What is EEOICPA?

EEOICPA history, EECAP, DOE, DOL, compensation

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Historic DOE Safety PosterNotice: This Claim has Finally been Approved!

In December 2014, ten years after Mary filed her first claim under the Energy Employees Occupational Illness Compensation Program, DEEOIC finally agreed that she is a covered employee and eligible for medical benefits and compensation.  Mary is glad to finally have received justice for the damage done to her during her service to the country. She would like to extend her thanks to all the people over the years who worked on her claim.

Anatomy of a Parkinson's Claim

Have you ever wondered what it is like to file an EEOICPA claim?  How the claim progresses?  What DOL does with the information you send them?

Here is a real claim, used with the claimant's permission, to show you what it is like.  It's a very complicated claim which makes it ideal to show what happens when DOL's Division of Energy Employees Occupational Illness Compensation (DEEOIC) makes mistakes and how those mistakes multiply over time as DEEOIC replicates them again and again.

The other thing this claim demonstrates is the huge burden which is placed on ill people to meet the demands of the federal agencies involved in EEOICPA, especially DEEOIC.

Some of the documents are missing.  As I locate copies they will be added.

One thing that is very evident in reading this claim is that despite the DOL Procedure Manual dictating how claim evidence should be evaluated, the procedures are not always followed which is always to the detriment of the claimant.

Beginnings:

Mary White (not her real name) was 21 years old on February 6, 1981 when she was hired at Mound Laboratory in Miamisburg Ohio as a janitor.  She worked as a janitor until August 13, 1981 when she was promoted to Analytical Laboratory Technician (Lab Tech C).  By December 1, 1982 she had been promoted again to a Lab Tech B.  While she was employed at Mound until February 6, 1987, she remembers returning to work there as a contractor.  Because of her illness her memory is spotty and she can no longer remember how long she worked as a contractor.  Her Social Security records show earnings from this in 1987.  Her DOE records show that she had a positive reading on her Mound's MESH Lifetime External Exposure Report on July 25, 1988 and the last date she was monitored was February 15, 1990.  DEEOIC stops her exposures on February 6, 1987, despite what is in her DOE records and the Social Security records.

What did a janitor and a lab technician do at Mound? 

DEEOIC describes:

  • "Custodian (janitor) working in cleaning up of radioactive and chemical substances.  Janitors and custodian perform a verity of heavy cleaning duties such as cleaning floors, shampooing rugs, washing walls and glass, and removing rubbish, fix leaky faucets, empty trash cans, pain, carpentry, replenish bathroom supplies, mow lawns, and see that heating/air conditioning equipment works properly.  On a typical day, janitors may wet or dry mop floors, clean bathrooms, vacuum carpets, dust furniture, make minor repairs, exterminate insects and rodents, clean snow or debris from sidewalks in from of buildings and notify management of the need for major repairs.  Use mops, buckets, electric polishing machines, special cleaning solution, chemical cleaners, improved building materials, and power equipment. "
  • DEEOIC offers no similar list of duties for a Lab Tech but DOL does provide a job description: "The Laboratory Technician (Laboratory Tester) performs laboratory tests according to prescribed standards to determine chemical and physical characteristics or composition of solid, liquid, or gaseous materials and substances for purposes such as quality control, process control, product development, or determining conformity to specifications. This incumbent sets up and adjusts laboratory apparatus, and operates grinders, agitators, centrifuges, ovens, condensers, and vibrating screens to prepare material for testing according to established laboratory procedure.  This worker performs physical tests on samples of cement or raw materials and controls quality of materials and mix during manufacturing process. Work involves running tests of the following materials, such as aggregate, limestone and sand, for such qualities as permeability, load-bearing  capacity, or cohesiveness; dry and liquid substances  used as ingredients in adhesives, propellants, lubricants, refractories, synthetic rubber, paint, paper, and other compounds for purity, viscosity, density, absorption or burning rate, melting point, or flash point, using viscometer, torsion balance scale, and pH meter; solutions used in processes, such as anodizing, waterproofing, cleaning, bleaching, and pickling, for chemical strength, specific gravity, or other specifications; materials for presence and content of elements or substances, such as hydrocarbons, manganese, natural grease or impurities, tungsten, sulfur, cyanide, ash or dust, and samples of manufactured products, such as cellophane or glassware, to verify conformity with heat resistance, tensile strength, ductibility, and other specifications, and examines materials, using microscope. The Laboratory Technician (Laboratory Tester) records test results on standard forms, writes test reports describing procedures used, and prepares graphs and charts, cleans and sterilizes laboratory apparatus, may prepare chemical solutions according to standard formulae, and may add chemicals or raw materials to process solutions or product batches to correct deviations from specifications. "
  • Although when she filed her claim, it had been almost 20 years since she had worked at Mound  Mary was able to remember some of her job duties as well.  She "took measurements of all routine samples submitted to the lab, scanned drums and fiberglass boxes of chemical and nuclear waste from all over the Mound Plant  assisted other group members with their projects and did special projects whenever asked, including metal surface analysis and general purpose Heat source project work, performed recalibrations of radioactive heat standards, moved drums of Mound waste materials, measured Mound waste materials with gamma ray spectrometry, assayed other materials for Mound Waste Management, prepared slides and overheads, filled dewers of liquid nitrogen, maintaining. and checking spectrometry equipment."

Mary's DOE file show that while at Mound the departments she worked in Engineering, Nuclear Operations, Analytical and Applied Physics, Research and Development, and Technology and Support.  Her file also documents that she worked in T (Technical and Production facility)-Building, rooms T-237 and T-242, E (Electronics development and maintenance)-Building room 101, PP (Plutonium production)-Building, H-Building, Engineering, Nuclear Operations, Analytical and Applied Physics, Research and Development, and Technology and Support.  Her file also documents that she worked in T (Technical and Production facility)-Building, rooms T-237 and T-242, E (Electronics development and maintenance)-Building room 101, PP (Plutonium production)-Building, H-Building.

In November 1993, at age 33, Mary was diagnosed with Parkinson's Disease, after spending months trying to pin down the strange symptoms she had been suffering from.  This was a huge shock as there was no history of early on-set Parkinson's in her family.  Indeed, there is only one family member who had Parkinson's at all; Mary's elderly aunt who developed it when she was in her sixties.   Mary  also developed basal cell carcinoma in 1995 and melanoma in 1988. 

2004:

  • DOE provided DOL with Mary's Personal Profile Document and other records.  Note the DOE record contains none of the mistakes DOL later introduced into Mary's claim.
  • On September 13, 2004 Mary filed a claim with the Energy Employees Occupational Illness Program for basal cell carcinoma and melanoma.
  • On September 27, 2004 DOL sent Mary a letter that they had received her claim.
  • On September 29, 2004 DOL sent Mary a letter that they had received her claim.
  • On November 2, 2004 DOL sent Mary a letter requesting medical evidence.
  • 2005:

  • On January 10, 2005 DOL sent Mary a letter and a Recommended Decision denying her claim.
  • On March 23, 2005, DOL sent Mary a letter and Final Decision denying her claim.
  • 2006:

  • On February 23, 2006 DEEOIC's Final Adjudication Branch (FAB) issued a Final Decision  denying Mary's claim.
  • 2007:

  •  In 2007, after learning more about the program, she reapplied.
  •  On May 31, 2007 DOL sent Mary a letter saying they had received her claim.
  • On June 1, 2007, DEEOIC provided her with a list of what they received from her and additional materials needed.
  • Mary requested a copy of her file from DOE. On June 6, 2007 DOE sent her two letters: one stating they had received her request and a second requesting additional information.
  • On July 25, 2007, Mary provided DEEOIC with copies of her medical records.
  • On July 30, 2007 DEEOIC sent her a letter requesting more information on her cancers.
  • On August 27, 2007,DEEOIC granted a 30 day time extension.
  • On October 3, 2007 Mary requested a time extension
  • On October 31, 2007 DOL sent Mary a letter that the next step in her claim was a dose reconstruction.  They sent a referral to NIOSH.
  • On November 14, 2007 NIOSH sent a letter explaining the claims process.
  • On December 10, 2007, Mary requested access to DEEOIC's Site Exposure Matrix (SEM) so she could better research her chemical exposures.  This request was subsequently denied.
  • 2008:

  • On April 2, 2008 NIOSH sent Mary a letter and a copy of her dose reconstruction.  The dose reconstruction determined that neither of these cancers was related to Mary's employment at Mound and found only a 24% chance that her cancers were caused by her work at Mound.
  • On July 10, 2008 DEEOIC sent a letter requesting more information on toxic exposures causing her melanoma and Parkinson's since the Site Exposure Matrix (SEM) did not have any links.  Since the SEM had a link between arsenic, carbon, and mineral oil in the buildings she worked in DOL referred her claim to a medical consultant for an opinion on whether these toxins were "at least as likely as not" a significant factor in causing, contributing to, or aggravating her basal cell carcinoma.
  • In August 2008 DEEOIC published Final Bulletin 08-15 which lists the following chemicals as having a known link between exposure and development of Parkinson's disease: carbon disulfide, carbon monoxide, diesel exhaust, manganese, manganese II chloride, potassium permanganate, cold drawn steel, tool steel, galvanized steel, Kovar, Hastelloy, MPTP.  This Bulletin conflicted with the SEM, which instead listed, carbon monoxide, carbon steel, diesel exhaust, manganese, manganese dioxide, manganese phospholine, potassium permanganate. The bulletin also goes on to say that carbon monoxide  exposure is only to be considered if the claimant has written proof that the worker lost consciousness or brain injury.  DEEOIC has never chosen to resolve this conflict and it continues to cause problems for claimants, despite DEEOIC being notified numerous times.
  • On August 6, 2008 DEEOIC responded to Mary that while she could have an extension of an additional 30 days for her Parkinson and basal cell carcinoma claims she could not have any additional time to find more evidence for her melanoma claim.  The letter also stated that Mary could not have access to the SEM to research her claim although she was provided with some SEM printout sheets.
  • On August 15, 2008 DEEOIC issued a Recommended Decision for denial of Mary's Melanoma claim because NIOSH found a less than 50% chance it had been caused by radiation at Mound and because her personnel file and the SEM did not provide any evidence of a toxic chemical link between the melanoma and her Mound work.
  • On August 26, DEEOIC confirmed that Mary had designated an authorized representative to help with her claim.
  • On October 29, 2008 DEEOIC sent a letter and Final Decision to Mary denying her Melanoma claim.
  • On November 24, 2008 EECAP provided DEEOIC with a letter addressing the claims, an affidavit from Mary on her work at Mound and a copy of EECAP's Report of Mary White's Chemical Exposures at Mound Lab, which was based on several weeks of research into Mary's DOE records and official DOE Mound documents.  EECAP also provided DEEOIC with copies of the DOE documents the report was drawn from.  The report seems to have been totally disregarded, as was the affidavit.
  • On December 2, 2008 DOL sent a memo stating that bulletin 08-15 precludes carbon monoxide exposure for Mary and that the SEM did not show that carbon disulfide was linked to Parkinson's.
  • On December 18, 2008 DEEOIC developed a Statement of Accepted Facts (SOAF), and wrote a referral request to a Dr. Patricia Hunt, a DOL District Medical Consultant (DMC) on whether Mary's Parkinson's disease or basal cell carcinoma had been caused by her work at Mound.  The SOAF contained numerous errors including incorrect dates, a false job category, incomplete list of buildings worked in, and incomplete list of job duties.  The SOAF also ignored several chemicals Mary may have been exposed to.
  • On December 22, 2008 DEEOIC sent a letter to Dr. Hunt requesting she offer a medical opinion.  A copy of the inaccurate SOAF was enclosed with the request to assist Dr. Hunt.  The questions the Claims Examiner asked Dr. Hunt were deficient.  Question 1 only asked if manganese could have caused, aggravated, or contributed to her developing Parkinson's. Other chemicals listed in the SEM to which Mary might have been exposed to at the time (Carbon monoxide, carbon steel, diesel exhaust, manganese dioxide, manganese phospholine, potassium permanganate) were not considered.  Dr. Hunt commented on Mary's melanoma although DEEOIC had previously denied this claim.

    Dr. Hunt's report also commented at length on how early onset and late onset Parkinson's disease differ and noted that Mary's aunt had had Parkinson's.  She also stated that less than 5% of all Parkinson's disease are genetic in nature but early onset Parkinson's tends to be more genetic.  She, however, did not use any of this information to link the possibility to Mary's development of Parkinson's being aggravated or contributed to by her work at Mound.  She jumped straight from her quoting of research to her conclusion that Mary's exposure was not related to her Parkinson's disease.

    Dr. Hunt's opinion was that, "The employee's toxic exposure to arsenic, carbon and/or mineral oil at the Mound Plant is at least as likely as not a significant factor in aggravating, causing, or contributing to her skin cancer."  Although she considered both melanoma and basal cell carcinoma, DEEOIC interpreted this to mean just the basal cell carcinoma.

    2009:

  • On January 9, 2009 DEEOIC sent Mary a letter and Recommended Decision approving her claim for basal cell carcinoma and denying her claim for Parkinson's disease.
  • On January 14, 2009 Mary sent DEEOIC a letter stating that she was signing the OCSS-1 but disagreed with its findings.
  • On February 3, 2009 DEEOIC sent Mary another letter and a Final Decision accepting her claim for skin cancer.  A third letter discussing medical benefits followed.  Mary found this ironic since she had no costs for the basal cell carcinoma.  DEEOIC also offered benefits from 2007 rather from when she first filed her claim in 2004. 
  • On February 4, 2009 EECAP sent DEEOIC a letter stating objections to the Recommended Decision and requesting a copy of the DMC report.  The letter noted that Final Bulletin 08-15 listed carbon disulfide as a causal agent for Parkinson's although the Recommended Decision said it was not.
  • On February 11, 2008 DEEOIC sent Mary a letter confirming that she had objected to her Recommended Decision for denial of Parkinson's disease and that DOL would be providing a copy of the DMC report used for the RD denial.  The letter gave Mary 20 days from the date of the letter to provide the Final Adjudication Board with additional evidence regarding Mary's objections.
  • On February 18, 2009 EECAP sent DEEOIC a letter requesting a copy of the SOAF and requesting an additional time extension.
  • On February 25, 2009 DEEOIC sent Mary a letter noting that a copy of the SOAF had been requested and giving 20 days to respond with new evidence.
  • On February 27, 2009  EECAP sent DEEOIC a letter objecting to the latest Recommended Decision and enclosed additional documentation linking Parkinson's disease to Mary's exposures at Mound:
    1. Print-out from HazMap the database the SEM is built on
    2. Carbon Disulfide Neurotoxicity: Taiwan Experience 2004 peer reviewed study abstract
    3. Parkinson's disease and Occupational Exposure to Organic Solvents, Agricultural Chemicals and Mercury, a case-referent study 1981 peer-reviewed study abstract
    4. Parkinson's Disease: Hope through Research, article from National Institutes of Health National Institute of Neurological Disorders and Stroke
    5. NIOSH Pocket Guide to Chemical Hazards-Carbon Disulfide
    6. DOL's Occupational Safety and Health Guideline for Carbon Disulfide
    7. Floor plan of T-building showing location of enclosed underground tunnel where trucks idled in relationship to Mary's lab.
    8. Mary's Affidavit on her exposures at Mound
  • On March 18, 2009 Dr. Freeman of the University of Cincinnati Center for Occupational Health provided a medical expert letter documenting his opinion that Mary's exposures to manganese, diesel fumes and carbon disulfide were "as likely as not a significant factor in aggravating, contributing to, or causing" Mary's Parkinson's. 
  • On March 20, 2009 EECAP faxed a copy of Dr. Freeman's letter to DEEOIC.
  • On April 22, 2009 DEEOIC sent a letter and a Remand Order to develop additional evidence. The Remand Order noted that the SEM showed that Parkinson's could be caused by manganese to which Mary would have been exposed in liquid form.  The Remand Order also noted again that genetic factors are a significant factor with early onset Parkinson's.  Since there were two conflicting medical opinions DOL determined that rather than determining which doctor was most credible it would be prudent instead to get a third doctor's opinion. 
  • On April 29, 2009 Mary was provided with a medical card covering her basal cell carcinoma.  Since then she has never used it because she has had no medical expenses for basal cell carcinoma.
  • On May 7, 2009 DEEOIC requested additional employment information from Mary for an Industrial Hygienist report.
  • On May 13, 2009 the Portsmouth Resource Center sent Mary a letter about how to request an impairment rating or wage loss.
  • On May 16, 2009 Mary provided DEEOIC with additional employment information from her DOE records.  The Authorized Representative asked questions about the IH report and asked how the three medical reports would be evaluated.
  • On May 22, 2009 Mary sent a letter to the Portsmouth Resource Center letting them know that she had already contacted DEEOIC about the impairment rating.
  • On June 5, 2009 DOL responded to Mary's authorized representative's question about why the IH report was being done.  DEEOIC responded that the IH report needed to be done to "get an expert opinion on the amount and duration of Ms. White's exposure to manganese, diesel fumes, and carbon disulfide."  DEEOIC responded to EECAP's questions on how the different medical reports will be weighed by saying, "we hope to have more detailed, specific information on Ms. White's exposures that were not available to either of the previous two doctors.  The district office has discretion to evaluate the weight of the medical evidence.  This is not just a "two our of three" determination."  DEEOIC also agreed to send copies of the IH and new DMC reports to Mary and her authorized representative.
  • On June 10, 2009 DEEOIC developed the SOAF for the new IH and DMC reports.  Although some of the dates were corrected this SOAF still contained the erroneous job title, Data Analyst, as one of Mary's jobs and did not consider all the possible chemical toxins listed in the SEM (carbon monoxide, carbon steel, diesel exhaust, manganese, welding fumes) at the time to which Mary might have been exposed.
  • On June 15, 2009 IH Gerald Houvener provided a report on Mary's exposures.  This report was deficient in many ways. 
  • While the Remand Order called for an IH report for "an accurate assessment of what toxic exposures" Mary had been subject to, this report eliminated all the specific information provided to DEEOIC that EECAP had found in Mary's DOE records as well as research into DOE Mound documents showing the processes that Mary was working on and instead based conclusions only on the SEM, and various generic websites.  If the IH had been given the material EECAP provided DEEOIC on Mary's exposures the outcome may have been different, but these materials were never shared with the IH.
  • The erroneous job title, Data Analyst, was considered as a valid job title.  A data analyst is very different than an Analytic Technician.  A Data Analyst sits at a desk and works with paper.  An Analytic Technician works with chemicals and radiation.
  • The IH report considered only three of the materials Mary would have worked with.
  • The "discussion" of the Mound Plant was not detailed enough to provide proper background on Mary's exposures nor did the references used.
  • The IH did not consider any of the particulates that make up diesel fumes and addressed only the carbon monoxide component, which DEEOIC will not recognize without loss of consciousness or brain damage.
  • The IH report did not address the extreme vehicle fumes drawn into Mary's lab from the enclosed underground tunnel where trucks were left idling.
  • The IH report seemed to indicate that manganese would be harmful and did not have access to all the forms of manganese to which Mary would have been exposed as an Analytic Technician because he only drew from generic sources rather than the detailed research EECAP had done on Mound and Mound's processes.
  • On July 6, 2009 DOL developed another SOAF for a DMC report.
  • July 13, 2009 Dr. David Orgel, who was not a neurologist, issued his opinion, based on the exposures detailed in the inaccurate and deficient IH report, on whether Mary's Parkinson's had been caused by her work at Mound.  He was asked to consider whether manganese, diesel fumes, or welding fumes might have caused her Parkinson's.  Dr. Orgel, although not a neurologist, seems to have a great deal of trouble giving this claim any credence.  This seems to be based on his own prejudices and perhaps lack of expertise as well as perhaps his out of date textbooks.
  •  The only references cited in this report are from 3 textbooks, two of which were published in 2001 and one from 2005.  He cites no current research for his conclusions.
  •  Dr. Orgel, although not a neurologist, disputes that Parkinson's can be caused by welding fumes or diesel exhaust.
  • He states that MPTP, an illegal drug which Mary never used, is the only environmental factor causing Parkinson's identified. 
  • He also disputes that Mary had Parkinson's.  This is based on lack of current medical records rather than anything in her record.  DEEOIC never requested any additional medical evidence from Mary.
  • He feels that the passage of time between Mary's diagnosis of Parkinson's and her exposures at Mound were too long.  This does not take into account, nor did he request additional information, on when her symptoms began and how long it took for a person in her late 20s to early 30s to be diagnosed with a condition which normally manifests in old age, especially when there is no family history of early onset Parkinson's.
  • In July 2009 DEEOIC sent copies to the IH and DMC reports to Mary's AR.
  • Apparently, DEEOIC wasn't satisfied with Dr. Orgel's report either and asked for him to redo it to conform with their SOAF.  On August 7, 2009 he presented a second opinion.  For this report he was also asked to consider acute or chronic exposure to carbon monoxide, diesel exhaust, manganese, welding fumes, carbon disulfide.  Dr. Orgel did additional research to satisfy DEEOIC.  However, all of the references he used for research were even more out of date that the ones he used in his original report and he still used no current research.   The books he used were to back up his opinion were:
  • Casarett and Doull's Toxicology, 6th Edition, which was then 8 years old, found no connection between manganese and the way Mary's Parkinson's manifested.
  •  Hamilton and Hardy's Industrial Toxicology, 4th. Ed. was written in 1983 and states that manganese exposure of at least 3 months present around the time of the exposure.
  • Rosenstock and Cullen, Clinical Occupational Medicine was written in 1994.  He uses this to back up his opinion on manganese poisoning. 
  • Rom, Environmental and Occupational Medicine, 2nd Edition was written in 1992 discusses three stages of Parkinson's.  While this textbook was outdated, the information presented does not rule out Mary's Parkinson's being caused by her work at Mound.  Her diagnosis was made in 1993 but her symptoms started before that.
  • Mitchell's Instant Medical Surveillance was published in 2002, states that "Chronic adverse health effects of manganese usually appear following exposures of six months to three years in duration".
  • His online research (source un-cited) changed his earlier opinion about welding fumes causing Parkinson's. His discussion on whether carbon disulfide causes Parkinson's was limited to a list of symptoms from the 1983 and a1994 textbooks listed above.  He again argues that Mary's medical records are too old.
  • On August 12, 2009 DOL sent EECAP copies of the requested IH and DMC reports.
  • On August 13, 2009 DEEOIC sent another letter and Recommended Decision for denial of Mary's Parkinson's claim.  This Recommended Decision changed the date of Mary's beginning employment at Mound from January to June 1981.  It also introduced the idea that Mary had a six month gap in her employment in 1983, which EECAP could not find verified anywhere.
  • On August 17, 2009 EECAP sent DEEOIC a letter requesting copies of the SOAFs used for the IH and DMC reports.
  • On August 21, 2009 Mary sent a letter to Social Security requesting a copy of her record for the time she worked for Mound Lab as a contractor.
  • On August 25, 2009 DOL sent Mary's Authorized Representative copies of the IH and DMC SOAFS she had requested.
  • On September 2, 2009 EECAP sent DEEOIC a letter documenting
  • mistakes within the latest SOAFs.
  • inappropriate use of the SEM.
  • how additions and removals of toxic chemicals within the SEM make it difficult to know which chemicals to judge a claim on.
  • how to evaluate trucks idling within the T-building tunnel given the change in the SEM.
  • Documentation of additional Parkinson causal agents which were not included in the Mound SEM.
  • Lack of pertinent Mound job categories and processes in the SEM.
  • On September 8, 2009 DEEOIC sent Mary a letter confirming her objections to the Final Decision.  The letter instructed Mary that any additional evidence must be received within 20 days of the date on the letter.
  • On September 15, 2009 EECAP requested an additional 30 days to research additional evidence for Mary's objections to her Final Decision.
  • On September 18, 2009 DEEOIC granted the additional 30 day extension.
  • On October 1, 2009, EECAP requested additional information on the basis of Gerald Houvener's IH report, specifically for Mound chemical monitoring reports, Industrial Hygienist reports, environmental reports or Health Physicist reports he used to reach his conclusion. EECAP also asked how he reached his conclusions and what he used to extrapolate from if he didn't have any hard data from Mound documents.
  • On October 9, 2009 DEEOIC declined to provide the information requested, stating that the only documents Houvenor used were referenced in his IH report.  This means he used no Mound data to reach his conclusions.
  • On October 15, 2009 EECAP sent a letter and additional evidence to DEEOIC on Mary's claim.  The reasons given were:
  • Mary was not evaluated for all the Parkinson's causing chemicals due to deficiencies in the SEM.
  • The IH report was deficient and used no actual Mound data relying instead on the SEM and generic websites.
  • Because the IH report was deficient, the DMC report was deficient as well.
  • Neither the DMC report nor the RD addressed the possibility that Dr. Freeman raised that if Mary was genetically predisposed to get Parkinson's because it was in her family (an aunt) as the DMC report found then her exposures at Mound may have contributed to or aggravated it in her.
  • Mary was waiting for Social Security to send a report on her earnings.
  • On November 20, 2009 DEEOIC sent a letter and a Final Decision to Mary denying her Parkinson's claim.  Unfortunately, DEEOIC neglected to send a copy of the FD to her Authorized Representative and Mary was in a medical crisis when the FD arrived and not able to open mail so neither Mary nor her AR knew of the decision until after the 30 day deadline for requesting reconsideration had passed.  The FD still did not evaluate Mary for all the toxic exposures pointed out by her AR. 
  • The IH report the FD was based on evaluated only manganese, diesel fumes and carbon disulfide.  The deficiencies in the report that the AR raised were listed but not addressed.
  • The erroneous job title, Data Analyst, was still considered as one of Mary's jobs.
  • The FD seems to have considered diesel/gasoline fumes as ONLY carbon monoxide exposure and not considered the other chemicals contained within these fumes.  Since Mary did not lose consciousness or have documentation of brain damage after being exposed to these fumes the intense exposures she suffered from the trucks idling right outside her lab were ignored.
  • The FD says both that carbon disulfide is in the SEM  and can and cannot cause Parkinson's disease.
  • The FD did not address Mary's request for Social Security to address her work at Mound as a consultant.
  • The FD did not address the report, Documentation from DOE Employment Records by Year.
  • The FD did not address the additional chemicals present at Mound that Mary's AR reported in the report, Parkinson causing Toxic Chemical Exposure referring instead to Final Bulletin 08-15, although it looks like from page 5, paragraph 1 that the report was being used to update the SEM.  However, on page 5, paragraph  4, the FD says, "However, if there is evidence of an exposure to toxic substances, but the medical rationale linking the exposure to the patient's condition is lacking, or not clear, the CE must follow up with the claimant's treating doctor, or refer the case to a DMC for a medical opinion on causation."  The CE in this claim did neither, Mary's physician was not contacted about the additional exposures nor was a DMC contacted.  The exposures were just ignored.
  • The Social Security records request, the report Documentation from DOE Employment Records by Year, and Building Documentation for Analytical Technician Work are referred to on page 5, paragraph 5 but not in any way that makes sense.  Instead the discussion is all about carbon monoxide exposure which Mary did not claim given the strict interpretation in Final Bulletin 08-15.It does not appear that the materials Mary's authorized representative submitted were read or considered for the FD nor was any reason given why DEEOIC did not use them in the FD.

    2010:

  • In early January 2010 Mary's AR called DEEOIC to ask about Mary's impairment rating.  During the conversation the Claims Examiner mentioned the Final Decision and the AR told her she had not received a copy.  The CE said she would send her a copy.
  • The Authorized Representative called Mary who was recovering from a severe illness.  Mary said she had received something from DEEOIC but had been too ill to open mail.  She had moved into an assisted living facility during her illness since she needed additional care that she could not receive in her home due to the progression of Parkinson's.
  • On January 6, 2010 DEEOIC send Mary a letter on getting her impairment rating for her basal cell carcinoma done.
  • On January 7, 2010 DEEOIC provided Mary's AR a copy of the November 20, 2009 Final Decision.
  • On January 12, 2010 EECAP requested a reopening and reconsideration, with additional information on the mistakes in the Final Decision, of Mary's claim because she did not get a copy of the Final Decision. 
  • On February 17, 2010 Dr. Freeman did an impairment rating on Mary's basal cell carcinoma.
  • On March 4, 2020 DOL denied Mary's request for a reopening and reconsideration.
  • On March 5, 2010 EECAP sent a copy of Dr. Freeman's Impairment Rating to DOL and asked about reimbursement for Mary's travel.  The question was never answered.
  • On March 24, 2010 DEEOIC sent a letter and issued a Recommended Decision on Mary's Impairment Rating.
  • On June 2, 2010 DEEOIC issued a Final Decision on Mary's Impairment Rating.
  •  

    2011:

  • On February 24, 2011 DEEOIC sent Mary a letter confirming she did not wish to file for wage loss for her basal cell carcinoma.
  • 2012:

  • On June 13, 2012 Mary requested copies of all Statements of Accepted Facts (SOAFs) issued by DOL.
  • On June 20, 2012 DEEOIC provided the SOAFs requested.

    2013:

  • On January 14, 2013 Mary requested a reopening and reconsideration of her claim with the submission of new evidence.  The new evidence included:
  • An expert report by Dr. David Manuta.  When DEEOIC issued its Recommended Decision, this issue was ignored and this report was dismissed out of hand, although DEEOIC policy required it to be evaluated by an expert to see if it was pertinent to the claim.
  • Argument 1: Chemicals used in E-101 and verification she worked in this location which proves with DOE documentation that Mary worked in this room and the processes and chemicals that were present in the room.  Chemical analysis was done in E-101 including etching, grinding/polishing of metals.  This would have exposed Mary to 10 of the metals which can cause Parkinson's disease, despite the IH report saying she wasn't exposed.  When DEEOIC issued its Recommended Decision, this issue was ignored and this exposure went unevaluated.
  • Argument 2: Gasoline/Diesel Fumes in T-Building Tunnel infiltrating T-237, T-242 addresses the intense truck fumes Mary was submitted to because of the negative building pressure which drew the fumes in through her lab.  Documentation includes proof that Mary worked in the lab i question, a floor plan and photos showing her lab next to the loading dock and document discussing the need to correct the problem.  When DEEOIC issued its Recommended Decision, the evidence Mary had submitted was ignored and was the exposure was dismissed in a verbal IH opinion as low.
  • Argument 3: Additional Contractor Work documented by Social Security shows that Mary was working as a contractor at Mound Lab in 1987 after her employment was terminated.  When DEEOIC issued its Recommended Decision, this evidence was ignored and went unaddressed.
  • Argument 4: Problems Caused by Mistakes in SOAF discusses how the inaccurate information given to the various DEEOIC doctors and experts led to false conclusions of the experts.  Each element of this argument is backed up by DOE documentation.  Do to the numerous errors that were introduced in previous SOAFs, Mary's AR requested that DOL provide copies to either Mary or her Authorized Representative before new SOAFs would be sent to any DOL contractor expert.  DEEOIC did not honor that request.
  • Argument 5: Errors in the Industrial Hygienist's Report discusses how the errors and omissions in the Industrial Hygienist's report led to Gerald Houvenor making  inaccurate assumptions.  Each point is backed up by DOE documentation. When DEEOIC issued its Recommended Decision, this issue was ignored and this exposure went unevaluated.  The new CMC report relied on this erroneous IH report as if it were factual.
  • Argument 6: Changes in Mound Parkinson's disease SEM discusses how the removal and additions to the SEM has affected Mary's claim.  This is demonstrated by past SEM print outs.  Also, contained are chemicals which were listed in the global Parkinson's SEM but not listed in the Mound SEM which EECAP was able to research and document were at Mound.  These are documented by official DOE documents.  When DEEOIC issued its Recommended Decision, this issue was ignored.
  • Argument 7: Peer reviewed Studies linking Parkinson's Certain Chemicals presents scientific peer-reviewed studies which are linked to Parkinson's disease.  These chemicals are:
  • Trichloroethylene--3 studies
  • Diesel Exhaust--3 studies
  • Rodenticides and Pesticides--3 studies
  • Pesticides documented use on Mound property--DOE documents
  • Carbon disulfide--1 study in addition to the others already submitted
  •          When DEEOIC issued its Recommended Decision, these studies and all the others provided earlier were ignored.   They were not sent to an expert, as required by DEEOIC policy to be evaluated to see if they were pertinent to the claim.

  • Argument 8: Problems with Previous Final Decision discusses the problems with previous Final Decisions which EECAP has raised in the past but DEEOIC has never responded to.  When DEEOIC issued its Recommended Decision, this issue was ignored.
  • Argument 9: Errors and Omissions in District Medical Consultants' Reports discusses how the errors and omissions in the DMC reports affected Mary's claim including 3 peer reviewed scientific studies addressing Dr. Orgel's contention that Mary's latency period was too long for the development of Parkinson's to be caused by her work at Mound.  To date DEEOIC has declined to address any of these errors and omissions.  When DEEOIC issued its Recommended Decision, this issue was ignored again.
  • Argument 10: Discrepancies between SEM and Bulletin 08-15 discusses the conflict between these two sources that DEEOIC used to evaluate Mary's Parkinson claim.  To date DOL has declined to address how this has affected Mary's claim.  When DEEOIC issued its Recommended Decision, this issue was ignored.
  • On January 31, 2013 the Claims Examiner sent a memo to the Claims Manager. He states the new evidence is around 100 pages and says "In actuality, this CD simply contains hundreds of general pages of information related to the Mound Plant and not specific to an argument for causation..."  With this statement the Claims Examiner makes it clear that he missed the point which was to connect Mary's job duties to chemicals she was exposed to.  The memo also says that since Dr. Manuta is not designated as a toxicologist, IH or medical doctor his analysis cannot be taken alone but "are not to be ignored", which they later were.  The memo then goes on to say he won't discuss each piece of evidence separately but "rather will a) discuss the SEM as it relates to this case and whether there are any changes to the SEM that could indicate a need to revisit the case and b.) whether any of the claimed exposures were not previously addressed."  In other words, he recommends ignoring the evidence if it isn't in the SEM.
  • On February 1, 2013 DOL sent Mary a letter saying that they are considering  a Reopening and Reconsideration of the claim.
  • On February 4, 2013 DOL allowed Reopening but denied Reconsideration because Reconsideration can only be done once per claim.
  • On March 9, 2013 EECAP sent DEEOIC a letter documenting an additional chemical, acrylonitrile combustion products, that Mary needed to be evaluated for.  Acrylonitrile combustion products had been added to the global SEM for Parkinson's causal agents but had not been added to the Mound SEM yet.  EECAP provided DEEOIC with DEEOIC documentation that it was on site at Mound.
  • On March 29, 2013 DEEOIC sent Mary a letter and Director's Order vacating her previous Final Decision and reopening Mary's claim based on the additional evidence provided in January 2013.
  • On May 9, 2013, the Claims Examiner called DOL's Industrial Hygienist to see if a referral was necessary.  Without reviewing any of the evidence Mary had provided the IH said no and gave his verbal opinion that her exposures would not have caused her illness.  Again.  This was just off the top of his head.  He reviewed NO evidence.
  • On June 10, 2013 DOL sent a Statement of Accepted Facts, still containing erroneous job information and based on the previously flawed Industrial Hygienist report to the Contract Medical Consultant.
  • On June 14, 2013 the DOL Contract Medical Consultant finished her report of Mary's exposures.  Unfortunately, she based in on faulty previous reports, a verbal opinion from an Industrial Hygienist who did not review any evidence and was not provided with any of the evidence the claimant had provided in January.
  • On June 18, 2013 the Claims Examiner approved the Contract Medical Consultant report.
  • On June 20, 2013 DEEOIC sent a letter and a new Recommended Decision for denial of Mary's Parkinson's claim.  As in all the previous denials this one did not address the issues raised.  Again, the peer reviewed studies were ignored and not evaluated.  All 10 arguments were ignored.  Dr. Manuta's expert report was dismissed because he was not "designated as a Toxicologist, IH, or medical doctor specializing in occupational medicine."  The Recommended Decision was based on an oral opinion from the Industrial Hygienist without him reviewing any evidence.
  • On June 24, 2013 EECAP requested copies of the Contracting Medical Consultant report and other information used in the latest RD denial.
  • On June 25, 2013 Mary's authorized representative called the Cleveland office to speak to the Claims Examiner about whether the Industrial Hygienist had seen the report Dr. Manuta sent and to ask about the verbal IH opinion.  The call went to voice mail.
  • On June 26, 2013, the authorized representative called the Cleveland Office again and left a second voice mail message.
  • On June 27, 2013 Mary's authorized representative made a third call to the Claims Examiner who wrote the Recommended Decision to ask about how Dr. Manuta's report was evaluated (it wasn't) and to ask when DEEOIC policy had been changed to allow using oral industrial hygienist reports. (It hasn't.)
  • On June 27, 2013 Mary Sullivan from the Cleveland Office FAB called to make sure the authorized representative had her questions answered.
  • On July 3, 2013 DEEOIC responded with a letter and the requested materials, except for the list of materials provided to the CMC.
  • Undated phone note from Claims Examiner Matthew Buehrle to Industrial Hygienist, David Levitt.
  • June 7, 2013 Amended Statement of Accepted Facts.
  • June 14, 2013 Contracting Medical Consultant report.  The doctor, Elizabeth Evans Gersch, is not a neurologist.  The references she used to form her opinion were from 2 out of date textbooks from  2002 and 2003.  No current or peer reviewed research was done to form her opinion.
  • On July 5, 2013 EECAP requested a copy of Mary's complete file.
  • On July 11, 2013 EECAP sent an email to DEEOIC's John Vance asking about the verbal IH opinion.  Mr. Vance responded that his Medical Science Team would be looking into it.  On July 30, after receiving an email from Director Leiton on the issue, EECAP wrote Mr. Vance again.  Here is the email string.
  • July 18, 2013 DOL sent a copy of Mary's complete file.
  • On July 25, 2013 Director Leiton sent EECAP an email stating that DEEOIC does not have a policy of rendering verbal IH opinions.  On July 30 EECAP responded to Director Leiton's email with additional information and questions.  You can seen the email conversation here.
  • On August 9, 2013 after not getting a response to the emails, Mary requested a face to face Hearing.
  • On August 12, 2013 Mr. Vance said he would have the case reviewed. On October 9, 2013 DOL remanded the claim to Cleveland.

    2014:

  • On March 19, 2014 Mary's representative called Cleveland District Office to inquire on the status of the claim.  The CE said he would review the file and get back to the representative the next day.
  • On April 12, 2014 Mary's representative send the CE a letter and again requested an update on the claim.
  • On April 15, 2014 DEEIOC sent Mary a letter and a recommended decision for denial.
  • On May 28, 2014 DEEOIC provided Mary's representative with the materials she had requested.
  • On June 9, 2014 Mary requested a hearing to object to the denial based on mistakes and incorrect information.
  • On June 9, 2014 after reviewing DEEOIC's Industrial Hygienist and Toxicologist reports Mary noticed that several references were missing and contacted DEEOIC for the missing references.  In a phone call with the Cleveland FAB office Mary was told that there were no additional references.
  • On June 10, 2014 DEEIOC acknowledged Mary's request for a hearing.
  • June 10, 2014 DEEOIC provided Mary with a Notice of Hearing scheduling the date of her hearing.
  • On June 26, 2014 Mary's representative contacted DEEOIC again to ask for the missing references.  All but one were supplied.  The one that wasn't supplied was because the work discusses was confidential and could not be shared.
  • July 24, 2014 a hearing was held in Dayton, Ohio on Mary's claim.  Mary's authorized representative submitted the following documents to document problems with the claim:
  • Mary White Claim History
  • Dates DEEOIC used for Ms. White's Work at Mound were incomplete
  • DEEOIC Final Bulletin 08-15 was Not Followed
  • T-Building Tunnel Exposure Evidence Not Evaluated
  • Erroneous Job Title, Data Analyst, used to Adjudicate Claim
  • Materials submitted by Claimant were Not Evaluated or Addressed in the Recommended Decision
  • Review of December 5, 2013 IH Report for White Claim
  • Review of November 14, 2013 Toxicologist Report submitted for White Claim
  • April 15, 2014 Recommended Decision
  • A CD of all photos, official Mound documents and diagrams discussed in the hearing.

    At the hearing the Hearing Officer told Mary's AR that he needed additional employment and medical evidence.

  • On August 7, 2014 Mary's AR sent a letter requesting an extension through mid November.  Unfortunately, a DEEOIC official verified that this letter was never received by the Hearing Officer.
  • On August 8, 2014 the Hearing transcript was loaded into the DEEOIC database.  Unfortunately, DEEOIC neglected to send a copy to Mary's AR and sent Mary's copy to an incorrect address.
  • On September 19, 2014 Mary's AR provided the hearing officer with an affidavit stating he checked her badge at Mound during the disputed time period.  The letter also contained other pertinent facts.
  • On October 10, 2014 Mary's AR contacted DEEOIC to see if the Hearing transcript had been finished yet.  The AR was told that the transcript had been uploaded into the system on August 8th.  A DEEOIC official emailed a copy of the transcript to Mary's AR.
  • On October 15, 2014 Mary's AR provided the hearing officer with a letter from a board certified Occupational Medicine doctor and professor stating that Mary's exposures at Mound were "more likely than not a significant factor in aggravating and contributing to: her development of Parkinsonism.
  • On October 27, 2014 Mary's AR provided the Hearing Officer with corrections to the Hearing transcript.
  • On October 30 or 31 the Hearing Officer called Mary's AR to touch base and discuss the claim.
  • On December 1, 2014 DEEOIC released a Final Decision which reversed the Cleveland District Offices Recommended Decision and approved Mary's claim.
  • On December 8, 2014 DEEOIC mailed Mary a letter asking if she wanted an impairment rating.
  • On December 12, 2014 Mary's authorized representative returned DEEOIC's form affirming that she wanted an impairment rating and naming the doctor who is to do it.
  • On December 31, 2014 Mary's AR returned a form requesting wage loss compensation.

    2015:

  • On January 12, 2015 Mary's AR submitted transportation costs and previously paid prescription charges to ACS for reimbursement.  ACS declined to pay for some prescriptions which had to be resubmitted.
  • On January 14, 2015 DOL issued a letter approving 3 weeks of home health care.
  • On January 17, 2015 Mary's AR sent another batch of pharmacy reimbursement claims through the Portsmouth Resource Center.
  • On January 20, 2015 Dr. Mulloy sent a clarification to the claims examiner about Mary's consequential conditions and spoke with the claims examiner on the phone.
  • On January 20, 2015 DOL sent Mary a letter to see if she wanted to file a claim for wage loss.
  • On January 27, 2015 Mary's AR submitted a doctor's letter for her impairment rating for a 96% impairment.
  • On January 29, 2015 Mary was sent a check for some travel expenses and previously paid medications.
  • On January 30, 2015 DOL sent an undated letter, postmarked 1/30/15, ordering Mary to attend a second opinion doctor appointment or her claim would be closed.  The letter referenced forms being enclosed which were not enclosed.  Mary's AR called the national office and pointed out that it was not unreasonable for someone with a 96% impairment rating to need home health care.  The appointment was canceled but the letter put Mary and her family through a lot of stress.
  • On February 5, Mary was sent an additional check.
  • On February 9, 2015 following a call from Mary's claims examiner Mary temporarily requested that her wage loss claim be closed so the impairment claim could progress faster.
  • On February 10, 2015 DOL sent a letter verifying Mary's covered consequential conditions based on the letters from the doctor who did the impairment rating.
  • On February 11, 2015 DOL issued a recommended decision for a 96 % impairment rating.  The recommended decision contained errors but the pertinent facts were correct.
  • On February 12, Mary was sent an additional check.
  • On March 2, Mary was sent an additional check.
  • On March 3, 2015 Mary's AR submitted another batch of medical reimbursement claims through the Portsmouth Resource Center. Some of these claims were returned because the form-1500 was not available.  Since the Resource Center can only submit reimbursement claims if the 1500 is attached it was no longer possible to submit the claims through the Resource Center.
  • On March 6, 2015 DOL issued a final decision on Mary's impairment rating claim.
  • On April 9, Mary received her impairment rating compensation.
  • On April 20, 2015 ACS requested a duplicate of a form Mary's AR had already submitted.  The AR resubmitted it.
  • On April 21, 2015 Mary requested that her wage loss claim be reopened.
  • On April 25, 2015 Mary's AR wrote the claims examiner to clarify Mary's consequential conditions since ACS was not paying for medications for some of the covered conditions.
  • On April 28, 2015 DOL contacted Mary's Home Health Care company to request pre-authorization to continue her approved home health care services.
  • On April 30, Mary was sent an additional check.
  • On May 8, 2015 Mary's AR submitted another batch of paid medical expenses for reimbursement.
  • On May 26, 2015 Mary's AR submitted another batch of paid medical expenses for reimbursement.
  • On June 4, Mary was sent an additional check.
  • On June 18, 2015 DOL sent Mary a letter approving her home health care for 6 months.
  • On June 25, 2015 DOL denied reimbursement for companion services while Mary was still in assisted living because they thought she was receiving services from two agencies.
  • At the end of June 2015 Mary's AR got a call from the DEEOIC fiscal office asking for clarification on a charge for home health care while Mary was still in assisted living.  DOL had the wrong start date. The call concluded with the request that the AR submit the charges again and assured her they would be quickly paid.
  • On June 29, 2015 the AR resubmitted the charges.
  • On July 1, 2015 the AR submitted additional medical expenses for reimbursement.
  • On July 3, the AR submitted additional medical expenses for reimbursement.
  • On July 6, the AR resubmitted the pharmacy expenses that ACS had erroneously denied.
  • On July 23 Mary was sent an additional check.
  • On July 27, 2015 DOL issued a recommended decision that Mary receive compensation for wage loss.  The first copy had someone else's name and facility worked in on it.  A correction was issued.
  • Only July 30, 2015 DOL requested additional documentation of Mary's assisted living charges.
  • On August 28 the AR submitted additional medical bills for reimbursement including a signed statement from her pharmacy of medications.
  • On September 10, Mary was sent an additional check.
  • On September 19 the AR submitted additional  medical bills for reimbursement.
  • In early November the AR noticed that around $30,000 in medical bills which had been submitted for reimbursement had not been denied or paid by ACS.  They were just ignored.  The problem was reported to DOL who gave Mary an additional year to get all the medical bills submitted/resubmitted.
  • On October 7, 2015 DOL sent Mary's AR a letter documenting Mary's consequential conditions.
  • On November 5, Mary was sent an additional check.
  • On November 19, these ignored bills were resubmitted along with some additional reimbursement requests.
  • On December 10, Mary was sent an additional check.
  • On December 10, 2015 ACS sent Mary a form letter requesting additional information.
  • On December 17, Mary was sent an additional check.
  • On December 28, the AR submitted additional medical bills along with resubmissions.
  • 2016:

  • On January 21, 2016 Mary was sent an additional check. 
  • On February 8, 2016 Mary's AR submitted additional medical bills for reimbursement.
  • A review on February 9 showed that over $25,000 in medical bills submitted for reimbursement between March 3, 2015 and November 28, 2015 had never been entered into the ACS system. This means these bills were not even considered for payment or denial.
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     Photos courtesy of DOE and Library of Congress