E of EEOICPA operates similar to a traditional workers’ compensation program. It pays variable cash benefits based on
impairment and wage loss and provides medical benefits to former DOE contractors and uranium workers exposed to toxic impairment and wage loss and provides medical benefits to former DOE contractors and uranium workers exposed to toxic
substances on the job.substances on the job.
In 2010, GAO raised oversight concerns about the lack of independent expert review of DOE’s Site Exposure Matrices In 2010, GAO raised oversight concerns about the lack of independent expert review of DOE’s Site Exposure Matrices
(SEM, a repository of information on the presence of toxic substances of covered sites). In 2014, Congress created the (SEM, a repository of information on the presence of toxic substances of covered sites). In 2014, Congress created the
Advisory Board on Toxic Substances and Worker Health to advise DOL on Part E, including the SEMAdvisory Board on Toxic Substances and Worker Health to advise DOL on Part E, including the SEM . The advisory board . The advisory board
sunsets in 2024. sunsets in 2024.
To date, Part B has paid To date, Part B has paid over $7.1 billion in compensation and Part E has paid $5.$7.1 billion in compensation and Part E has paid $5.13 billion in compensation. Combined Parts billion in compensation. Combined Parts B B
and E medical benefits exceed $and E medical benefits exceed $~~5.9~~6.4 billion. The Energy Employees Occupational Illness Compensation Fund pays EEOICPA billion. The Energy Employees Occupational Illness Compensation Fund pays EEOICPA
benefits. The fund is financed through general revenues, and it is not subject to annual appropriations. benefits. The fund is financed through general revenues, and it is not subject to annual appropriations.
The EEOICPA Office of Ombudsman, which assists claimants and medical providers navigate the program, The EEOICPA Office of Ombudsman, which assists claimants and medical providers navigate the program, iswas scheduled to sunset on October 28, 2020, but was permanently authorized by a provision in the William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 (P.L. 116-283). ~~scheduled to~~
~~sunset on October 28, 2020. However, in the past, when the Office of Ombudsman’s authority had expired before Congress~~
~~could extend it, the Secretary of Labor used her authority to continue the office’s operations. In the 116th Congress, H.R.~~
~~6009, the Nuclear Workers’ Ombudsman Extension Act, would extend the sunset date to 2025.~~

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The Energy Employees Occupational Illness Compensation Program Act (EEOICPA)

he Energy Employees Occupational he Energy Employees Occupational ~~Illness~~Il ness Compensation Program Act (EEOICPA) Compensation Program Act (EEOICPA)
provides cash benefits and medical coverage to civilians who worked in the development provides cash benefits and medical coverage to civilians who worked in the development
T and testing of the nation’s nuclear weapons stockpile.1 Administered by the Department of T and testing of the nation’s nuclear weapons stockpile.1 Administered by the Department of
Labor (DOL), Office of Workers’ Compensation Programs (OWCP), with assistance from the Labor (DOL), Office of Workers’ Compensation Programs (OWCP), with assistance from the
Departments of Health and Human Services (HHS), Energy (DOE), and Justice (DOJ),2 Departments of Health and Human Services (HHS), Energy (DOE), and Justice (DOJ),2
EEOICPA provides benefits under two parts of its statute: Part B and Part E. Part B provides a EEOICPA provides benefits under two parts of its statute: Part B and Part E. Part B provides a
fixed rate of cash benefits and Part E pays variable benefits based on impairment and wage loss, fixed rate of cash benefits and Part E pays variable benefits based on impairment and wage loss,
operating similar to a traditional workers’ compensation program. Medical coverage is available operating similar to a traditional workers’ compensation program. Medical coverage is available
under both Parts B and E. under both Parts B and E.
The Energy Employees Occupational The Energy Employees Occupational ~~Illness~~Il ness Compensation Fund, established by Part A of Compensation Fund, established by Part A of
EEOICPA, pays EEOICPA.3 This fund is financed, without further appropriations, by transfers of EEOICPA, pays EEOICPA.3 This fund is financed, without further appropriations, by transfers of
such sums as are necessary from the General Fund of the Treasury. The EEOICPA program’s such sums as are necessary from the General Fund of the Treasury. The EEOICPA program’s
administrative costs are not paid from the Energy Employees Occupational administrative costs are not paid from the Energy Employees Occupational ~~Illness~~Il ness Compensation Compensation
Fund but are Fund but are ~~annually~~annual y appropriated to DOL. appropriated to DOL.
The Energy Employees Occupational The Energy Employees Occupational ~~Illness~~Il ness Compensation Program was established in 2000 as Compensation Program was established in 2000 as
Title XXXVI of the Floyd D. Spence National Defense Authorization Act for 2001 (P.L. 106-Title XXXVI of the Floyd D. Spence National Defense Authorization Act for 2001 (P.L. 106-
398). The program was amended to replace the original Part D with Part E in 2004 by Subtitle E 398). The program was amended to replace the original Part D with Part E in 2004 by Subtitle E
of Division C of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 of Division C of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005
(P.L. 108-375). EEOICPA is codified at 42 U.S.C. §§7384-7385s-16, with Part B codified at 42 (P.L. 108-375). EEOICPA is codified at 42 U.S.C. §§7384-7385s-16, with Part B codified at 42
U.S.C. §§7384l-7384w-1, and Part E codified at 42 U.S.C. §§7385s-7385s16. U.S.C. §§7384l-7384w-1, and Part E codified at 42 U.S.C. §§7385s-7385s16.
EEOICPA Part B
Part B provides cash benefits and medical coverage for former nuclear weapons complex workers Part B provides cash benefits and medical coverage for former nuclear weapons complex workers
with certain radiogenic cancers, beryllium sensitivity or chronic beryllium disease, and chronic with certain radiogenic cancers, beryllium sensitivity or chronic beryllium disease, and chronic
silicosis; and for uranium miners, silicosis; and for uranium miners, ~~millers~~mil ers, and ore transporters already receiving benefits under , and ore transporters already receiving benefits under
the Radiation Exposure Compensation Act (RECA; P.L. 101-426).4the Radiation Exposure Compensation Act (RECA; P.L. 101-426).4
Cancer Claims
Workers with certain radiogenic cancers are eligible for Part B based on their exposure to ionizing Workers with certain radiogenic cancers are eligible for Part B based on their exposure to ionizing
radiation at DOE facilities and atomic weapons employers. radiation at DOE facilities and atomic weapons employers.

1 For background1 For background information on the development and testing of the information on the development and testing of the ~~nation~~natio n’s nuclear weapons stockpile and the health ’s nuclear weapons stockpile and the health
effects of this work, see Department of Energy (DOE), effects of this work, see Department of Energy (DOE), Closing the Circle on the Splitting of the Atom : The
~~Environmental~~Environm ental Legacy of Nuclear Weapons Production in the United States and What ~~the Department of Energy~~ the Departm ent of Energ y is
Doing About It, DOE/EM-0266, January 1996, https://www.energy.gov/sites/prod/files/2014/03/f8/, DOE/EM-0266, January 1996, https://www.energy.gov/sites/prod/files/2014/03/f8/
Closing_the_Circle_Report.pdf; and DOE, Closing_the_Circle_Report.pdf; and DOE, Linking Legacies: Connecting the Cold War Nuclear Weapons Production
Processes to Their ~~Environmental~~ Environm ental Consequences, DOE/EM-0319, January 1997, https://www.osti.gov/servlets/purl/, DOE/EM-0319, January 1997, https://www.osti.gov/servlets/purl/
353361. 353361.
2 Specific responsibilities for each agency are provided in Executive Order 13179, “Providing Compensation to 2 Specific responsibilities for each agency are provided in Executive Order 13179, “Providing Compensation to
America’s Nuclear Weapons Workers,” 65America’s Nuclear Weapons Workers,” 65 Federal Register 77487, December 11, 2000. 77487, December 11, 2000.
3 42 U.S.C.3 42 U.S.C. §7384e. §7384e.
4 For additional information on RECA, see CRS4 For additional information on RECA, see CRS Report R43956, Report R43956, The Radiation Exposure Compensation Act (RECA):
~~Compensation~~Com pensation Related to Exposure to Radiation from ~~Atomic~~ Atom ic Weapons Testing and Uranium Mining ~~Mining~~. .
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Eligible Workers
The following groups of workers are eligible for Part B benefits based on developing a type of The following groups of workers are eligible for Part B benefits based on developing a type of
radiogenic cancer: radiogenic cancer:
 DOE employees who worked at DOE facilities;5  DOE employees who worked at DOE facilities;5
 DOE contractor employees who worked at DOE facilities;  DOE contractor employees who worked at DOE facilities;
 employees who worked for an “atomic weapons employer” at an “atomic  employees who worked for an “atomic weapons employer” at an “atomic
weapons employer facility.” weapons employer facility.”
An An atomic weapons employer is defined in the statute as an employer that processed or produced is defined in the statute as an employer that processed or produced
material that emitted radiation and that was used in the production of nuclear weapons, and an material that emitted radiation and that was used in the production of nuclear weapons, and an
atomic weapons employer facility is defined as a facility owned by an atomic weapons employer is defined as a facility owned by an atomic weapons employer
where such processing or production occurred. Atomic weapons employers’ employees are where such processing or production occurred. Atomic weapons employers’ employees are
eligibleeligible for Part B if they worked at an atomic weapons employer facility during a period when for Part B if they worked at an atomic weapons employer facility during a period when
radiation-emitting material was being processed or produced. In addition, employees at atomic radiation-emitting material was being processed or produced. In addition, employees at atomic
weapons employer facilities with residual contamination, as determined by the National Institute weapons employer facilities with residual contamination, as determined by the National Institute
for Occupational Safety and Health (NIOSH), are eligiblefor Occupational Safety and Health (NIOSH), are eligible even if they worked at the site after even if they worked at the site after
material processing and production was completed.6 DOE makes determinations of which material processing and production was completed.6 DOE makes determinations of which
facilities qualify as atomic weapons employer facilities under Part B.7facilities qualify as atomic weapons employer facilities under Part B.7
Disease Requirements
To be eligible To be eligible for Part B benefits for a radiogenic cancer, a covered worker must have developed for Part B benefits for a radiogenic cancer, a covered worker must have developed
one of the types of cancers specified in statute after beginning employment as a DOE employee, one of the types of cancers specified in statute after beginning employment as a DOE employee,
DOE contractor, or atomic weapons employeeDOE contractor, or atomic weapons employee. Table 1 lists the specified cancers. lists the specified cancers.
Table 1. Specified Cancers for Eligibility for EEOICPA Part B Benefits
Onset of the disease was any time after beginning covered employment
Bone Cancer Bone Cancer
Renal Cancers Renal Cancers
Onset of the disease was at least two years after first exposure to radiation
Leukemia Leukemia (other than chronic lymphocytic leukemia) (other than chronic lymphocytic leukemia)
Onset of the disease was at least five years after first exposure to radiation
Bile Bile Duct Cancer Duct Cancer
Multiple Myeloma Multiple Myeloma
Brain Cancer Brain Cancer
Ovarian Cancer Ovarian Cancer
Breast Cancer (male Breast Cancer (male or female)or female)
Pancreatic Cancer Pancreatic Cancer
Colon Cancer Colon Cancer
Pharynx Cancer Pharynx Cancer
Esophageal Cancer Esophageal Cancer
Salivary Gland Cancer Salivary Gland Cancer

5 For the purposes of Part B, DOE employees, contractors, and facilities include5 For the purposes of Part B, DOE employees, contractors, and facilities include those of DOE predecessor agencies, those of DOE predecessor agencies,
such assuch as the Atomic Energy Commission and the Manhattan Engineering District. the Atomic Energy Commission and the Manhattan Engineering District.
6 6 ~~These~~T hese facilities are identified by facilities are identified by the National Institute for Occupational Safety and Health (NIOSH) in its 2003 report the National Institute for Occupational Safety and Health (NIOSH) in its 2003 report
Report on Residual Radioactive and Beryllium ~~Contamination at Atomic Weapons Employer~~ Contam ination at Atom ic Weapons Em ployer Facilities and Beryllium
Vendor Facilities. NIOSH. NIOSH is is an institute of the Department of Health and Human Servicesan institute of the Department of Health and Human Services (HHS), Centers for Disease (HHS), Centers for Disease
Control and Prevention (CDC). Control and Prevention (CDC).
7 A database of covered facilities is7 A database of covered facilities is available on the DOE websiteavailable on the DOE website at https://ehss.energy.gov/Search/Facility/at https://ehss.energy.gov/Search/Facility/
findfacility.aspx. findfacility.aspx.
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~~Gall~~ Gal Bladder Cancer Bladder Cancer
~~Small~~ Smal Intestine Cancer Intestine Cancer
Liver Liver Cancer (except if CirrhosisCancer (except if Cirrhosis or Hepatitis B is indicated) or Hepatitis B is indicated)
Stomach Cancer Stomach Cancer
Lung Cancer (other than in situ Lung Cancer that is discovered Lung Cancer (other than in situ Lung Cancer that is discovered
Thyroid Cancer Thyroid Cancer
during or after a post-mortem during or after a post-mortem exam) exam)
Lymphomas Lymphomas (other than Hodgkin’s Disease) (other than Hodgkin’s Disease)
Urinary Bladder Cancer Urinary Bladder Cancer
Source: 42 U.S.C. 42 U.S.C. §7384l(17) and 20 C.F.R. §30.5(ff). §7384l(17) and 20 C.F.R. §30.5(ff).
Notes: With the exception of bone cancer and renal cancers, the specified cancers for eligibility With the exception of bone cancer and renal cancers, the specified cancers for eligibility for Part B for Part B
benefits are the same cancers specified for the eligibilitybenefits are the same cancers specified for the eligibility of onsite participants (persons who were of onsite participants (persons who were ~~physically~~physical y
present at the site of an atmospheric test of a nuclear weapon) and downwinders (persons who lived in areas present at the site of an atmospheric test of a nuclear weapon) and downwinders (persons who lived in areas
near the Nevada Test Site during atmospheric tests of nuclear weapons) under RECA and are incorporated by near the Nevada Test Site during atmospheric tests of nuclear weapons) under RECA and are incorporated by
referencereference in the EEOICPA statute. in the EEOICPA statute.
Pathways to Eligibility
The two pathways for eligibility The two pathways for eligibility for Part B benefits based on radiogenic cancer are dose for Part B benefits based on radiogenic cancer are dose
reconstruction and the Special Exposure Cohort (SEC). reconstruction and the Special Exposure Cohort (SEC).
Radiation Dose Reconstruction
Under the dose reconstruction pathway, each individual’s work history and exposure to ionizing Under the dose reconstruction pathway, each individual’s work history and exposure to ionizing
radiation at a covered facility is independently evaluated to determine the probability that his or radiation at a covered facility is independently evaluated to determine the probability that his or
her cancer was caused by radiation exposure. Pursuant to federal regulations, NIOSH her cancer was caused by radiation exposure. Pursuant to federal regulations, NIOSH
reconstructs, or estimates, the quantitative dose of radiation that a person received while working reconstructs, or estimates, the quantitative dose of radiation that a person received while working
at a covered facility.8at a covered facility.8
To estimate a claimant’s individual dose of radiation, NIOSH may use existing dose monitoring To estimate a claimant’s individual dose of radiation, NIOSH may use existing dose monitoring
data, such as that obtained from the dosimetry readings or bioassay samples.9 If monitoring data data, such as that obtained from the dosimetry readings or bioassay samples.9 If monitoring data
is not availableis not available or inadequate for dose reconstruction, NIOSH may use other sources, including or inadequate for dose reconstruction, NIOSH may use other sources, including
data from the data from the ~~overall~~ overal worksite and workers with comparable exposures. In the absence of data worksite and workers with comparable exposures. In the absence of data
from the from the ~~overall~~ overal worksite or comparable populations of workers, NIOSH may develop a model of worksite or comparable populations of workers, NIOSH may develop a model of
estimated exposure based on information about the claimant’s work processes and work estimated exposure based on information about the claimant’s work processes and work
environment. In completing dose reconstructions, NIOSH interviews the claimant and may use environment. In completing dose reconstructions, NIOSH interviews the claimant and may use
any relevant information, including statements and records provided by the claimant or others, any relevant information, including statements and records provided by the claimant or others,
including labor unions, coworkers, and data from health research on workers. including labor unions, coworkers, and data from health research on workers.
Once NIOSH has estimated a quantifiable radiation dose for the worker, NIOSH then determines Once NIOSH has estimated a quantifiable radiation dose for the worker, NIOSH then determines
a quantitative measure of the probability that the claimant’s cancer was caused by this dose of a quantitative measure of the probability that the claimant’s cancer was caused by this dose of
radiation (probability of causation) using the following formula: radiation (probability of causation) using the following formula:

8 42 C.F.R. §§82.0-82.33. 8 42 C.F.R. §§82.0-82.33.
9 9 Dosimetry readings measure the amount of radiation absorbed by measure the amount of radiation absorbed by a device, calleda device, called a dosimeter, which is worn by a a dosimeter, which is worn by a
person. person. Bioassay ~~samples~~sam ples are samples of human tissue are samples of human tissue ~~used~~ used to detect radiation absorption. to detect radiation absorption.
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in which in which PC is the quantitative probability of causation, is the quantitative probability of causation, RadRisk is the risk that the cancer was is the risk that the cancer was
caused by the radiation dose, and caused by the radiation dose, and BasRisk is the risk of this cancer in the total population.10 is the risk of this cancer in the total population.10
Estimates are “based on the upper 99% confidence interval of the probability of causation.”11 Estimates are “based on the upper 99% confidence interval of the probability of causation.”11
To calculate the probability of causation, NIOSH uses the agency’s Interactive Radio To calculate the probability of causation, NIOSH uses the agency’s Interactive Radio
EpidemiologicalEpidemiological Program (IREP), which is based on updates to the radio-epidemiological tables Program (IREP), which is based on updates to the radio-epidemiological tables
developed by the National Cancer Institute (NCI) in 1985.12 The radio-epidemiological tables and developed by the National Cancer Institute (NCI) in 1985.12 The radio-epidemiological tables and
IREP data for IREP data for ~~all~~ al cancers except thyroid cancer are taken from the morbidity studies of the cancers except thyroid cancer are taken from the morbidity studies of the
survivors of the atomic bomb detonations in Japan in 1945. Thyroid cancer data are from a survivors of the atomic bomb detonations in Japan in 1945. Thyroid cancer data are from a
pooled analysis of several international cohorts.13 pooled analysis of several international cohorts.13 ~~All~~ Al data are adjusted for the U.S. population, data are adjusted for the U.S. population,
based on U.S. cancer rates and are used to calculate based on U.S. cancer rates and are used to calculate RadRisk,, the risk that a given cancer was the risk that a given cancer was
caused by a given radiation dose. caused by a given radiation dose. ~~Overall~~ Overal cancer rates for the U.S. population are used to cancer rates for the U.S. population are used to
calculate calculate BasRisk, the risk of cancer in the total population. , the risk of cancer in the total population.
Because the EEOICPA statute specifies that benefits are to be awarded if the worker’s cancer Because the EEOICPA statute specifies that benefits are to be awarded if the worker’s cancer
“was at least as likely“was at least as likely as not related” to his or her covered employment, a probability of causation as not related” to his or her covered employment, a probability of causation
of 50% or greater is required to qualify for benefits.14 of 50% or greater is required to qualify for benefits.14
Special Exposure Cohort
The Special Exposure Cohort pathway to Part B benefits is based on the presumptive eligibilityThe Special Exposure Cohort pathway to Part B benefits is based on the presumptive eligibility of of
a group of workers, rather than the eligibilitya group of workers, rather than the eligibility of an individualof an individual claimant. If a claimant is a member claimant. If a claimant is a member
of the SEC and has one of the cancers specified for Part B eligibility,of the SEC and has one of the cancers specified for Part B eligibility, he or she is entitled to Part he or she is entitled to Part
B benefits without having to go through the dose reconstruction process. B benefits without having to go through the dose reconstruction process.
The EEOICPA statute grants SEC status to the following groups of workers: The EEOICPA statute grants SEC status to the following groups of workers:
 employees who worked a total of at least 250 days before February 1, 1993, at a  employees who worked a total of at least 250 days before February 1, 1993, at a
gaseous diffusion plant15 at Paducah, KY; Portsmouth, OH; or Oak Ridge, TN; gaseous diffusion plant15 at Paducah, KY; Portsmouth, OH; or Oak Ridge, TN;
and either and either
 were monitored for radiation exposure via dosimetry badges or  were monitored for radiation exposure via dosimetry badges or
 had jobs with similar exposures to radiation as those who were monitored via  had jobs with similar exposures to radiation as those who were monitored via
dosimetry badges; and dosimetry badges; and
 DOE employees and contractors on Amchitka Island, Alaska, before January 1,  DOE employees and contractors on Amchitka Island, Alaska, before January 1,
1974, who were exposed to ionizing radiation on the job from the Long Shot, 1974, who were exposed to ionizing radiation on the job from the Long Shot,
Milrow, or Cannikin underground atomic weapons tests.16Milrow, or Cannikin underground atomic weapons tests.16

10 For additional information on the calculation of probability of causation, see the NIOSH website10 For additional information on the calculation of probability of causation, see the NIOSH website at at
https://www.cdc.gov/niosh/ocas/pccalc.html. https://www.cdc.gov/niosh/ocas/pccalc.html.
11 42 U.S.C.11 42 U.S.C. §7384n(c)(3)(A). §7384n(c)(3)(A).
12 12 ~~The~~T he creation of the National Cancer Institute (NCI) radio-epidemiological tables was creation of the National Cancer Institute (NCI) radio-epidemiological tables was mandated by Section 7(b) of mandated by Section 7(b) of
the Orphan Drug Act (P.L. 97-414). the Orphan Drug Act (P.L. 97-414).
13 42 C.F.R. §81.10. For additional 13 42 C.F.R. §81.10. For additional ~~information~~informat ion on the Interactive Radio Epidemiological Program (IREP), see the on the Interactive Radio Epidemiological Program (IREP), see the
NIOSHNIOSH ~~website~~ website at https://www.cdc.gov/niosh/ocas/faqsirep.html and the NCI websiteat https://www.cdc.gov/niosh/ocas/faqsirep.html and the NCI website at at
https://radiationcalculators.cancer.gov/irep/. https://radiationcalculators.cancer.gov/irep/.
14 42 U.S.C.14 42 U.S.C. §7384n(b). §7384n(b).
15 15 Gaseous diffusion is a method of enriching uranium for use is a method of enriching uranium for use in nuclear weapons. in nuclear weapons.
16 42 U.S.C.16 42 U.S.C. §7384l(14). §7384l(14).
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Additional Additional classes of workers may be added to the SEC through an official petitioning process. A classes of workers may be added to the SEC through an official petitioning process. A
worker, group of workers, survivors of deceased workers, or labor unions may petition to add a worker, group of workers, survivors of deceased workers, or labor unions may petition to add a
new class of workers. For a class of workers to be added to the SEC, it must be determined that new class of workers. For a class of workers to be added to the SEC, it must be determined that
 it is not feasible to determine with sufficient accuracy the dose of radiation the  it is not feasible to determine with sufficient accuracy the dose of radiation the
class received; and class received; and
 there is a reasonable likelihood  there is a reasonable likelihood that such radiation dose may have endangered the that such radiation dose may have endangered the
health of the members of the class.17 health of the members of the class.17
An SEC petition is first reviewed by NIOSH, which has 180 days to evaluate the petition and An SEC petition is first reviewed by NIOSH, which has 180 days to evaluate the petition and
make a recommendation on the inclusion of the class in the SEC. After NIOSH makes its make a recommendation on the inclusion of the class in the SEC. After NIOSH makes its
recommendation, either for or against inclusion, the petition is forwarded to the Advisory Board recommendation, either for or against inclusion, the petition is forwarded to the Advisory Board
on Radiation and Worker Health for action. on Radiation and Worker Health for action.
The EEOIPCA established the advisory board, and the President appoints its members and chair.18 The EEOIPCA established the advisory board, and the President appoints its members and chair.18
There is no Senate confirmation requirement or member term length or term limit provisions. The There is no Senate confirmation requirement or member term length or term limit provisions. The
statute does, however, require that the board membership “reflect a balance of scientific, medical, statute does, however, require that the board membership “reflect a balance of scientific, medical,
and worker perspectives.”19 Pursuant to Executive Order 13179, the board consists of up to 20 and worker perspectives.”19 Pursuant to Executive Order 13179, the board consists of up to 20
members.20members.20
The advisory board investigates the petition and holds public meetings before making a The advisory board investigates the petition and holds public meetings before making a
recommendation on an SEC class inclusion. If the advisory board recommends a class be recommendation on an SEC class inclusion. If the advisory board recommends a class be
included, then the recommendation must be acted on by the HHS Secretary within 30 days of included, then the recommendation must be acted on by the HHS Secretary within 30 days of
receiving the board’s recommendation.21 If the Secretary does not act within 30 days, the class is receiving the board’s recommendation.21 If the Secretary does not act within 30 days, the class is
deemed to have been added to the SEC. deemed to have been added to the SEC.
If the Secretary adds a class to the SEC, Congress has 30 days to change or modify this action. If If the Secretary adds a class to the SEC, Congress has 30 days to change or modify this action. If
Congress does not act within 30 days, the class is Congress does not act within 30 days, the class is ~~officially~~official y added to the SEC.22 added to the SEC.22
To date, 128 classes of workers have been added to the SEC through the petitioning process.23 To date, 128 classes of workers have been added to the SEC through the petitioning process.23
Pathway Data
Although the original EEOICPA legislationAlthough the original EEOICPA legislation included only four SEC sites, the SEC pathway has included only four SEC sites, the SEC pathway has
become the predominant method of entry into the EEOICPA program. The SEC pathway become the predominant method of entry into the EEOICPA program. The SEC pathway
currently accounts for 70% of paid Part B cases and 70% of total Part B cancer benefits.24 Thus, currently accounts for 70% of paid Part B cases and 70% of total Part B cancer benefits.24 Thus,
presumptive eligibility,presumptive eligibility, similar to that used to pay benefits in the RECA program, rather than similar to that used to pay benefits in the RECA program, rather than
specific dose reconstruction based on the individual exposure histories of workers, has become specific dose reconstruction based on the individual exposure histories of workers, has become

~~17 42 U.S.C.~~ 17 42 U.S.C. §7384q(b). §7384q(b).
18 For additional information on the advisory board, see the NIOSH website18 For additional information on the advisory board, see the NIOSH website at https://www.cdc.gov/niosh/ocas/at https://www.cdc.gov/niosh/ocas/
ocasadv.html. ocasadv.html.
19 42 U.S.C. 19 42 U.S.C. §7384o(a)(2). §7384o(a)(2).
20 Executive Order 13179, “Providing Compensation to America’s Nuclear 20 Executive Order 13179, “Providing Compensation to America’s Nuclear ~~Weapons~~Weapo ns Workers,” 65 Workers,” 65 Federal Register
77487, December 11, 2000. 77487, December 11, 2000.
21 Per 42 C.F.R. §83.16, the Secretary must provide a written report of decision, including 21 Per 42 C.F.R. §83.16, the Secretary must provide a written report of decision, including a decisiona decision -based-based summary to summary to
the petitioners and a publishedthe petitioners and a published summary in the summary in the Federal Register. If the Secretary decides. If the Secretary decides not to add a classnot to add a class to the SEC, to the SEC,
a notice with the rationale for this decision must be provided to Congress.a notice with the rationale for this decision must be provided to Congress.
22 42 U.S.C.22 42 U.S.C. §7384l(14)(C)(ii). §7384l(14)(C)(ii).
23 Information on the status of all SEC23 Information on the status of all SEC petitions can be found on the NIOSH websitepetitions can be found on the NIOSH website at https://www.cdc.gov/niosh/at https://www.cdc.gov/niosh/
ocas/ocas/~~secstatusTable~~secstatusT able.html. .html.
24 Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP), 24 Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP), EEOICP Program Statistics, ,
June 6, 2020, https://www.dol.gov/owcp/energy/regs/compliance/weeklystats.htm. June 6, 2020, https://www.dol.gov/owcp/energy/regs/compliance/weeklystats.htm.
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the primary means of providing benefits to DOE employees, contractors, and atomic weapons the primary means of providing benefits to DOE employees, contractors, and atomic weapons
employees with covered cancers. employees with covered cancers.
Benefits
Part B pays the following benefits for claims of DOE employees, contractors, and atomic Part B pays the following benefits for claims of DOE employees, contractors, and atomic
weapons employees, based on radiogenic cancer: weapons employees, based on radiogenic cancer:
 $150,000, payable to the claimant, or if deceased, to an eligible  $150,000, payable to the claimant, or if deceased, to an eligible survivor;25 and survivor;25 and
 medical coverage for the covered cancer.  medical coverage for the covered cancer.
Part B claimants are entitled to full medical coverage and pay no deductibles, coinsurance, or Part B claimants are entitled to full medical coverage and pay no deductibles, coinsurance, or
copayments for their covered medical conditions. Medical services must be provided by enrolled copayments for their covered medical conditions. Medical services must be provided by enrolled
providers that agree to the OWCP medical fee schedules.26 Covered medical services include providers that agree to the OWCP medical fee schedules.26 Covered medical services include
doctors’ visits; outpatient and inpatient care; laboratory testing; physical, occupational, and doctors’ visits; outpatient and inpatient care; laboratory testing; physical, occupational, and
speech therapy; home and residential medical care; prescriptions; durable medical equipment; and speech therapy; home and residential medical care; prescriptions; durable medical equipment; and
travel expenses related to medical services.27 Although EEOICPA is the primary payer for travel expenses related to medical services.27 Although EEOICPA is the primary payer for
covered medical costs, it does not pay for medical care for conditions unrelated to the claim. covered medical costs, it does not pay for medical care for conditions unrelated to the claim.
Beryllium Claims
In addition to workers with radiogenic cancers, certain workers are eligible for Part B based on In addition to workers with radiogenic cancers, certain workers are eligible for Part B based on
their exposure to beryllium.28their exposure to beryllium.28
Eligible Workers
The following groups of workers are eligible for Part B benefits based on exposure to beryllium: The following groups of workers are eligible for Part B benefits based on exposure to beryllium:
 DOE employees exposed to beryllium at a DOE facility or at a facility owned,  DOE employees exposed to beryllium at a DOE facility or at a facility owned,
operated, or occupied by a beryllium vendor;29 operated, or occupied by a beryllium vendor;29
 DOE contractors who worked at a DOE facility; and  DOE contractors who worked at a DOE facility; and
 beryllium vendors’ employees and contractors who were engaged in the  beryllium vendors’ employees and contractors who were engaged in the
production or processing of beryllium for sale to the DOE or who were engaged production or processing of beryllium for sale to the DOE or who were engaged
in environmental remediation of a beryllium vendor facility under contract with in environmental remediation of a beryllium vendor facility under contract with
DOE.DOE.

~~25 The~~ 25 T he order of payment to survivors is provided at 42 U.S.C. order of payment to survivors is provided at 42 U.S.C. §7384s(e). §7384s(e).
26 A database of enrolled providers can be accessed26 A database of enrolled providers can be accessed at https://owcpmed.dol.gov/portal/provider/search. at https://owcpmed.dol.gov/portal/provider/search. ~~The~~T he OWCP OWCP
medical fee schedulesmedical fee schedules can be accessedcan be accessed at https://www.dol.gov/OWCP/regs/feeschedule/fee.htm. at https://www.dol.gov/OWCP/regs/feeschedule/fee.htm.
27 Additional medical services, such as 27 Additional medical services, such as travel costs for a companion to accompany a claimant to a medical appointment travel costs for a companion to accompany a claimant to a medical appointment
or home or vehicle modifications may beor home or vehicle modifications may be approved by OWCP basedapproved by OWCP based on necessity. For additional information on on necessity. For additional information on
EEOICPA medicalEEOICPA medical coverage, see DOL, OWCP, coverage, see DOL, OWCP, DEEOIC Medical Benefits, https://www.dol.gov/owcp/energy/regs/, https://www.dol.gov/owcp/energy/regs/
compliance/brochure/medical_benefits.pdf. compliance/brochure/medical_benefits.pdf.
28 Beryllium is 28 Beryllium is a lightweight metal that was useda lightweight metal that was used in the production of components of nuclear weapons and has other in the production of components of nuclear weapons and has other
current industrial applications. Beryllium iscurrent industrial applications. Beryllium is not radioactive, but inhalation of beryllium dustnot radioactive, but inhalation of beryllium dust or fumes can cause an or fumes can cause an
immune response calledimmune response called beryllium sensitivity, which can lead to chronic beryllium disease.beryllium sensitivity, which can lead to chronic beryllium disease. ~~The~~ T he Occupational Safety Occupational Safety
and Health Administration (OSHA) regulates berylliumand Health Administration (OSHA) regulates beryllium exposure in the workplace. For additional information on exposure in the workplace. For additional information on
beryllium, seeberyllium, see the DOE websitethe DOE website at https://www.energy.gov/ehss/about-beryllium.at https://www.energy.gov/ehss/about-beryllium. For additional information on the For additional information on the
health effects of beryllium, see the NIOSHhealth effects of beryllium, see the NIOSH ~~website~~ website at https://www.cdc.gov/niosh/topics/beryllium/. at https://www.cdc.gov/niosh/topics/beryllium/.
29 A list of covered beryllium vendors is provided at 42 U.S.C.29 A list of covered beryllium vendors is provided at 42 U.S.C. §7384l(6) and can be expanded by DOE by publishing§7384l(6) and can be expanded by DOE by publishing a a
notice in the notice in the Federal Register. A listing of all sites covered by Part B, includingA listing of all sites covered by Part B, including beryllium vendors, is available on the beryllium vendors, is available on the
DOE websiteDOE website at https://ehss.energy.gov/Search/Facility/findfacility.aspx. at https://ehss.energy.gov/Search/Facility/findfacility.aspx.
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Disease Requirements
To be eligible To be eligible for Part B benefits based on exposure to beryllium, a worker must have either for Part B benefits based on exposure to beryllium, a worker must have either
chronic beryllium disease or beryllium sensitivity. chronic beryllium disease or beryllium sensitivity.
Benefits
Under Part B, covered workers with chronic beryllium disease are eligible Under Part B, covered workers with chronic beryllium disease are eligible for the following for the following
benefits: benefits:
 $150,000, payable to the claimant, or if deceased, to an eligible  $150,000, payable to the claimant, or if deceased, to an eligible survivor; and survivor; and
 medical coverage for the disease in the same manner as medical coverage is  medical coverage for the disease in the same manner as medical coverage is
provided for Part B cancer claims. provided for Part B cancer claims.
Covered workers with beryllium sensitivity are entitled only to medical monitoring, including Covered workers with beryllium sensitivity are entitled only to medical monitoring, including
regular medical examinations to determine if they have developed chronic beryllium disease. regular medical examinations to determine if they have developed chronic beryllium disease.
There are no cash or other medical benefits based on beryllium sensitivity. There are no cash or other medical benefits based on beryllium sensitivity.
Chronic Silicosis Claims
Workers are eligibleWorkers are eligible for Part B based on their exposure to for Part B based on their exposure to ~~crystalline~~crystal ine silica in which they silica in which they
developed chronic silicosis. 30 developed chronic silicosis. 30
Eligible Workers
To be eligible To be eligible for Part B benefits based on chronic silicosis, a worker must have worked as a for Part B benefits based on chronic silicosis, a worker must have worked as a
DOE employee or contractor for at least 250 total work days during the mining of tunnels for DOE employee or contractor for at least 250 total work days during the mining of tunnels for
underground testing at the atomic weapons testing sites in Nevada or Alaska. underground testing at the atomic weapons testing sites in Nevada or Alaska.
Disease Requirements
To be eligible To be eligible for Part B benefits for chronic silicosis, a worker must have a nonmalignant lung for Part B benefits for chronic silicosis, a worker must have a nonmalignant lung
disease that meets the following conditions: disease that meets the following conditions:
 the onset of the silicosis was at least 10 years after initial exposure to silica dust;  the onset of the silicosis was at least 10 years after initial exposure to silica dust;
and and
 a written diagnosis of silicosis made by a physician and accompanied by  a written diagnosis of silicosis made by a physician and accompanied by
 a chest x-ray, interpreted by a NIOSH-certified B reader to have  a chest x-ray, interpreted by a NIOSH-certified B reader to have
pneumoconioses of category 1/0 or higher;31 pneumoconioses of category 1/0 or higher;31

30 Chronic silicosis30 Chronic silicosis is an irreversible interstitial lung diseaseis an irreversible interstitial lung disease that develops after prolonged inhalation exposure that develops after prolonged inhalation exposure tot o
crystalline silica. Crystalline silicacrystalline silica. Crystalline silica in dustin dust commonly occurs when workers cut, saw,commonly occurs when workers cut, saw, grind, drill, or crush materials grind, drill, or crush materials
such assuch as glass,glass, stone, rock, concrete, brick, or industrial sand. Exposure also occurs whenstone, rock, concrete, brick, or industrial sand. Exposure also occurs when industrial sand isindustrial sand is ~~used~~ used in in
abrasive operations, such as sandblasting,abrasive operations, such as sandblasting, and in the hydraulic fracturing process. Exposure to crystalline silica in the and in the hydraulic fracturing process. Exposure to crystalline silica in the
workplace is regulatedworkplace is regulated by the Occupational Safety and Health Administration (OSHA) and Mine Safety andby the Occupational Safety and Health Administration (OSHA) and Mine Safety and Health Health
Administration (MSHA). For additional information on the health effects of crystalline silica, see National Institute for Administration (MSHA). For additional information on the health effects of crystalline silica, see National Institute for
Occupational Safety and Health, Occupational Safety and Health, Health Effects of Occupational Exposure to Respirable Crystalline Silica ~~Silica~~, NIOSH , NIOSH
Hazard Review,Hazard Review, April 2002, https://www.cdc.gov/niosh/docs/2002-129/pdfs/2002-129.pdf. April 2002, https://www.cdc.gov/niosh/docs/2002-129/pdfs/2002-129.pdf.
31 A B reader is a physician who is31 A B reader is a physician who is ~~NIOSH~~ NIOSH certified after passing an examination to read xcertified after passing an examination to read x -rays to detect -rays to detect
pneumoconioses, diseasespneumoconioses, diseases ~~caused~~ caused by the inhalation of dust into the lungs. A category of 1/0 is basedby the inhalation of dust into the lungs. A category of 1/0 is based on the on the
International Labour Office (ILO) International Classification of Radiographs of Pneumoconioses. International Labour Office (ILO) International Classification of Radiographs of Pneumoconioses.
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 results of a computer assisted tomography scan (CAT scan) or other imaging  results of a computer assisted tomography scan (CAT scan) or other imaging
tests that are consistent with silicosis; or tests that are consistent with silicosis; or
 lung biopsy consistent with silicosis.  lung biopsy consistent with silicosis.
Benefits
Under Part B, covered workers with chronic silicosis are eligible for the following benefits: Under Part B, covered workers with chronic silicosis are eligible for the following benefits:
 $150,000, payable to the claimant, or if deceased, to an eligible  $150,000, payable to the claimant, or if deceased, to an eligible survivor; and survivor; and
 medical coverage for the chronic silicosis in the same manner as medical benefits  medical coverage for the chronic silicosis in the same manner as medical benefits
are provided for Part B cancer claims. are provided for Part B cancer claims.
Uranium Worker Claims
Any uranium miner, Any uranium miner, ~~miller~~mil er, or ore transporter who has received a $100,000 payment pursuant to , or ore transporter who has received a $100,000 payment pursuant to
Section 5 of the Radiation Exposure Compensation Act (RECA) 32 is Section 5 of the Radiation Exposure Compensation Act (RECA) 32 is ~~automatically eligible for the~~
automatical y eligible for the following Part B benefits: following Part B benefits:
 $50,000, payable to the claimant, or, if deceased, to an eligible  $50,000, payable to the claimant, or, if deceased, to an eligible survivor; and survivor; and
 medical coverage for the disease covered by Section 5 of RECA in the same  medical coverage for the disease covered by Section 5 of RECA in the same
manner as medical coverage is provided for Part B cancer claims. manner as medical coverage is provided for Part B cancer claims.
Figure 1 summarizes EEOICPA Part B eligibilitysummarizes EEOICPA Part B eligibility and benefits. and benefits.
Figure 1. EEOICPA Part B Eligibility and Benefits

Source: CongressionalCongressional Research ServiceResearch Service (CRS). (CRS).
Note: RECA is the Radiation Exposure Compensation Act. RECA is the Radiation Exposure Compensation Act.

32 Section 5 of RECA32 Section 5 of RECA provides $100,000 in compensation to certain uranium miners, millers, and ore transporters with provides $100,000 in compensation to certain uranium miners, millers, and ore transporters with
diseasesdiseases specified in the RECA statute. RECA does not provide medical coverage. specified in the RECA statute. RECA does not provide medical coverage.
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EEOICPA Part E
Part E provides variable cash and medical benefits to former DOE contractors who contracted Part E provides variable cash and medical benefits to former DOE contractors who contracted
~~illnesses~~il nesses or to their survivors as a result of the worker’s exposure to any toxic substance while or to their survivors as a result of the worker’s exposure to any toxic substance while
working at a DOE facility, and to uranium miners, working at a DOE facility, and to uranium miners, ~~millers~~mil ers, and ore transporters receiving benefits , and ore transporters receiving benefits
under Section 5 of RECA.33 Similar to workers’ compensation programs, the amount of cash under Section 5 of RECA.33 Similar to workers’ compensation programs, the amount of cash
benefits is based on the worker’s level of impairment and wage loss suffered due to his or her benefits is based on the worker’s level of impairment and wage loss suffered due to his or her
covered covered ~~illness.34~~
il ness.34 Part E was not part of the original EEOICPA legislation. Rather, the original EEOICPA legislation Part E was not part of the original EEOICPA legislation. Rather, the original EEOICPA legislation
included Part D, which permitted DOE to enter into agreements with states to assist DOE included Part D, which permitted DOE to enter into agreements with states to assist DOE
contractors in applying for state workers’ compensation benefits for contractors in applying for state workers’ compensation benefits for ~~illnesses~~il nesses and deaths related to and deaths related to
exposures to toxic substances at DOE facilities, but did not provide any federal benefits to these exposures to toxic substances at DOE facilities, but did not provide any federal benefits to these
contractors. Part E replaced Part D when EEOICPA was amended in 2004.35 contractors. Part E replaced Part D when EEOICPA was amended in 2004.35
Eligible Workers
The following groups of workers are eligible for Part E benefits: The following groups of workers are eligible for Part E benefits:
 DOE contractors who worked at DOE facilities; and  DOE contractors who worked at DOE facilities; and
 uranium miners,  uranium miners, ~~millers~~mil ers, and ore transporters who have received benefits under , and ore transporters who have received benefits under
Section 5 of RECA. Section 5 of RECA.
Disease Requirements
DOE contractors are eligible for Part E benefits if it is “at least as likely as not” that exposure to a DOE contractors are eligible for Part E benefits if it is “at least as likely as not” that exposure to a
toxic substance at a DOE facility caused, contributed to, or aggravated the worker’s toxic substance at a DOE facility caused, contributed to, or aggravated the worker’s ~~illness~~il ness or or
death. Uranium miners, death. Uranium miners, ~~millers~~mil ers, and ore transporters are eligible for Part E benefits if they , and ore transporters are eligible for Part E benefits if they
contracted an contracted an ~~illness~~il ness or died due to exposure to toxic substances at a facility covered by Section 5 or died due to exposure to toxic substances at a facility covered by Section 5
of RECA. of RECA.
DOL maintains the Site Exposure Matrices (SEM), a database of covered sites and the toxic DOL maintains the Site Exposure Matrices (SEM), a database of covered sites and the toxic
substances that were present at those sites.36 Under EEOICPA regulations, the SEM may be used substances that were present at those sites.36 Under EEOICPA regulations, the SEM may be used
to provide “probative factual evidence” that a toxic substance was present at a DOE facility or a to provide “probative factual evidence” that a toxic substance was present at a DOE facility or a
facility covered by Section 5 of RECA.37 facility covered by Section 5 of RECA.37
In 2010, the Government Accountability Office (GAO) raised concerns about the lack of In 2010, the Government Accountability Office (GAO) raised concerns about the lack of
independent expert review of the SEM and cited the concerns of occupational physicians that independent expert review of the SEM and cited the concerns of occupational physicians that
criticized the “scientific soundness” of the SEM.38 In its report, GAO recommended that an criticized the “scientific soundness” of the SEM.38 In its report, GAO recommended that an

33 DOE and other federal employees are not eligible33 DOE and other federal employees are not eligible for EEOICPA Part E benefits, but may befor EEOICPA Part E benefits, but may be ~~eligible~~ eligible for workers’ for workers’
compensation for employment-related exposures to toxic substances undercompensation for employment-related exposures to toxic substances under the Federal Employees’ Compensation Act the Federal Employees’ Compensation Act
(FECA). For additional information on FECA, see CRS(FECA). For additional information on FECA, see CRS Report R42107, Report R42107, The Federal ~~Employees’ Compensation~~Em ployees’ Com pensation Act
(FECA): Workers’ Compensation for Federal Employees.
34 For additional information on workers’ compensation programs, see CRS34 For additional information on workers’ compensation programs, see CRS Report R44580, Report R44580, Workers’ Compensation:
Overview and Issues. .
35 Subtitle35 Subtitle E of Division C of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (P.L. E of Division C of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (P.L.
108-375). 108-375).
36 36 ~~The~~T he Site Exposure Matrices are available Site Exposure Matrices are available at https://www.sem.dol.gov/expanded/index.cfm. at https://www.sem.dol.gov/expanded/index.cfm.
37 20 C.F.R. §30.231(b). 37 20 C.F.R. §30.231(b).
38 U.S.38 U.S. Government Accountability Office (GAO), Government Accountability Office (GAO), Energy Employees Compensation: Additional Independent
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independent review board for Part E of EEOICPA be created. In 2014, Part E was amended to independent review board for Part E of EEOICPA be created. In 2014, Part E was amended to
create the Advisory Board on Toxic Substances and Worker Health to advise DOL on Part E, create the Advisory Board on Toxic Substances and Worker Health to advise DOL on Part E,
including on the SEM.39 The advisory board is scheduled to sunset on December 19, 2024, 10 including on the SEM.39 The advisory board is scheduled to sunset on December 19, 2024, 10
years after the date of its enactment.40years after the date of its enactment.40
Benefits
Part E benefits include medical coverage and variable cash benefits based on a worker’s wage Part E benefits include medical coverage and variable cash benefits based on a worker’s wage
loss and level of impairment due to a covered loss and level of impairment due to a covered ~~illness~~il ness. Survivors of a deceased worker may also . Survivors of a deceased worker may also
receive benefits based on the worker’s wage loss and death. receive benefits based on the worker’s wage loss and death.
Workers’ Benefits
Part E workers’ benefits are based on a combination of wage loss and impairment caused by a Part E workers’ benefits are based on a combination of wage loss and impairment caused by a
covered covered ~~illness~~il ness. Wage loss benefits are calculated using the following formulas: . Wage loss benefits are calculated using the following formulas:
 $10,000 for each year before Social Security full retirement age (FRA) that the  $10,000 for each year before Social Security full retirement age (FRA) that the
worker’s wages were between 25% and 50% lower than the worker’s average worker’s wages were between 25% and 50% lower than the worker’s average
wage during the three years prior to the first quarter of wage loss;41 and wage during the three years prior to the first quarter of wage loss;41 and
 $15,000 for each year before FRA that the worker’s wages were at least 50%  $15,000 for each year before FRA that the worker’s wages were at least 50%
lower than the worker’s average wage during the three years prior to the first lower than the worker’s average wage during the three years prior to the first
quarter of wage loss. quarter of wage loss.
Impairment benefits are in addition to any wage loss benefits and are calculated using the Impairment benefits are in addition to any wage loss benefits and are calculated using the
following formula: following formula:
 $2,500 for each percentage point of whole body impairment as determined using  $2,500 for each percentage point of whole body impairment as determined using
the current edition of the American Medical Association’s the current edition of the American Medical Association’s Guides to the
Evaluation of Permanent Impairment (commonly referred to as the AMA’s(commonly referred to as the AMA’s
Guides).42 ).42
The maximum amount of Part E cash benefits that a worker may receive is $250,000. Workers The maximum amount of Part E cash benefits that a worker may receive is $250,000. Workers
may receive both Parts B and E benefits for the same medical condition. A worker’s Part E may receive both Parts B and E benefits for the same medical condition. A worker’s Part E
benefit amount is reduced by the amount of any other workers’ compensation benefits that the benefit amount is reduced by the amount of any other workers’ compensation benefits that the
worker has received for the same worker has received for the same ~~illness~~il ness caused by the same exposure. Oversight and Transparency Would Im prove Program ~~caused by the same exposure.~~
~~Survivors Benefits~~
~~Survivors of a deceased DOE contractor or uranium miner, miller, or ore transporter may receive~~
~~one of the following levels of cash benefits under Part E if it is “at least as likely as not” that~~

~~Oversight and Transparency Would Improve Program~~’s Credibility, GAO-10-302, March 22, 2010, p. 32, , GAO-10-302, March 22, 2010, p. 32,
https://www.gao.gov/assets/310/302183.pdf. https://www.gao.gov/assets/310/302183.pdf.
39 Section 3141(a) of the Carl Levin and Howard 39 Section 3141(a) of the Carl Levin and Howard P. “Buck” McKeon National Defense Authorization Act for Fiscal P. “Buck” McKeon National Defense Authorization Act for Fiscal
Year 2015 (P.L. 113-291); codified at 42 U.S.C. §7385s-16. Year 2015 (P.L. 113-291); codified at 42 U.S.C. §7385s-16. ~~The~~T he National Defense Authorization Act for Fiscal Year National Defense Authorization Act for Fiscal Year
2014 (P.L. 113-66)2014 (P.L. 113-66), included a provision at Section 3148 expressing the sense of Congress included a provision at Section 3148 expressing the sense of Congress that the President should that the President should
establish an Advisory Boardestablish an Advisory Board ~~on Toxic Substances~~ on T oxic Substances and Worker Health, citing GAO-10-302. and Worker Health, citing GAO-10-302.
~~40 The~~40 T he Advisory Board on Advisory Board on ~~Toxic Substances~~ T oxic Substances and Worker Health was originally scheduledand Worker Health was originally scheduled to sunset on December 19, to sunset on December 19,
2019, five years after the date of its enactment. Section 3120 of National Defense Authorization Act for Fiscal Year 2019, five years after the date of its enactment. Section 3120 of National Defense Authorization Act for Fiscal Year
2018 (P.L. 115-91)2018 (P.L. 115-91), extended the sunset date to December 19, 2024. extended the sunset date to December 19, 2024.
41 41 ~~The~~T he full retirement age (FRA) ranges from 65 to 67 based full retirement age (FRA) ranges from 65 to 67 based on the person’s date of birth. For additional information on on the person’s date of birth. For additional information on
the FRA, see CRSthe FRA, see CRS Report R44670, Report R44670, The Social Security ~~Retirement~~Retirem ent Age. .
~~42 The~~42 T he use of the current edition is specified at 20 C.F.R. use of the current edition is specified at 20 C.F.R. §30.901(b). §30.901(b). ~~The~~T he sixth edition is the current edition of the sixth edition is the current edition of the
AMA’sAMA’s Guides.
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Survivors Benefits Survivors of a deceased DOE contractor or uranium miner, mil er, or ore transporter may receive one of the following levels of cash benefits under Part E if it is “at least as likely as not” that exposure to a toxic substance at a DOE facility or a facility covered by Section 5 of RECA exposure to a toxic substance at a DOE facility or a facility covered by Section 5 of RECA
caused, contributed to, or aggravated the worker’s death: caused, contributed to, or aggravated the worker’s death:
 $125,000 if the worker had no covered wage loss;  $125,000 if the worker had no covered wage loss;
 $150,000 if the worker’s wages were at least 50% lower than the worker’s  $150,000 if the worker’s wages were at least 50% lower than the worker’s
average wage during the three years prior to the first quarter of wage loss for at average wage during the three years prior to the first quarter of wage loss for at
least 10 years before FRA; or least 10 years before FRA; or
 $175,000 if the worker’s wages were at least 50% lower than the worker’s  $175,000 if the worker’s wages were at least 50% lower than the worker’s
average wage during the three years prior to the first quarter of wage loss for at average wage during the three years prior to the first quarter of wage loss for at
least 20 years before FRA. least 20 years before FRA.
Survivors benefits are payable in accordance with the following schedule: Survivors benefits are payable in accordance with the following schedule:
 if there is a living spouse who was married to the worker for at least one year  if there is a living spouse who was married to the worker for at least one year
before the worker’s death—100% to the spouse; before the worker’s death—100% to the spouse;
 if there is no eligible  if there is no eligible spouse—100% in equal shares to any children who are spouse—100% in equal shares to any children who are
under the age of 18, or under the age of 23 if a full-time student, or of any age if under the age of 18, or under the age of 23 if a full-time student, or of any age if
incapable of self-support; and incapable of self-support; and
 if there is an eligible  if there is an eligible spouse and any eligiblespouse and any eligible children of the worker who are not children of the worker who are not
legal children of the spouse—50% to the spouse and 50% to the eligible children legal children of the spouse—50% to the spouse and 50% to the eligible children
in equal shares. in equal shares.
If there is no eligible If there is no eligible spouse or eligible children, then no survivors benefits are paispouse or eligible children, then no survivors benefits are paid. Figure 2
summarizes EEOICPA Part E eligibilitysummarizes EEOICPA Part E eligibility and benefits. and benefits.
Figure 2. EEOICPA Part E Eligibility and Benefits

Source: CongressionalCongressional Research ServiceResearch Service (CRS). (CRS).
Note: RECA is the Radiation Exposure Compensation Act. RECA is the Radiation Exposure Compensation Act.
Ombudsman
Part E of EEOICPAPart E of EEOICPA and the Office of Ombudsman were created in 2004 under the same and the Office of Ombudsman were created in 2004 under the same
legislation. Congress created the Office of the Ombudsman—as an independent office within the legislation. Congress created the Office of the Ombudsman—as an independent office within the
Congressional Research Service 11 The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) DOL, headed by a Secretary of Labor-designated ombudsman43—to assist Part E claimants and DOL, headed by a Secretary of Labor-designated ombudsman43—to assist Part E claimants and
medical providers and to address concerns related to available EEOICPA benefits. In 2009, the medical providers and to address concerns related to available EEOICPA benefits. In 2009, the

~~43 The ombudsman may be an existing DOL employee or a private-sector individual.~~
~~Congressional Research Service~~
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~~The Energy Employees Occupational Illness Compensation Program Act (EEOICPA)~~

Office of Ombudsman’s authority was extended to Part B of EEOICPA.44 As required by statute, Office of Ombudsman’s authority was extended to Part B of EEOICPA.44 As required by statute,
the office must be independent from other DOL offices and employees who have responsibilities the office must be independent from other DOL offices and employees who have responsibilities
for Part B or E of EEOICPA.45 for Part B or E of EEOICPA.45
~~Responsibilities of the Ombudsman~~
The EEOICPA statute provides an October 28, 2020, sunset date for the Office of Ombudsman.46 The initial legislation authorizing the office provided an October 28, 2007, sunset date. However, legislation has extended the sunset date several times, most recently in 2019.47 Twice the extension occurred after the current authorization period had expired. In both cases—the 2007 and 2012 expirations—the Office of Ombudsman continued to operate pursuant to decisions of the Labor Secretary.48 Section 3145 of the Wil iam M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 (P.L. 116-283) repealed the sunset date for the Office of Ombudsman. The EEOICPA Office of Ombudsman has the following responsibilities related to EEOICPA’s The EEOICPA Office of Ombudsman has the following responsibilities related to EEOICPA’s
Parts B and E: Parts B and E:
 provide information on Part B and E benefits and the procedures applicable to the  provide information on Part B and E benefits and the procedures applicable to the
provision of these benefits; provision of these benefits;
 provide guidance and assistance to Part B and E claimants;  provide guidance and assistance to Part B and E claimants;
 make recommendations to the Labor Secretary on the location of EEOICPA  make recommendations to the Labor Secretary on the location of EEOICPA
Resource Centers; Resource Centers;4649
 other duties as assigned by the Labor Secretary.  other duties as assigned by the Labor Secretary.4750
The ombudsman must provide an annual report to Congress on the office’s activities. The Labor The ombudsman must provide an annual report to Congress on the office’s activities. The Labor
Secretary is required to provide to Congress an annual response to the ombudsman’s annual Secretary is required to provide to Congress an annual response to the ombudsman’s annual
report. 43 T he ombudsman may be an existing DOL employee or a private-sector individual. ~~report.~~
~~Ombudsman Sunset Date~~
~~The EEOICPA statute provides an October 28, 2020, sunset date for the Office of Ombudsman.48~~
~~The initial legislation authorizing the office provided an October 28, 2007, sunset date. However,~~
~~legislation has extended the sunset date several times, most recently in 2019.49 Twice the~~
~~extension occurred after the current authorization period had expired. In both cases, the 2007 and~~
~~2012 expirations, the Office of Ombudsman continued to operate pursuant to decisions of the~~
~~Labor Secretary.50 In the 116th Congress, H.R. 6009, the Nuclear Workers’ Ombudsman Extension~~
~~Act, would extend the Office of Ombudsman’s sunset date to October 28, 2025.~~

44 Section 3142 of the National Defense Authorization Act for Fiscal Year 2010 (P.L. 111-84). 44 Section 3142 of the National Defense Authorization Act for Fiscal Year 2010 (P.L. 111-84).
45 42 U.S.C.45 42 U.S.C. ~~§7385s-15(d).~~
~~46 Resource centers provide EEOICPA outreach, assist claimants with their claims, accept claims, and assist claimants~~
~~and medical providers with EEOICPA medical benefits. A list of EEOICPA resources centers is available at~~
~~https://www.dol.gov/owcp/energy/regs/compliance/ResourceMeetings/ResourceCenters.htm.~~
~~47 42 U.S.C. §7385s-15(c).~~
~~48 42 U.S.C.~~ §7385s-15(d). 46 42 U.S.C. §7385s-15(h). §7385s-15(h).
4947 Section 3134(a)(2) of the National Defense Authorization Act for Fiscal Year 2020 (P.L. 116-92). Section 3134(a)(2) of the National Defense Authorization Act for Fiscal Year 2020 (P.L. 116-92).
5048 Memorandum from Elaine L. Chao, Secretary of Labor, to Malcolm Nelson, ombudsman Memorandum from Elaine L. Chao, Secretary of Labor, to Malcolm Nelson, ombudsman for Part E of the Energy for Part E of the Energy
Employees Occupational Illness Compensation Program, October 22, 2007; and Employees Occupational Illness Compensation Program, October 22, 2007; and ~~Memorandum~~memorandum from Malcolm L. from Malcolm L.
Nelson, ombudsman,Nelson, ombudsman, Energy Employees Occupational Illness Compensation Program, to Energy Employees Occupational Illness Compensation Program, to ~~Hilda~~Hi lda L. Solis, L. Solis, Secretary of Labor, October 24, 2012. 49 Resource centers provide EEOICPA outreach, assist claimants with their claims, accept claims, and assist claimants and medical providers with EEOICPA medical benefits. A list of EEOICPA resources center s is available at https://www.dol.gov/owcp/energy/regs/compliance/ResourceMeetings/ResourceCenters.htm. 50 42 U.S.C. §7385s-15(c). ~~Secretary of~~
~~Labor, October 24, 2012.~~
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The Energy Employees Occupational Illness Compensation Program Act (EEOICPA)

Appendix. EEOICPA Program Statistical Data
Table 2. EEOICPA Statistics
(from program inception in 2000 through (from program inception in 2000 through ~~July 6, 2020~~January 3, 2021) )

Part B
Part E

Claims
Cases
Claims
Cases
Applications Applications
~~175,579~~
~~111,521~~
~~144,941~~
~~103,129~~
~~Decisions~~
~~160,993~~
~~105,973~~
~~130,146~~
~~95,579~~

~~Approved~~
~~87,395~~
~~56,375~~
~~60,636~~
~~49,779~~

~~Denied~~
~~73,598~~
~~49,598~~
~~69,510~~
~~45,800~~
~~Compensation Payments~~
~~81,647~~
~~53,185~~
~~44,510~~
~~39,501~~
~~Compensation Paid~~
~~$7,095,120,428~~
~~$5,136,850,479~~
~~Medical Bil s Paid, Parts B and E Combined~~
~~$5,973,228,340~~
Source: Department of Labor, Office of Workers’ Compensation Programs, EEOICP Program Statistics, June 6,
~~2020~~177,180 112,540 146,783 104,436 Decisions 162,741 107,209 132,057 97,062 Approved 88,388 57,084 62,038 50,907 Denied 74,353 50,125 70,019 46,155 Compensation Payments 82,591 53,893 45,842 40,668 Compensation Paid $7,196,126,043 $5,330,018,457 Medical Bil s Paid, Parts B and E Combined $6,444,045,046 Source: Department of Labor, Office of Workers’ Compensation Programs, EEOICP Program Statistics, January 3, 2021, https://www.dol.gov/owcp/energy/regs/compliance/weeklystats.htm. , https://www.dol.gov/owcp/energy/regs/compliance/weeklystats.htm.
Notes: “Cases” representCases” represent covered employeescovered employees for whom a claimfor whom a claim is filed. “Claims”is filed. “Claims” represent the employeerepresent the employee and and
any survivorsany survivors that filethat file a claim based on an employee.a claim based on an employee. There can be multiple claimsThere can be multiple claims per case. The difference per case. The difference
between “Approved” cases and claimsbetween “Approved” cases and claims and “Compensation Payments” is due to cases and claims that have been and “Compensation Payments” is due to cases and claims that have been
approved but have not yet been paid compensation by DOL.approved but have not yet been paid compensation by DOL.

Author Information

Scott D. Szymendera Scott D. Szymendera

Analyst in Disability Policy Analyst in Disability Policy

~~Congressional Research Service~~
13

~~The Energy Employees Occupational Illness Compensation Program Act (EEOICPA)~~

Disclaimer
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