20 CFR Part 30
PART 30—CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED
- PART 30—CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED
- Chapter I—Office of Workers' Compensation Programs, Department of Labor › Subchapter C—Energy Employees Occupational Illness Compensation Program Act of 2000
- Subpart A—General Provisions
- Introduction
- § 30.0 What are the provisions of EEOICPA, in general?
- § 30.1 What rules govern the administration of EEOICPA and this chapter?
- § 30.2 In general, how have the tasks associated with the administration of EEOICPA claims process been assigned?
- § 30.3 What do these regulations contain?
- Definitions
- § 30.5 What are the definitions used in this part?
- Information in Program Records
- § 30.10 Are all OWCP records relating to claims filed under EEOICPA considered confidential?
- § 30.11 Who maintains custody and control of claim records?
- § 30.12 What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?
- Rights and Penalties
- § 30.15 May EEOICPA benefits be assigned, transferred or garnished?
- § 30.16 What penalties may be imposed in connection with a claim under the Act?
- § 30.17 Is a beneficiary who defrauds the government in connection with a claim for EEOICPA benefits still entitled to those benefits?
- Subpart B—Filing Claims; Evidence and Burden of Proof; Special Procedures for Certain Cancer Claims
- Filing Claims for Benefits Under EEOICPA
- § 30.100 In general, how does an employee file an initial claim for benefits?
- § 30.101 In general, how is a survivor's claim filed?
- § 30.102 In general, how does an employee file a claim for additional impairment or wage-loss under Part E of EEOICPA?
- § 30.103 How does a claimant make sure that OWCP has the evidence necessary to process the claim?
- Verification of Alleged Employment
- § 30.105 What must DOE do after an employee or survivor files a claim?
- § 30.106 Can OWCP request employment verification from other sources?
- Evidence and Burden of Proof
- § 30.110 Who is entitled to compensation under the Act?
- § 30.111 What is the claimant's responsibility with respect to burden of proof, production of documents, presumptions, and affidavits?
- § 30.112 What kind of evidence is needed to establish covered employment and how will that evidence be evaluated?
- § 30.113 What are the requirements for written medical documentation, contemporaneous records, and other records or documents?
- § 30.114 What kind of evidence is needed to establish a compensable medical condition and how will that evidence be evaluated?
- Special Procedures for Certain Radiogenic Cancer Claims
- § 30.115 For those radiogenic cancer claims that do not seek benefits under Part B of the Act pursuant to the Special Exposure Cohort provisions, what will OWCP do once it determines that an employee contracted cancer?
- Subpart C—Eligibility Criteria
- General Provisions
- § 30.200 What is the scope of this subpart?
- Eligibility Criteria for Claims Relating to Covered Beryllium Illness Under Part B of EEOICPA
- § 30.205 What are the criteria for eligibility for benefits relating to beryllium illnesses covered under Part B of EEOICPA?
- § 30.206 How does a claimant prove that the employee was a “covered beryllium employee” exposed to beryllium dust, particles or vapor in the performance of duty?
- § 30.207 How does a claimant prove a diagnosis of a beryllium disease covered under Part B?
- Eligibility Criteria for Claims Relating to Radiogenic Cancer Under Parts B and E of EEOICPA
- § 30.210 What are the criteria for eligibility for benefits relating to radiogenic cancer?
- § 30.211 How does a claimant establish that the employee has or had contracted cancer?
- § 30.212 How does a claimant establish that the employee contracted cancer after beginning employment at a DOE facility, an atomic weapons employer facility or a RECA section 5 facility?
- § 30.213 How does a claimant establish that the radiogenic cancer was at least as likely as not related to employment at the DOE facility, the atomic weapons employer facility, or the RECA section 5 facility?
- § 30.214 How does a claimant establish that the employee is a member of the Special Exposure Cohort?
- § 30.215 How does a claimant establish that the employee has sustained an injury, illness, impairment or disease as a consequence of a diagnosed cancer?
- Eligibility Criteria for Claims Relating to Chronic Silicosis Under Part B of EEOICPA
- § 30.220 What are the criteria for eligibility for benefits relating to chronic silicosis?
- § 30.221 How does a claimant prove exposure to silica in the performance of duty?
- § 30.222 How does a claimant establish that the employee has been diagnosed with chronic silicosis or has sustained a consequential injury, illness, impairment or disease?
- Eligibility Criteria for Certain Uranium Employees Under Part B of EEOICPA
- § 30.225 What are the criteria for eligibility for benefits under Part B of EEOICPA for certain uranium employees?
- § 30.226 How does a claimant establish that a covered uranium employee has sustained a consequential injury, illness, impairment or disease?
- Eligibility Criteria for Other Claims Under Part E of EEOICPA
- § 30.230 What are the criteria necessary to establish that an employee contracted a covered illness under Part E of EEOICPA?
- § 30.231 How does a claimant prove employment-related exposure to a toxic substance at a DOE facility or a RECA section 5 facility?
- § 30.232 How does a claimant establish that the employee has been diagnosed with a covered illness, or sustained an injury, illness, impairment or disease as a consequence of a covered illness?
- Subpart D—Adjudicatory Process
- General Provisions
- § 30.300 What administrative process will OWCP use to decide claims for entitlement, and how can claimants obtain judicial review of final decisions on their claims?
- § 30.301 May subpoenas be issued for witnesses and documents in connection with a claim under Part B of EEOICPA?
- § 30.302 Who pays the costs associated with subpoenas?
- § 30.303 What information may OWCP request in connection with a claim under Part E of EEOICPA?
- Recommended Decisions on Claims
- § 30.305 How does OWCP determine entitlement to EEOICPA compensation?
- § 30.306 What does the recommended decision include?
- § 30.307 Can one recommended decision address the entitlement of multiple claimants?
- § 30.308 To whom is the recommended decision sent?
- Hearings and Final Decisions on Claims
- § 30.310 What must the claimant do if he or she objects to the recommended decision or wants to request a hearing?
- § 30.311 What happens if the claimant does not object to the recommended decision or request a hearing within 60 days?
- § 30.312 What will the FAB do if the claimant objects to the recommended decision but does not request a hearing?
- § 30.313 How is a review of the written record conducted?
- § 30.314 How is a hearing conducted?
- § 30.315 May a claimant postpone a hearing?
- § 30.316 How does the FAB issue a final decision on a claim?
- § 30.317 Can the FAB request a further response from the claimant or return a claim to the district office?
- § 30.318 How will FAB consider objections to NIOSH's reconstruction of a radiation dose, or to OWCP's calculation of the recommended probability of causation, in a Part B claim for radiogenic cancer?
- § 30.319 May a claimant request reconsideration of a final decision of the FAB?
- Reopening Claims
- § 30.320 Can a claim be reopened after the FAB has issued a final decision?
- Subpart E—Medical and Related Benefits
- Medical Treatment and Related Issues
- § 30.400 What are the basic rules for obtaining medical treatment?
- § 30.401 What are the special rules for the services of chiropractors?
- § 30.402 What are the special rules for the services of clinical psychologists?
- § 30.403 Will OWCP pay for home health care, nursing home, and assisted living services?
- § 30.404 Will OWCP pay for transportation to obtain medical treatment?
- § 30.405 After selecting a treating physician, may an employee choose to be treated by another physician instead?
- § 30.406 Are there any exceptions to these procedures for obtaining medical care?
- Directed Medical Examinations
- § 30.410 Can OWCP require an employee to be examined by another physician?
- § 30.411 What happens if the opinion of the physician selected by OWCP differs from the opinion of the physician selected by the employee?
- § 30.412 Who pays for second opinion and referee examinations?
- Medical Reports
- § 30.415 What are the requirements for medical reports?
- § 30.416 How and when should medical reports be submitted?
- § 30.417 What additional medical information may OWCP require to support continuing payment of benefits?
- Medical Bills
- § 30.420 How should medical bills and reimbursement requests be submitted?
- § 30.421 What are the time frames for submitting bills and reimbursement requests?
- § 30.422 If an employee is only partially reimbursed for a medical expense, must the provider refund the balance of the amount paid to the employee?
- Subpart F—Survivors; Payments and Offsets; Overpayments
- Survivors
- § 30.500 What special statutory definitions apply to survivors under EEOICPA?
- § 30.501 What order of precedence will OWCP use to determine which survivors are entitled to receive compensation under EEOICPA?
- § 30.502 When is entitlement for survivors determined for purposes of EEOICPA?
- Payment of Claims and Offset for Certain Payments
- § 30.505 What procedures will OWCP follow before it pays any compensation?
- § 30.506 To whom and in what manner will OWCP pay compensation?
- § 30.507 What compensation will be provided to covered Part B employees who only establish beryllium sensitivity under Part B of EEOICPA?
- § 30.508 What is beryllium sensitivity monitoring?
- § 30.509 Under what circumstances may a survivor claiming under Part E of the Act choose to receive the benefits that would otherwise be payable to a covered Part E employee who is deceased?
- Overpayments
- § 30.510 How does OWCP notify an individual of a payment made on a claim?
- § 30.511 What is an “overpayment” for purposes of EEOICPA?
- § 30.512 What does OWCP do when an overpayment is identified?
- § 30.513 Under what circumstances may OWCP waive recovery of an overpayment?
- § 30.514 If OWCP finds that the recipient of an overpayment was not at fault, what criteria are used to decide whether to waive recovery of it?
- § 30.515 Is a recipient responsible for an overpayment that resulted from an error made by OWCP?
- § 30.516 Under what circumstances would recovery of an overpayment defeat the purpose of the Act?
- § 30.517 Under what circumstances would recovery of an overpayment be against equity and good conscience?
- § 30.518 Can OWCP require the recipient of the overpayment to submit additional financial information?
- § 30.519 How does OWCP communicate its final decision concerning recovery of an overpayment?
- § 30.520 How are overpayments collected?
- Subpart G—Special Provisions
- Representation
- § 30.600 May a claimant designate a representative?
- § 30.601 Who may serve as a representative?
- § 30.602 Who is responsible for paying the representative's fee?
- § 30.603 Are there any limitations on what the representative may charge the claimant for his or her services?
- Third Party Liability
- § 30.605 What rights does the United States have upon payment of compensation under EEOICPA?
- § 30.606 Under what circumstances must a recovery of money or other property in connection with an illness for which benefits are payable under EEOICPA be reported to OWCP?
- § 30.607 How is a structured settlement (that is, a settlement providing for receipt of funds over a specified period of time) treated for purposes of reporting the recovery?
- § 30.608 How does the United States calculate the amount to which it is subrogated?
- § 30.609 Is a settlement or judgment received as a result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that must be reported to OWCP?
- § 30.610 Are payments to a covered Part B employee, a covered Part E employee or an eligible surviving beneficiary as a result of an insurance policy which the employee or eligible surviving beneficiary has purchased a recovery that must be reported to OWCP?
- § 30.611 If a settlement or judgment is received for more than one medical condition, can the amount paid on a single EEOICPA claim be attributed to different conditions for purposes of calculating the amount to which the United States is subrogated?
- Effect of Tort Suits Against Beryllium Vendors and Atomic Weapons Employers
- § 30.615 What type of tort suits filed against beryllium vendors or atomic weapons employers may disqualify certain claimants from receiving benefits under Part B of EEOICPA?
- § 30.616 What happens if this type of tort suit was filed prior to October 30, 2000?
- § 30.617 What happens if this type of tort suit was filed during the period from October 30, 2000 through December 28, 2001?
- § 30.618 What happens if this type of tort suit was filed after December 28, 2001?
- § 30.619 Do all the parties to this type of tort suit have to take these actions?
- § 30.620 How will OWCP ascertain whether a claimant filed this type of tort suit and if he or she has been disqualified from receiving any benefits under Part B of EEOICPA?
- Coordination of Part E Benefits With State Workers' Compensation Benefits
- § 30.625 What does “coordination of benefits” mean under Part E of EEOICPA?
- § 30.626 How will OWCP coordinate compensation payable under Part E of EEOICPA with benefits from state workers' compensation programs?
- § 30.627 Under what circumstances will OWCP waive the statutory requirement to coordinate these benefits?
- Subpart H—Information for Medical Providers
- Medical Records and Bills
- § 30.700 In general, what responsibilities do providers have with respect to enrolling with OWCP, seeking authorization to provide services, billing, and retaining medical records?
- § 30.701 How are medical bills to be submitted?
- § 30.702 How should an employee prepare and submit requests for reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses?
- § 30.703 What are the time limitations on OWCP's payment of bills?
- Medical Fee Schedule
- § 30.705 What services are covered by the OWCP fee schedule?
- § 30.706 How are the maximum fees for professional medical services defined?
- § 30.707 How are payments to providers calculated?
- § 30.708 Does the fee schedule apply to every kind of procedure?
- § 30.709 How are payments for medicinal drugs determined?
- § 30.710 How are payments for inpatient medical services determined?
- § 30.711 How are payments for outpatient medical services determined?
- § 30.712 When and how are fees reduced?
- § 30.713 If OWCP reduces a fee, may a provider request reconsideration of the reduction?
- § 30.714 If OWCP reduces a fee, may a provider bill the employee for the balance?
- Exclusion of Providers
- § 30.715 What are the grounds for excluding a provider from payment under this part?
- § 30.716 What will cause OWCP to automatically exclude a physician or other provider of medical services and supplies?
- § 30.717 When are OWCP's exclusion procedures initiated?
- § 30.718 How is a provider notified of OWCP's intent to exclude him or her?
- § 30.719 What requirements must the provider's response and OWCP's decision meet?
- § 30.720 How can an excluded provider request a hearing?
- § 30.721 How are hearings assigned and scheduled?
- § 30.722 How are subpoenas or advisory opinions obtained?
- § 30.723 How will the administrative law judge conduct the hearing and issue the recommended decision?
- § 30.724 How does a recommended decision become final?
- § 30.725 What are the effects of non-automatic exclusion?
- § 30.726 How can an excluded provider be reinstated?
- Subpart I—Wage-Loss Determinations Under Part E of EEOICPA
- General Provisions
- § 30.800 What types of wage-loss are compensable under Part E of EEOICPA?
- § 30.801 What special definitions does OWCP use in connection with Part E wage-loss determinations?
- Evidence of Wage-Loss
- § 30.805 What are the criteria for eligibility for wage-loss benefits under Part E?
- § 30.806 What kind of medical evidence must the claimant submit to prove that he or she lost wages due to a covered illness?
- § 30.807 What factual evidence does OWCP use to determine a covered Part E employee's average annual wage?
- Determinations of Average Annual Wage and Percentages of Loss
- § 30.810 How will OWCP calculate the average annual wage of a covered Part E employee?
- § 30.811 How will OWCP calculate the duration and extent of a covered Part E employee's initial period of compensable wage-loss?
- § 30.812 May a covered Part E employee claim for subsequent periods of compensable wage-loss?
- Special Rules for Certain Survivor Claims Under Part E of EEOICPA
- § 30.815 Are there special rules that OWCP will use to determine the extent of a deceased covered Part E employee's compensable wage-loss?
- Subpart J—Impairment Benefits Under Part E of EEOICPA
- General Provisions
- § 30.900 Who can receive impairment benefits under Part E?
- § 30.901 How does OWCP determine the extent of an employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at a DOE facility or a RECA section 5 facility, as appropriate?
- § 30.902 How will OWCP calculate the amount of the award of impairment benefits that is payable under Part E?
- Medical Evidence of Impairment
- § 30.905 How may an impairment evaluation be obtained?
- § 30.906 Who will pay for an impairment evaluation?
- § 30.907 Can an impairment evaluation obtained by OWCP be challenged prior to issuance of the recommended decision?
- § 30.908 How will the FAB evaluate new medical evidence submitted to challenge the impairment determination in the recommended decision?
- Ratable Impairments
- § 30.910 Will an impairment that cannot be assigned a numerical percentage using the AMA's Guides be included in the impairment rating?
- § 30.911 Does maximum medical improvement always have to be reached for an impairment to be included in the impairment rating?
- § 30.912 Can a covered Part E employee receive benefits for additional impairment following an award of such benefits by OWCP?
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