106TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 106–697

RADIATION EXPOSURE COMPENSATION ACT

AMENDMENTS OF 1999

JUNE 26, 2000.—Committed to the Committee of the Whole House on the State of

the Union and ordered to be printed

Mr. HYDE, from the Committee on the Judiciary,

submitted the following

R E P O R T

[To accompany S. 1515]

[Including cost estimate of the Congressional Budget Office]

The Committee on the Judiciary, to whom was referred the bill

(S. 1515) amending the Radiation Exposure Compensation Act, and

for other purposes, having considered the same, reports favorably

thereon with technical amendments and recommends that the bill

as amended do pass.

TABLE OF CONTENTS

Page

The Amendment ......................................................................................... 2

Purpose and Summary .............................................................................. 2

Background and Need for the Legislation ................................................ 2

Hearings ...................................................................................................... 8

Committee Consideration .......................................................................... 8

Committee Oversight Findings ................................................................. 8

Committee on Government Reform Findings .......................................... 8

New Budget Authority and Tax Expenditures ........................................ 8

Congressional Budget Office Cost Estimate ............................................ 8

Constitutional Authority Statement ......................................................... 13

Section-by-Section Analysis and Discussion ............................................ 13

Agency Views .............................................................................................. 17

Changes in Existing Law Made by the Bill, as Reported ....................... 19

2

The technical amendments (stated in terms of the page and

line numbers of the reported bill) are as follows:

Strike ‘‘1999’’ each place it appears and insert ‘‘2000’’.

Page 9, line 24, insert ‘‘and’’ after ‘‘ ‘corpulmonale’ ’’.

Page 10, line 4, strike ‘‘pneumoconiosis’; and’’ and insert ‘‘pneumoconiosis;’’.

Page 10, strike lines 6 and 7.

PURPOSE AND SUMMARY

S. 1515, ‘‘The Radiation Exposure Compensation Act Amendments of 1999’’ updates the 1990 law that currently compensates

individuals exposed to radiation from either being downwind of a

nuclear test blast or involved in the mining of uranium ore during

the Cold War. Uranium is used by our Government in the production of nuclear weapons. This legislation increases the number of

radiogenic and chronic diseases compensable under the Act. The

bill also increases the number of individuals and States eligible for

compensation based on scientific and medical information gathered

over the past decade.

BACKGROUND AND NEED FOR THE LEGISLATION

During the 1980’s, large bodies of evidence were presented before

Congress, documenting two groups of individuals who had been directly harmed by the failure of the Federal Government to take

necessary precautions during the planning, experimentation and

execution of the government’s program to create a nuclear arsenal.

The first group were either present at the atomic test sites in Nevada during the 1950’s and early 1960’s when above-ground nuclear tests were performed, or were ‘‘downwind’’ of the test sites

and were bombarded by radioactive fallout. These individuals developed a variety of diseases caused by radiation, primarily cancers. Prior to 1990, Commissions on the Biological Effects of Ionizing Radiation (BEIR) had issued three reports, which were used

to define cancers that arose at higher numbers among members of

these groups than among individuals exposed to only normal background radiation. A standard of proof was established by which individuals deemed eligible for compensation had to demonstrate

that they were in specified locations during the specific time periods of nuclear fallout, and that they contracted specified diseases.

This burden of proof became the basis for the 1990 legislation,

which instructed the Department of Justice (DOJ) to administer

the Radition Exposure Compensation Program (RECP) to aid in the

compensation of eligible individuals. In brief, individuals who were

present in specified counties of Utah, Nevada, Colorado, and New

Mexico from January 21, 1951, to October 31, 1958, or from June

30, 1962, to July 31, 1962, and could provide medical documentation to support the basis of disease as defined in the Act, are eligible for $50,000 if they were downwind from a test site or $75,000

if they were an on-site participant during the atomic testing.

In addition, the Radiation Exposure Compensation Act (RECA) of

1990 offered compassionate compensation in the amount of

$100,000 to underground uranium miners who extracted the uranium/vanadium radioactive ore, which was the primary fuel source

for the atomic bombs. The U.S. government purchased ore and

3

1Faden, R.R. (Chair) Advisory Committee on Human Radiation Experiments. October 1995,

p. 565. 2 Ibid. p.569.

3John N. Begay v. United States, 591 F. Supp. 991 (1984). 4Op.Cit. Advisory Committee on Human Radiation Experiments. October 1995, p. 577.

sponsored mining operations from 1942 through 1971. During the

early portion of this period, few attempts were made to forewarn

or protect miners from the known dangers of exposure to radiation.

For the most part, workers were unskilled laborers, often of Native

American heritage, who were unaware of the potential health hazards of working in and around the uranium mines. The radioactive

dust and subsequent exposure to radioactive particles (radium and

radon gas) has been recognized as a cause of disease, particularly

of lung diseases and cancers for decades. Information from studies

of mines outside the U.S. documented carcinogenic rates of about

1 percent per year of lung carcinoma among uranium mine workers

(10,000 times normal) and that approximately 70 percent of all

deaths of mine workers were due to primary cancer of the respiratory system 1. In August 1949, the Public Health Service (PHS)

was commissioned to study the effects of exposure to radiation on

mine workers. It concluded that there was not enough information

known on the potential health hazards from radiation in the uranium mining and milling industry 2. In 1950, a PHS study of uranium mines began epidemiological studies and general physical examinations (including chest x-rays and blood and urine analyses)

of on-site participants to determine the relationship between exposures to radioactivity and the biological effects on the miners. During the course of a decade, consensual studies were performed on

miners who were told that the examinations were part of a study

of the health of uranium miners. It was not until 1964/1965 that

the results of these studies and the Federal guidelines were established for the conduct of federally-funded research projects involving radioactive substances. On July 27, 1967, the President approved the Federal Regulatory Commission’s proposal (Tr. 1555–

1559; Def.Ex. 414; 507) for a uniform Federal radiation standard

for underground uranium mines. By 1970, the regulations concerning the safety procedures that were to be maintained in mining

were in place. In 1979, in Begay et al., and Anderson, et al., suits

were filed against the United States of America on behalf of Navajo

uranium miners asserting various negligence claims arising from

decisions of the Federal Government in the 1940’s through the

1960’s with respect to safety in uranium mines sponsored by the

U.S. In a 1984 decision, the U.S. District Court in Arizona dismissed the suits ruling that there was no subject-matter jurisdiction to proceed since the alleged acts and omissions of government

officials were shielded from tort liability by the discretionary function exception to the Federal Tort Claims Act 3. In Begay v. United

States the court highlighted several pieces of information that had

not been analyzed in public prior to the court hearing and ‘‘concluded that the plight of the uranium miners calls for redress.’’ 4

The evidence was used as the basis for hearings held by the Congress in 1987–1989 that laid the groundwork for RECA. The Radiation Exposure Compensation Act of 1990 was signed into law on

October 15, 1990 as Public Law 101–426.

4

5The National Research Council’s Committees on the Biological Effects of Ionizing Radiation

(BIER) have prepared a series of reports to advise the U.S. government on the health consequences of radiation exposure. The committee may be convened at the request of the Office

of Science and Technology Policy to conduct a comprehensive review of the biological effects of

ionizing radiation focusing on specific elements of interest.

After the passage of RECA in 1990 and the implementation of

the Department of Justice’s regulations in 1992, complaints began

to be registered with congressional offices. The major complaints

fell into three categories which became the basis for the amendments contained in S. 1515. The first complaint was over the limited number of diseases for the basis for compensation under the

Act and those diseases being so narrowly defined that many people

are excluded. The second complaint was over narrow or

hypertechnical constructions of the DOJ regulations that imposed

limitations on individuals never intended by Congress. Third, complaints were registered from numerous individuals and groups concerning the exclusion of other workers involved in the mining of

uranium. Over the past decade there were also complaints about

DOJ delay in the processing of claims (Delays were also often

caused by the work of lawyers representing applicants who file incomplete or inaccurate claims). Congressional review of the situation has found that, by and large, the Program has been administered as well as could be expected given budget constraints. Frustrations, disappointments and perceived injustices have resulted

from either lack of statutory coverage or from a perceived lack of

compassion in the administration of the Program. S. 1515 attempts

to broaden the covered individuals and diseases while giving the

DOJ greater latitude to implement the Program.

Presently, RECA 1990 sets forth a list of 13 ‘‘compensable diseases’’ that form the basis for compensation for downwinders who

resided in specific geographical areas within specific times during

nuclear tests. RECA’s list of compensable diseases was originally

designed to mirror the diseases covered under the Radiation Exposed Veterans Compensation Act of 1988 (REVCA), which provides for compassionate compensation for service-based radiation

exposure. The 13 diseases covered under RECA and REVCA were

based on the findings of the 1980 report of the Commission on the

Biological Effects of Ionizing Radiation (BIER).5 Late in 1990, after

the passage of RECA into law, the BIER V report was released providing a great deal of additional information on which cancers

could truly be deemed as radiogenic. Commissioned by the Office

of Science and Technology Policy’s Committee on Interagency Radiation Research and Policy Coordination (CIRRPC) of the National

Research Council, the expert panel provided a detailed summary of

the current understanding of radiation-induced genetic effects, cellular radiobiology and carcinogenic mechanisms, radiation carcinogenesis, the effects of radiation on the fetus, and radiation epidemiology and risk modeling. The report became the principal framework by which requests were made to change RECA 1990 eligibility

requirements. A representative of the Navajo Nation (per 1993 testimony before the Senate Labor and Human Resources Committee)

and the National Association of Radiation Survivors, along with the

Department of Justice, offered recommendations for changes in the

list of compensable diseases and changes within the restrictions on

the current statutory list.

5

6Duncan C. Thomas, Ph.D., Professor and Director, Biostatistics Division, University of

Southern California School of Medicine, Los Angeles, CA. letter to from Senator Orrin G. Hatch,

July 11, 1997.

In 1995, the President’s Advisory Committee on Human Radiation Experiments presented its report to President Clinton summarizing the experiments involving human subjects and ionizing

radiation conducted from 1944 through 1974. Chapter 18 of the report dealt specifically with considerations of the uranium miners’

and downwinders’ exposure. The report offered specific recommendations with respect to: lowering the stringent requirements

for compensation of exposed miners; eliminating the distinction between smokers and non-smokers in any amendments to RECA

1990; and using length of employment instead of exposure levels to

verify miner eligibility requirements. The suggestions were supported by the President’s Advisory Committee’s finding that no exposure measurements are available for 90 percent of the years covered for government-sponsored mines and that the extrapolation

used to calculate ‘‘reconstructed exposure times’’ are quite uncertain. Furthermore, the President’s Advisory Committee found that

statutory requirement for 200 Working Level Months (WLM) was

far in excess of the ‘‘probability of causation’’ and, that if these criteria were to remain, it should be lowered.

In 1997, at the request of Senator Orrin Hatch three experts provided specific recommendations on changes to RECA based on the

advances in medical knowledge concerning radiation induced-disease. Dr. Arthur C. Upton (Chairman, Dept. of Environmental

Medicine, New York University Medical Center and Chair of the

BEIR V Committee), Dr. John M. Samet (Professor and Chairman,

Department of Epidemiology, Johns Hopkins University and Chair

of the National Research Council) and Dr. Duncan C. Thomas (Professor, Department of Preventive Medicine, University of Southern

California, Los Angeles and member of the BIER V Committee)

recommended that the ‘‘list of compensable diseases for

downwinders be expanded to include lung, colon, brain, urinary

bladder, salivary gland and ovarian...[which] will help bring compensation restrictions into line with current scientific understanding.’’ 6 In addition, it was recommended that the following restrictions on eligibility for downwinders be eliminated based on

current scientific evidence:

1) with regard to leukemia, eliminate requirement that initial

exposure occur after the age of 20, and retain 2-year minimum latency period between first-exposure and onset of

disease, but eliminate the requirement that onset of the disease occur 30 years after first exposure;

2) with regard to primary cancer of the thyroid, eliminate exclusion for initial exposures after age 40;

3) with regard to breast cancer, eliminate exclusion for initial

exposures, and include male and female;

4) with regard to cancer of the esophagus, remove restrictions

for alcohol consumption and smoking;

5) with regard to cancer of the stomach, eliminate requirement

that initial exposure occur before age 30;

6

7 Robert Raben, Assistant Attorney General, U.S. Department of Justice, letter to Congressman Henry J. Hyde, January 24, 2000.

6) with regard to cancer of the pharynx, eliminate smoking restrictions;

7) with regard to cancer of the pancreas, eliminate smoking

and coffee consumption restrictions; and

8) with regard to cancer of the liver, remove restrictions related to cirrhosis and hepatitis B.

The experts also supported reducing the exposure threshold for

uranium miners to approximately 40 WLM or using a 1-year minimum duration of employment criteria for millers. Drs. Samet and

Thomas recommended extending the uranium miners’ provision regarding compensation for non-malignant respiratory diseases to all

former uranium miners (not just those who worked in mines on an

Indian reservation.)

In a letter dated January 24, 2000, Robert Raben, Assistant Attorney General, U.S. Department of Justice wrote to the Judiciary

Committee with the views of that Department on S. 1515. The Department of Justice had been actively involved in drafting many of

the amendments to RECA 1990 and supports many of the provisions offered in S. 1515. The Department supports:

1. the extension of compensation for silicosis or pneumoconomiosis to all eligible claimants (previously limited only to

miners employed on an Indian reservation);

2. the inclusion of in situ lung cancers for compensation;

3. the use of pathology reports of tissue biopsies as supportive

medical documentation for establishing a non-malignant

respiratory disease or lung cancer;

4. the use of written affidavits by a personal physician as evidence of a disease state;

5. the use of affidavits to substantiate employment history for

purposes of determining working levels months of exposure;

and

6. the ability to use Native American law, tradition, and custom with respect to the submission and processing of claims

filed by Native Americans.

In the January 24, 2000 letter, three significant concerns were

raised which have been addressed in S. 1515.

First, the Department believed that expanding compensation to

include uranium millers and ore transporters was premature and

should await the results of a National Institute of Occupational

Safety and Health (NIOSH) study commissioned by Congress in

1993. The letter states that this ‘‘ongoing study promises to offer

meaningful information concerning the health effects of radiation

on uranium millers.’’ 7 This committee believes that S. 1515 should

not be delayed to await a study that may never be completed. This

study, commissioned in 1993, was to be completed within 2 years.

Whatever the cause for its delay, the report is not finished, no preliminary data are available, and an exact date of completion has

yet to be established. Furthermore, given the extremely small

groups of millers being studied, it is projected that the data will

have limited statistical significance and will therefore be merely

7

anecdotal in nature. It is deemed unnecessary and cruel to tell victims awaiting compensation, some near death, to wait for a study

that may never come or may be inadequate. S. 1515, well-grounded

in scientific principles, represents an intent to apologize and offer

compassionate compensation to an expanded list of individuals who

were not included in the 1990 Act but who, nonetheless, deserve

restitution.

The Department objected to the expansion of downwinder’s areas

to regions not defined by the National Cancer Institute (NCI). However, the NCI has no studies ongoing specifically monitoring the

downwinders’ cancer epidemiology. To ignore the written and personal testimonies of the hundreds of victims themselves or survivors concerning their illnesses is unwarranted. The strong evidence they have supplied is sufficient to provide relief.

The Department of Justice objected to lowering the radiation exposure threshold requirements for uranium miners to 40 Working

Level Months and the imposition of a 1-year duration of employment requirement for millers and transport workers. The Department argues that ‘‘no single exposure figure is appropriate to establish a point at which it is more likely than not that all uranium

miners’ exposure was the cause of subsequent lung disease.’’ The

Department statement argues that, even the current level of exposure, imposed in RECA 1990, of 200 WLMs is insufficient to warrant compensation. Based upon the thousands of individuals who

have been denied compensation because of inaccurately counted

WLMs and the testimony of experts in radiation oncology mentioned earlier in this report, the committee determined that a level

of 40 WLMs was an appropriate resolution between abolishing the

exposure limits and the current standard. The Department’s letter

states that ‘‘ignoring the relative risk variables and compensation

criteria that the RECA Committee’s scientists determined were

‘significant’ fails to demonstrate a sound, scientifically-based approach.’’ DOJ has suggested the implementation of a multi-scale

criteria using either the exposure-based or duration of employment

models. These models involve computing the WLMs, age, time since

exposure, smoking habits, and other factors for each individual

prior to evaluating the disease status of the claimant. The major

objection to such an approach is that for the vast majority of claimants, data will be incomplete (e.g. a worker might have a WLM

value but no documentation of smoking habits). Many workers in

the 1940’s, 50’s, and early 60’s worked in loosely regulated mines

or for mines whose records are no longer accessible or interpretable. To impose additional levels of proof onto an already burdensome claims process under such circumstances does not further the

intent of Congress to provide expanded relief.

In conclusion, S. 1515 addresses the problems that have been

identified in the last 10 years with the Act’s applicability to uranium miners and other individuals.

The committee wishes to recognizes the tireless efforts of the late

Mr. Paul Hicks on behalf of those who served in the uranium

mines and mills throughout the nation. Mr. Hicks fought passionately to improve upon the Radiation Exposure Compensation Act.

The result of his efforts, and those of the Navajo Nation and countless others, is the Radiation Exposure Compensation Act Amendments of 1999.’’

8

HEARINGS

The committee’s Subcommittee on Immigration and Claims held

a June 25, 1998, hearing on H.R. 3539, a similar measure introduced in the 105th Congress. Testimony was received from Honorable Bill Redmond; Donald M. Remy, Deputy Assistant Attorney

General, Civil Division, Department of Justice; Lawrence J. Fine,

M.D., Dr. P.H., Director, Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety

and Health, Center for Disease Control and Prevention, Department of Health and Human Services; Dr. David Coultos, Health

Science Center, University of New Mexico; Dr. Susan E. Dawson,

Department of Sociology, Utah State University, accompanied by

Dr. Gary E. Madsen, Utah State University; Mr. Paul Robinson,

S.W. Research & Information Center; Honorable Thomas Atcitty,

President, The Navajo Nation, accompanied by George Arthur,

Counsel Delegate, Navajo National Counsel, and E. Cooper Brown,

Esquire; Honorable Roland Johnson, Governor, Pueblo of Laguna,

accompanied by Tribal Councilman Larry Lente; Honorable Reginald Pascual, Governor, Pueblo of Acoma, accompanied by Tribal

Councilman David Villo; Mr. Paul Hicks, New Mexico Uranium

Workers Council, accompanied by Kevin Martinez, Esquire; Earl

Chavez, Chairman, Cibola County Commission; and Curtis Freeman, Utah Uranium Workers Council with additional material submitted by the Honorable Jeff Bingaman; the Honorable Chris Cannon; and Brandon Reed.

COMMITTEE CONSIDERATION

On May 24, 2000, the committee met in open session and ordered

favorably reported the bill S. 1515 without amendment by voice

vote, a quorum being present.

COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII of the Rules of the

House of Representatives, the committee reports that the findings

and recommendations of the committee, based on oversight activities under clause 2(b)(1) of rule X of the Rules of the House of Representatives, are incorporated in the descriptive portions of this report.

COMMITTEE ON GOVERNMENT REFORM FINDINGS

No findings or recommendations of the Committee on Government Reform were received as referred to in clause 3(c)(4) of rule

XIII of the Rules of the House of Representatives.

NEW BUDGET AUTHORITY AND TAX EXPENDITURES

Clause 3(c)(2) of House Rule XIII is inapplicable because this legislation does not provide new budgetary authority or increased tax

expenditures.

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

In compliance with clause 3(c)(3) of rule XIII of the Rules of the

House of Representatives, the committee sets forth, with respect to

9

the bill, S. 1515, the following estimate and comparison prepared

by the Director of the Congressional Budget Office under section

402 of the Congressional Budget Act of 1974:

U.S. CONGRESS,

CONGRESSIONAL BUDGET OFFICE,

Washington, DC, May 31, 2000.

Hon. HENRY J. HYDE, Chairman,

Committee on the Judiciary,

House of Representatives, Washington, DC.

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for S. 1515, the Radiation Exposure Compensation Act Amendments of 1999.

If you wish further details on this estimate, we will be pleased

to provide them. The CBO staff contacts are Cynthia Dudzinski (for

costs to the Department of Health and Human Services), who can

be reached at 226–9010; Mark Grabowicz (for all other federal

costs), who can be reached at 226–2860; Lisa Cash Driskill (for the

state and local impact), who can be reached at 225–3220; and John

Harris (for the private-sector impact), who can be reached at 226–

2618.

Sincerely,

DAN L. CRIPPEN, Director.

Enclosure

cc: Honorable John Conyers Jr.

Ranking Democratic Member

S. 1515—Radiation Exposure Compensation Act Amendments of

1999.

SUMMARY

S. 1515 would broaden the population covered by the Radiation

Exposure Compensation Act, which authorizes monetary compensation to individuals who were present, or nearby when nuclear

weapons tests were conducted, or who worked in uranium mines,

and later developed certain diseases. The legislation also would authorize the appropriation of such sums as may be necessary for

each of the fiscal years 2000 through 2009 for the Department of

Health and Human Services (HHS) to make grants to states to

combat radiogenic cancers and diseases.

CBO estimates that implementing S. 1515 would result in addi- tional discretionary spending of about $750 million over the 2000–

2005 period, assuming appropriation of the necessary amounts.

About $650 million of this total would be for compensation payments to individuals for radiation exposure, and the remainder

would be spent on HHS grant programs. Because S. 1515 would

not affect direct spending or receipts, pay-as-you-go procedures

would not apply.

Current law restricts compensation for radiation exposure only to

individuals who were present in certain western states between

1947 and 1971, and who meet certain requirements relating to radiation exposure and medical conditions. S. 1515 would increase

the number of persons eligible for compensation payments, by:

• Adding more qualifying occupations relating to uranium production,

10

• Increasing the number of states covered and extending the

time period considered for radiation exposure,

• Adding more diseases which may qualify individuals for compensation,

• Decreasing the level of radiation exposure that is necessary

to qualify, and

• Making certain medical criteria less stringent for potential

claimants.

S. 1515 contains no intergovernmental mandates as defined in

the Unfunded Mandates Reform Act (UMRA) and would impose no

costs on state, local, or tribal governments. This legislation would

create a new private-sector mandate that would reduce the fees

paid to claimants’ attorneys, but CBO estimates that the total costs

of the mandate would fall below the threshold established in

UMRA ($109 million in 2000, adjusted annually for inflation).

ESTIMATED COST TO THE FEDERAL GOVERNMENT

The estimated budgetary impact of S. 1515 is shown in the following table. The costs of this legislation fall within budget functions 550 (health) and 050 (national defense).

By Fiscal Year, in Millions of Dollars

2000 2001 2002 2003 2004 2005

SPENDING SUBJECT TO APPROPRIATION

Compensation Under Current Law 1

Budget Authority/Estimated

Authorization Level 2 3 10 10 5 5 5

Estimated Outlays 12 10 10 5 5 5

Proposed Changes

Additional Radiation Exposure

Compensation

Estimated Authorization Level 0 20 120 200 200 106

Estimated Outlays 0 20 120 200 200 106

HHS Grants

Estimated Authorization Level 20 21 21 21 22 22

Estimated Outlays 1 19 23 22 21 21

Total Changes

Estimated Authorization Level 20 41 141 221 222 128

Estimated Outlays 1 39 143 222 221 127

Spending Under S. 1515

Estimated Authorization Level 23 51 151 226 227 133

Estimated Outlays 13 49 153 227 226 132

1 Over the 1991–1999 period, total appropriations of about $238 million were provided for radiation exposure compensation. 2 The 2000 level is the amount appropriated for that year. The 2001–2005 levels are CBO estimates of compensation

payments under current law for those years.

BASIS OF ESTIMATE

For this cost estimate, CBO assumes that funds will be appropriated for each fiscal year as they are needed to pay valid claims

and to provide the HHS grants.

11

Additional Radiation Exposure Compensation

CBO expects that spending authorized by S. 1515 would follow

a pattern similar to the payments authorized by the Radiation Exposure Compensation Act, but probably would occur somewhat faster because potential claimants are more familiar with the program.

Most payments probably would occur within two to four years after

enactment and virtually all payments would be made within 10

years of enactment. We estimate that compensation payments that

would be authorized by this legislation total about $650 million

over the 2000–2005 period, and an additional $200 million over the

following five years.

Uranium Miners. CBO estimates that most of the payments

under S. 1515 would be made to individuals who have worked in

underground uranium mines. Based on information from the National Institute of Occupational Safety and Health, we estimate

that there are about 20,000 former uranium miners in the United

States (some of whom may be deceased, but whose families could

receive payments). Under the Radiation Exposure Compensation

Act, about 3,000 of these miners have filed claims and about half

of them were successful. Because S. 1515 would cover more diseases that these miners may have developed and mining operations

in more states over a longer time period, CBO estimates that

roughly 1,775 additional miners would file claims for the first time

from 2000 through 2005 and that 75 percent of these claims would

be approved. In addition, we expect that most of the 1,500 miners

whose claims were previously denied would refile and that about

75 percent of these claims would be approved, resulting in a total

of about 2,500 successful claims from 2000 through 2005. CBO expects approval rates under S. 1515 to be higher than under current

law because this legislation eases the requirements for approval.

Each eligible uranium miner would be authorized to be paid

$100,000 under S. 1515. Thus, implementing these provisions

would cost about $250 million over the 2001–2005 period.

Other Groups Covered by S. 1515. Five other groups of individuals may be eligible for compensation under this act, including people who:

• Worked in uranium mills,

• Worked in above-ground uranium mines,

• Transported uranium ore from mines to mills,

• Participated in atmospheric nuclear tests conducted by the

federal government (‘‘on-site participants’’), and

• Were present in certain areas close to such tests (known as

‘‘down-winders’’).

Based on information about these groups from the Department

of Justice, CBO estimates that roughly 9,600 persons would file

claims during the 2000–2005 period, and that about 60 percent

would gain approval and receive payments of $50,000 (for downwinders), $75,000 (for on-site participants), or $100,000 (for other

individuals). CBO estimates that, in total, the other groups targeted by this legislation would be authorized to receive payments

of $400 million over the 2001–2005 period.

12

HHS Grants

S. 1515 would authorize the appropriation of funds for state programs to screen individuals for cancer, provide referrals and followup services, develop and disseminate public information for the detection, prevention, and treatment of radiogenic cancers and diseases, and assist applicants in the documentation of compensation

claims. Based on information from HHS, we estimate this work

would cost about $20 million annually.

PAY-AS-YOU-GO CONSIDERATIONS:

None.

ESTIMATED IMPACT ON STATE, LOCAL, AND TRIBAL GOVERNMENTS

S. 1515 contains no intergovernmental mandates as defined in

UMRA and could benefit state, local, and tribal governments. The

act would provide competitive grants to entities, including state

and local governments, that carry out certain programs relating to

radiation-related diseases.

ESTIMATED IMPACT ON THE PRIVATE SECTOR

S. 1515 would create a new private-sector mandate by reducing

the limit on attorneys’ fees under the Radiation Exposure Compensation Act. Current law limits attorneys’ fees to 10 percent of

the payment by the government to the claimant, but S. 1515 would

set the maximum allowable fee at 2 percent. The mandate would

primarily affect lawyers representing uranium miners and their

survivors with claims pending under current law. For a successful

claim of this type, S. 1515 could cost the miner’s attorney up to

$6,000. CBO anticipates, however, that the number of successful

claims would be quite low. The limit on fees also applies to other

types of claims under S. 1515, but because such claims are difficult

to pursue under current law costs related to them would not be significant. Consequently, the total costs of the mandate would fall

below the threshold established in UMRA ($109 million in 2000,

adjusted annually for inflation).

PREVIOUS CBO ESTIMATE

On April 5, 2000, CBO transmitted a cost estimate for S. 1515,

the Radiation Exposure Compensation Act Amendments of 1999, as

passed by the Senate on November 19, 1999. The two versions of

the legislation are identical, as are the cost estimates.

ESTIMATE PREPARED BY:

Federal Costs (Health and Human Services): Cynthia Dudzinski

(226–9010)

Federal Costs (all other costs): Mark Grabowicz (226–2860)

Impact on State, Local, and Tribal Governments: Lisa Cash

Driskill (225–3220)

Impact on the Private Sector: John Harris (226–2618)

ESTIMATE APPROVED BY:

Peter H. Fontaine

Deputy Assistant Director for Budget Analysis

13

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House

of Representatives, the committee finds the authority for this legislation in Article 1, section 8 of the Constitution.

SECTION-BY-SECTION ANALYSIS AND DISCUSSION

Section 1. Short Title

Section 1 contains the short title, the ‘‘Radiation Exposure Compensation Act Amendments of 1999.’’

Section 2. Findings

Section 2 contains the findings, purpose, and apology. A new

statement of findings is added. This new statement finds that since

the enactment of the initial Act regulatory burdens have made it

too difficult for some deserving individuals to be fairly and efficiently compensated. The findings also note the need to extend eligibility to States in which the Federal Government sponsored uranium mining and milling from 1941 to 1971, and that scientific

data has provided medical validation for the extension of compensable radiogenic diseases. The findings also add that above-ground

uranium miners, millers, and transporters of ore should be compensated in a manner similar to underground uranium miners

when injured by radiation exposure. Finally, there is a finding that

the Federal Government should work with State and local governments and healthcare organizations to provide programs for early

detection, prevention, and education on radiogenic diseases to aid

the individuals adversely affected by uranium mining and nuclear

weapons testing.

Section 3. Amendments to the Radiation Exposure Compensation

Act

Section 3 terminates the Trust Fund 22 years after the enactment of the RECA Amendments of 1999.

Section 3 also amends Section 4 of RECA 1990 with regard to

claims relating to leukemia and other radiogenic diseases as a result of atmospheric nuclear testing.

An individual who was physically present in the affected area for

at least 1 year during the period from 1/21/51 to 10/31/58, or who

was physically present in the affected area for the period beginning

on 6/30/62 and ending on 7/31/62 and submits written documentation that they developed leukemia after the applicable periods of

exposure described above more than 2 years after the first exposure

to fallout are eligible for $50,000. An individual who participated

in an on-site atmospheric nuclear test and submits written documentation that they contracted leukemia more than 2 years following the nuclear test is eligible for $75,000. Further conditions

for leukemia claims are that initial exposure to radiation from atmospheric testing occurred prior to age 21, that the claim for payment is filed with the Attorney General by or on behalf of the individual, and that the Attorney General determines in accordance

with Section 6 of the Act that the claim meets the requirements of

the Act.

An individual who was physically present in the affected area for

at least 2 years between 1/15/51 and 10/31/58 or was present in the

14

affected area between 6/30/62 and 7/31/62 and submits written documentation of the development of a specified radiogenic disease is

eligible for $50,000. An individual who participated in an onsite atmospheric nuclear test, and submits written documentation that he

or she developed a specified radiogenic disease more than 2 years

after the first exposure to fallout is eligible for $75,000. These individuals are eligible if the claim for such payment is filed with the

Attorney General by or on behalf of the individual and if the Attorney General determines in accordance with Section 6 of RECA that

the claim meets the requirements of the Act.

Affected areas for purposes of the Act in which individuals were

exposed to radiation between 1/15/51–10/31/58 or 6/30/62–7/31/62

are as follows: Washington, Iron, Kane, Garfield, Sevier, Beaver,

Milliard, Wayne, San Juan and Piute counties in Utah, White Pine,

Nye, Lander, Lincoln, Eureka, and Clark counties in Nevada, and

Coconino, Yavapai, Navajo, Apache, and Gila counties in Arizona.

The specified radiogenic diseases that would qualify individuals

for compensation are leukemia (other than chronic lymphocytic leukemia) provided that initial exposure occurred after the age of 20

and the onset of the disease was at least 2 years after first exposure; lung cancer (other than in situ lung cancer that is discovered

during or after a post-mortem exam); and the following diseases

provided onset was at least 5 years after first exposure: multiple

myeloma, lymphomas (other than Hodgkin’s disease), and primary

cancer of the thyroid, male or female breast, esophagus, stomach

(provided initial exposure occurred before age 30), pharynx, small

intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary

bladder, brain, colon, ovary, or liver (except if cirrhosis or hepatitis

B is indicated).

Section 3 also amends Section 5 of RECA which deals with

claims relating to uranium mining. An individual is eligible for

$100,000 if that individual was employed in a uranium mine or

mill, or transported uranium ore or vanadium-uranium ore between 1/1/42 and 12/31/71. If an individual was a miner exposed to

40 or more working level months of radiation, he or she qualifies

for compensation if written medical documentation is submitted

that the individual developed lung cancer or a nonmalignant respiratory disease. If the individual was a miller or ore transporter,

he or she qualifies for compensation if they worked for at least 1

year between 1/1/42 and 12/31/71 and submits written medical documentation that they developed lung cancer or a nonmalignant respiratory disease or renal cancers and other chronic renal disease

including nephritis and kidney tubal tissue injury. Individuals are

eligible if they worked at a mill in Colorado, New Mexico, Arizona,

Wyoming, South Dakota, Washington, Utah, Idaho, North Dakota,

Oregon, Texas, or any other State if an Atomic Energy Commission

uranium mine was operated in such State between 1/1/42 and

12/31/71, the State submits an application to DOJ to include such

a State, and the Attorney General determines to include said State.

These individuals can receive payment if the claim is filed with the

Attorney General by them or on their behalf, and if the Attorney

General determines that the claim meets the requirements of the

Act in accordance with Section 6.

The term ‘‘medical written documentation’’ is defined as including ABGs and a chest X-ray read by two certified ‘‘B’’ readers or

15

an interpreted HRCT scan, or pathology reports of tissue biopsies,

or pulmonary function tests. Under this criteria, written documentation is considered conclusive and subject to a fair and random audit procedure established by the Attorney General. Written

documentation provided by a physician must be provided by a physician who is employed by the Indian Health Service, the Department of Veterans Affairs, or is a board certified physician, and has

a documented ongoing physician-patient relationship with the

claimant.

The term ‘‘uranium mine’’ is defined as any underground excavation as well as open pit, strip, rim, surface, or other aboveground

mines where uranium ore or vanadium-uranium was mined and

extracted, and the term ‘‘uranium mill’’ is defined to include milling

operations involving the processing of uranium ore or vanadiumuranium ore.

Section 3 changes Section 6 of RECA by first amending the establishment of filing procedures to require the Attorney General to

take into account and make allowances for the law, tradition, and

customs of Indian tribes and members of Indian tribes to the maximum extent possible when establishing these procedures. In the

determination of claims, all reasonable doubt with regard to whether a claim meets the requirements of the Act will be resolved in

favor of the claimant. Payments to individuals or survivors on a

claim relating to presence at an on-site nuclear test shall be offset

by any payment made pursuant to a final award or settlement on

a claim (other than a claim for workers’ compensation), or any payment made by the Department of Veterans Affairs based on injuries incurred as a result of their exposure, based on the actuarial

present value of such payments. In the case of deceased persons,

the determination of those individuals eligible to receive compensation by virtue of marriage, relationship, or survivorship shall take

into consideration the laws, traditions, and customs of affected Indian tribes.

With regard to action on claims, the Attorney General shall determine each claim no later than 12 months after the claim is received. If the claim is denied, the claimant has a reasonable period

in which to seek administrative review of the denial of the claim,

after which the Attorney General will make a final determination

within 90 days of receipt of the claimant’s request for review. If the

Attorney General fails to render a determination within 12 months

after receipt of such request, the claim will be awarded as a matter

of law and paid. The Attorney General may request any reasonable

additional information or documentation to determine the claim in

accordance with the established procedures. The period starting

when the Attorney General makes a request for additional information and ending when the claimant provides that additional information or documentation, or notifies the Attorney General that

they will not or cannot provide the information does not fall under

the 12-month limitation.

The Attorney General shall ensure that approved claims are paid

within 6 weeks of approval. Any procedures on claims shall take

into consideration and incorporate Native American law, tradition,

and custom with respect to the claims of Native Americans. Not

later than 180 days after the date of the enactment of the RECA

Amendments of 1999, the Attorney General shall issue revised regVerDate 11-MAY-2000 04:00 Jun 27, 2000 Jkt 079006 PO 00000 Frm 00015 Fmt 6659 Sfmt 6601 E:\HR\OC\HR697.XXX pfrm03 PsN: HR697
16

ulations to carry out the Act. It should be noted that the DOJ has

indicated that they feel, due to the nature of this expansion of the

Act, that 180 days will not be sufficient to thoroughly revise the

regulations. In addition to any other material that substantiates

employment history for determining working level months, an individual filing a claim may make a substantiation by affidavit that

meets requirements established by the Attorney General which is

made by a person other than the individual filing a claim attesting

to the claimant’s employment history.

After the date of enactment of the RECA Amendments of 1999,

any claimant who has been denied compensation may resubmit a

claim for consideration by the Attorney General a maximum of 3

times. Any resubmittal made prior to the date of enactment does

not apply to the limitation. The time limit to file a claim is extended to 22 years following the enactment of the 1999 RECA

Amendments.

Attorney fee limitations are reduced from a 10% limit to a 2%

limit of a claimant’s payment.

GAO is directed to submit a report to Congress 18 months following the enactment of this Act and every 18 months thereafter

detailing the administration of RECA by DOJ, analyzing claims,

awards, and administrative costs and the budget of DOJ relating

to the Act.

Section 4. Establishment of Program of Grants to States for Education, Prevention, and Early Detection of Radiogenic Cancers

and Diseases

Section 4 establishes a program of grants to States for education,

prevention, and early detection of radiogenic cancers and diseases.

Section 4 amends the Public Health Service Act (42 U.S.C. § 285)

by adding Section 417C. This amendment enables the Secretary of

Health and Human Services to make grants to any National Cancer Institute-designated cancer center, Department of Veterans Affairs hospital or medical center, Federally Qualified Health Center,

community health center, or hospital, or an agency of any State or

local government, including any State department of health, or

nonprofit organization. The purpose of these will be to carry out

programs to screen individuals having been exposed to radiation

for cancer as a preventive health measure, to provide referrals for

medical treatment of such individuals, to ensure that follow-up

services are available, to develop and disseminate public information programs for the detection, prevention and treatment of

radiogenic cancers and diseases, and to assist applicants in the documentation of claims. This includes programs provided through Indian Health Service or through tribal contracts, compacts, grants,

or agreements with the Indian Health Service which are determined appropriate to raising the health status of Indians. These

grants do not affect any coverage obligation of a government or private health plan or program relating to an individual .

Beginning on October 1 following the first appropriation of this

section and annually on October 1 thereafter, the Secretary is to

submit a report to the Senate Committees on the Judiciary and

Health, Education, Labor, and Pensions, and the House Judiciary

and Commerce Committees summarizing the expenditures and programs funded under this section. This Act authorizes $20 million

17

in appropriations to carry out this section for fiscal year 1999 and

such sums as may be necessary for fiscal years 2000–2009.

AGENCY VIEWS

DEPARTMENT OF JUSTICE,

Washington, DC, January 24, 2000.

Hon. HENRY J. HYDE, Chairman,

Committee on the Judiciary,

House of Representatives, Washington, DC.

DEAR MR. CHAIRMAN: This provides the views of the Department

of Justice on S. 1515, the ‘‘Radiation Exposure Compensation Act

Amendments of 1999,’’ as passed by the Senate on November 19,

1999, to amend the Radiation Exposure Compensation Act (RECA),

42 U.S.C. § 2210 note (1994). Although the Department of Justice

supports many provisions of S. 1515, we do have concerns about

several others, as outlined in more detail below, and consequently

oppose the bill as it is currently drafted.

As an initial matter, the Department supports Section

3(c)(2)(A)(ii), which would amend RECA to extend compensation for

silicosis or pneumoconiosis to all eligible claimants. Currently,

RECA limits compensation for silicosis and pneumoconiosis to miners employed in mines on ‘‘an Indian reservation.’’ 42 U.S.C. § 2210,

Section 5(b). Additionally, the Department supports Section

3(c)(2)(C), which would allow claimants to satisfy the eligibility requirements of RECA through the submission of pathology reports

of tissue biopsies as medical documentation for purposes of establishing a non-malignant respiratory disease or lung cancer in cases

in which the claimant is living. Pursuant to our revised regulations, the Department has expanded the use of pathology reports

of tissue biopsies as proof of a non-malignant respiratory disease.

See 28 C.F.R. § 79.36(d)(ii). The Department also supports that part

of Section 3(c)(2)(C) of S. 1515 that would provide compensation for

in situ lung cancers. Recent revisions to the Department’s implementing regulations include in situ cancers in the definition of ‘‘primary lung cancer.’’ See 28 C.F.R. § 79.31(h). Section 3(c)(3) would

permit a claimant’s treating physician to submit a written diagnosis of a non-malignant respiratory disease or lung cancer accompanied by written documentation as conclusive evidence of that disease. We would support such a provision, provided that it were

amended to require that the accompanying written documentation

included medical records substantiating the treating physician’s diagnosis.

The Department also supports the offset provisions contained in

Section 3(d) of S. 1515 and the provisions contained in Section

3(d)(4), which would provide for the consideration and incorporation, to the fullest extent feasible, of Native American law, tradition, and custom with respect to the submission and processing of

claims filed by Native Americans. Finally, the Department supports Section 3(e)(2)(A), which would allow, under certain circumstances, affidavits to substantiate employment history for purposes of determining working level months. As you know, the regulations implementing the Act permit claimants to set forth under

oath on the standard claim form the name of each mine in which

18

the claimant worked, as well as the actual time period worked in

each mine. See 28 C.F.R. § 79.33(b)(2).

Nevertheless, the Department does have concerns about S. 1515

and therefore opposes enactment of the bill as it is currently drafted. We would be pleased to work with the Committee to make appropriate revisions to address our concerns. In particular, Section

3(c)(1) of the bill proposes to expand compensation under RECA to

include uranium millers, but does not define what constitutes a

‘‘mill,’’ or who will be considered a ‘‘miller.’’ We believe these fundamental questions should be addressed before Congress expands

RECA coverage to this subset of workers. An ongoing study conducted by experts at the U.S. Department of Health and Human

Services, National Institute of Occupational Safety and Health

(NIOSH), upon whom the Department of Justice relies for scientific

advice and expertise, may yield meaningful information concerning

the health effects of radiation on uranium millers. While the Administration recognizes that this study has been ongoing for a

longer period than initially expected, results are anticipated within

a year. It is important that any expansion of the entitlements in

the Act be supported by scientific evidence. Accordingly, we believe

that changes in this area should await the completion of the

NIOSH study.

Similar concerns exist with respect to that part of Section 3(c)(1)

which proposes to compensate transport workers. There is little scientific information about this particular category of workers. Because uranium ore was transported by truck, rail, and even occasionally river barge, the extent of this claimant population could be

quite extensive. Further, the scarcity of existing documentary evidence to establish a work history could make administration of this

provision problematic. The potential cost could be very large. A detailed study of this potential group of claimants would likely resolve some of the questions concerning eligibility criteria.

Section 3(b) of S. 1515 would also add several new ‘‘Downwinder’’

and ‘‘Onsite Participant’’ diseases. Similarly, S. 1515 would increase the Downwinder ‘‘affected area’’ to include Wayne and San

Juan counties in Utah and the counties of Coconino, Yavapai, Navajo, Apache, and Gila in Arizona. The National Cancer Institute

(NCI), the experts in the field, advises us that, at this time, NCI

cannot offer any scientific support for the expansion of the RECA

program to include these additional diseases, nor are there

radiodosimetric studies or other scientific findings to support the

inclusion of the proposed areas.

We also have concerns about that part of Section 3(c) of S. 1515

that would reduce the radiation exposure threshold requirements

for uranium miners to 40 Working Level Months and impose a oneyear duration of employment requirement for millers and transport

workers. We object to this provision. The Radiation Exposure Compensation Act Committee (‘‘RECA Committee’’), chartered by the

Human Radiation Interagency Working Group in 1996, found that

no single exposure figure is appropriate to establish a point at

which it is more likely than not that all uranium miners’ exposure

was the cause of subsequent lung disease, and that individual history factors must be considered in determining if an illness in a

particular case is in fact caused by radiation exposure. The RECA

Committee recommended, alternatively, an exposure-based model

19

and a duration of employment model. Both of these are based on

the relative risk models developed by the National Research Council’s Committee on the Biological Effects of Ionizing Radiation, and

applied to updated cohorts of Colorado Plateau and New Mexico

underground uranium miners.

In the exposure-based model, compensation is conditioned on risk

variables that the latest data indicate most significantly affect the

risk of lung cancer in underground uranium miners: cumulative exposure to radon progeny, attained age (the age at which the claimants developed cancer), and time since the miner’s last exposure to

radon in the mines. Alternatively, the duration of employment

model contains criteria that are dependent on attained age, time

since last exposure and the calendar year of first employment.

(This last factor is significant because the mean level of radon in

the mines declined appreciably over the years.) In both sets of criteria, the miner’s smoking status is retained, providing assurances

that miners are being compensated for the effects of exposure to

radon, not smoking. Ignoring the relative risk variables and compensation criteria that the RECA Committee’s scientists determined were ‘‘significant,’’ fails to demonstrate a sound, scientifically-based approach for compensation. Finally, we note that expansion of the RECA eligibility criteria, as proposed in S. 1515,

would require a significant commitment of additional resources.

The Department is proud of the Radiation Exposure Compensation Act Program and we look forward to working with Congress

to improve this unique statute. The Department has granted nearly

50 percent of all claims filed, for a total amount of $241,192,606.

We would be pleased to meet with you to discuss these issues in

more detail, and to discuss how we might work together to craft appropriate legislation. Thank you for the opportunity to comment on

this bill. We hope you find this information helpful. Please do not

hesitate to contact this office if you have additional questions or

concerns. The Office of Management and Budget has advised that

there is no objection from the standpoint of the Administration’s

program to the presentation of this letter.

Sincerely,

ROBERT RABEN, Assistant Attorney General.

cc: The Honorable John Conyers

Ranking Minority Member

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the

House of Representatives, changes in existing law made by the bill,

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics,

existing law in which no change is proposed is shown in roman):

RADIATION EXPOSURE COMPENSATION ACT

* * * * * * *

20

SEC. 3. TRUST FUND.

(a) * * *

* * * * * * *

(d) TERMINATION.—The Fund shall terminate 22 years after

the ødate of the enactment of this Act¿ date of enactment of the Radiation Exposure Compensation Act Amendments of 1999. If all of

the amounts in the Fund have not been expended by the end of

that 22-year period, investments of amounts in the Fund shall be

liquidated and receipts thereof deposited in the Fund and all funds

remaining in the Fund shall be deposited in the miscellaneous receipts account in the Treasury.

* * * * * * *

SEC. 4. CLAIMS RELATING TO ATMOSPHERIC NUCLEAR TESTING.

(a) CLAIMS.— ø(1) CLAIMS RELATING TO CHILDHOOD LEUKEMIA.—Any individual who was physically present in the affected area for a

period of at least 1 year during the period beginning on January 21, 1951, and ending on October 31, 1958, or was physically present in the affected area for the period beginning on

June 30, 1962, and ending on July 31, 1962, and who submits

written medical documentation that he or she, after such period of physical presence and between 2 and 30 years after first

exposure to the fallout, contracted leukemia (other than chronic lymphocytic leukemia), shall receive $50,000 if—

ø(A) initial exposure occurred prior to age 21,

ø(B) the claim for such payment is filed with the Attorney General by or on behalf of such individual, and

ø(C) the Attorney General determines, in accordance

with section 6, that the claim meets the requirements of

this Act.¿

(1) CLAIMS RELATING TO LEUKEMIA.— (A) IN GENERAL.—An individual described in this subparagraph shall receive an amount specified in subparagraph (B) if the conditions described in subparagraph (C)

are met. An individual referred to in the preceding sentence

is an individual who—

(i)(I) was physically present in an affected area for

a period of at least 1 year during the period beginning

on January 21, 1951, and ending on October 31, 1958;

(II) was physically present in the affected area for

the period beginning on June 30, 1962, and ending on

July 31, 1962; or

(III) participated onsite in a test involving the atmospheric detonation of a nuclear device; and

(ii) submits written documentation that such individual developed leukemia—

(I) after the applicable period of physical presence described in subclause (I) or (II) of clause (i)

or onsite participation described in clause (i)(III)

(as the case may be); and

(II) more that 2 years after first exposure to

fallout.

(B) AMOUNTS.—If the conditions described in subparagraph (C) are met, an individual—

21

(i) who is described in subclause (I) or (II) of sub- paragraph (A)(i) shall receive $50,000; or

(ii) who is described in subclause (III) of subpara- graph (A)(i) shall receive $75,000.

(C) CONDITIONS.—The conditions described in this subparagraph are as follows:

(i) Initial exposure occurred prior to age 21.

(ii) The claim for a payment under subparagraph

(B) is filed with the Attorney General by or on behalf

of the individual.

(iii) The Attorney General determines, in accordance with section 6, that the claim meets the requirements of this Act.

* * * * * * *

(b) DEFINITIONS.—For purposes of this section, the term—

(1) ‘‘affected area’’ means—

(A) in the State of Utah, the counties of Washington,

Iron, Kane, Garfield, Sevier, Beaver, Millard, Wayne, San

Juan, and Piute;

* * * * * * *

ø(C) that part of Arizona that is north of the Grand

Canyon and west of the Colorado River; and¿

(C) in the State of Arizona, the counties of Coconino,

Yavapai, Navajo, Apache, and Gila; and

(2) ‘‘specified disease’’ means leukemia (other than chronic

lymphocytic leukemia), provided that initial exposure occurred

after the age of 20 and øthe onset of the disease was between

2 and 30 years of first exposure,¿ the onset of the disease was

at least 2 years after first exposure, lung cancer (other than in

situ lung cancer that is discovered during or after a postmortem exam), and the following diseases, provided onset was

at least 5 years after first exposure: multiple myeloma,

lymphomas (other than Hodgkin’s disease), and primary cancer

of the: thyroid ø(provided initial exposure occurred by the age

of 20)¿, male or female breast ø(provided initial exposure occurred prior to age 40)¿, esophagus ø(provided low alcohol consumption and not a heavy smoker)¿, stomach ø(provided initial

exposure occurred before age 30)¿, pharynx ø(provided not a

heavy smoker)¿, small intestine, pancreas ø(provided not a

heavy smoker and low coffee consumption)¿, bile ducts, gall

bladder, salivary gland, urinary bladder, brain, colon, ovary, or

liver (except if cirrhosis or hepatitis B is indicated).

SEC. 5. CLAIMS RELATING TO URANIUM MINING.

ø(a) ELIGIBILITY OF INDIVIDUALS.—Any individual who was employed in a uranium mine located in Colorado, New Mexico, Arizona, Wyoming, or Utah at any time during the period beginning

on January 1, 1947, and ending on December 31, 1971, and who,

in the course of such employment—

ø(1)(A) if a nonsmoker, was exposed to 200 or more working level months of radiation and submits written medical documentation that he or she, after such exposure, developed lung

cancer, or

ø(B) if a smoker, was exposed to 300 or more working level

months of radiation and cancer incidence occurred before age

22

45 or was exposed to 500 or more working level months of radiation, regardless of age of cancer incidence, and submits written medical documentation that he or she, after such exposure,

developed lung cancer; or

ø(2)(A) if a nonsmoker, was exposed to 200 or more working level months of radiation and submits written medical documentation that he or she, after such exposure, developed a

nonmalignant respiratory disease, or

ø(B) if a smoker, was exposed to 300 or more working level

months of radiation and the nonmalignant respiratory disease

developed before age 45 or was exposed to 500 or more working

level months of radiation, regardless of age of disease incidence, and submits written medical documentation that he or

she, after such exposure, developed a nonmalignant respiratory disease,

shall receive $100,000, if—

ø(i) the claim for such payment is filed with the Attorney

General by or on behalf of such individual, and

ø(ii) the Attorney General determines, in accordance with

section 6, that the claim meets the requirements of this Act.

Payments under this section may be made only in accordance with

section 6.¿

(a) ELIGIBILITY OF INDIVIDUALS.—

(1) IN GENERAL.—An individual shall receive $100,000 for

a claim made under this Act if—

(A) that individual—

(i) was employed in a uranium mine or uranium

mill (including any individual who was employed in

the transport of uranium ore or vanadium-uranium ore

from such mine or mill) located in Colorado, New Mexico, Arizona, Wyoming, South Dakota, Washington,

Utah, Idaho, North Dakota, Oregon, and Texas at any

time during the period beginning on January 1, 1942,

and ending on December 31, 1971; and

(ii)(I) was a miner exposed to 40 or more working

level months of radiation and submits written medical

documentation that the individual, after that exposure,

developed lung cancer or a nonmalignant respiratory

disease; or

(II) was a miller or ore transporter who worked for

at least 1 year during the period described under

clause (i) and submits written medical documentation

that the individual, after that exposure, developed lung

cancer or a nonmalignant respiratory disease or renal

cancers and other chronic renal disease including nephritis and kidney tubal tissue injury;

(B) the claim for that payment is filed with the Attorney General by or on behalf of that individual; and

(C) the Attorney General determines, in accordance

with section 6, that the claim meets the requirements of this

Act.

(2) INCLUSION OF ADDITIONAL STATES.—Paragraph (1)(A)(i)

shall apply to a State, in addition to the States named under

such clause, if—

23

(A) an Atomic Energy Commission uranium mine was

operated in such State at any time during the period beginning on January 1, 1942, and ending on December 31,

1971;

(B) the State submits an application to the Department

of Justice to include such State; and

(C) the Attorney General makes a determination to include such State.

(3) PAYMENT REQUIREMENT.—Each payment under this section may be made only in accordance with section 6.

(b) DEFINITIONS.—For purposes of this section—

(1) * * *

* * * * * * *

(3) the term ‘‘nonmalignant respiratory disease’’ means fibrosis of the lung, pulmonary fibrosis, øand¿ corpulmonale related to fibrosis of the lungø; and if the claimant, whether Indian or non-Indian, worked in a uranium mine located on or

within an Indian Reservation, the term shall also include moderate or severe silicosis or pneumoconiosis; and¿, silicosis, and

pneumoconiosis;

(4) the term ‘‘Indian tribe’’ means any Indian tribe, band,

nation, pueblo, or other organized group or community, that is

recognized as eligible for special programs and services provided by the United States to Indian tribes because of their

status as Indiansø.¿;

(5) the term ‘‘written medical documentation’’ for purposes

of proving a nonmalignant respiratory disease or lung cancer

means, in any case in which the claimant is living—

(A)(i) an arterial blood gas study; or

(ii) a written diagnosis by a physician meeting the requirements of subsection (c)(1); and

(B)(i) a chest x-ray administered in accordance with

standard techniques and the interpretive reports of a maximum of 2 National Institute of Occupational Health and

Safety certified ‘‘B’’ readers classifying the existence of the

nonmalignant respiratory disease of category 1/0 or higher

according to a 1989 report of the International Labor Office

(known as the ‘‘ILO’’), or subsequent revisions;

(ii) high resolution computed tomography scans (commonly known as ‘‘HRCT scans’’) (including computer assisted tomography scans (commonly known as ‘‘CAT

scans’’), magnetic resonance imaging scans (commonly

known as ‘‘MRI scans’’), and positron emission tomography

scans (commonly known as ‘‘PET scans’’)) and interpretive

reports of such scans;

(iii) pathology reports of tissue biopsies; or

(iv) pulmonary function tests indicating restrictive lung

function, as defined by the American Thoracic Society;

(6) the term ‘‘lung cancer’’—

(A) means any physiological condition of the lung, trachea, or bronchus that is recognized as lung cancer by the

National Cancer Institute; and

(B) includes in situ lung cancers;

(7) the term ‘‘uranium mine’’ means any underground excavation, including ‘‘dog holes’’, as well as open pit, strip, rim,

24

surface, or other aboveground mines, where uranium ore or vanadium-uranium ore was mined or otherwise extracted; and

(8) the term ‘‘uranium mill’’ includes milling operations involving the processing of uranium ore or vanadium-uranium

ore, including both carbonate and acid leach plants.

(c) WRITTEN DOCUMENTATION.— (1) DIAGNOSIS ALTERNATIVE TO ARTERIAL BLOOD GAS

STUDY.—(A) IN GENERAL.—For purposes of this Act, the written

diagnosis and the accompanying interpretive reports described in subsection (b)(5)(A) shall—

(i) be considered to be conclusive; and

(ii) be subject to a fair and random audit procedure established by the Attorney General.

(B) CERTAIN WRITTEN DIAGNOSES.— (i) IN GENERAL.—For purposes of this Act, a written diagnosis made by a physician described under

clause (ii) of a nonmalignant pulmonary disease or

lung cancer of a claimant that is accompanied by written documentation shall be considered to be conclusive

evidence of that disease.

(ii) DESCRIPTION OF PHYSICIANS.—A physician referred to under clause (i) is a physician who—

(I) is employed by the Indian Health Service or

the Department of Veterans Affairs; or

(II) is a board certified physician; and

(III) has a documented ongoing physician patient relationship with the claimant.

(2) CHEST X-RAYS.— (A) IN GENERAL.—For purposes of this Act, a chest xray and the accompanying interpretive reports described in

subsection (b)(5)(B) shall—

(i) be considered to be conclusive; and

(ii) be subject to a fair and random audit procedure established by the Attorney General.

(B) CERTAIN WRITTEN DIAGNOSES.— (i) IN GENERAL.—For purposes of this Act, a written diagnosis made by a physician described in clause

(ii) of a nonmalignant pulmonary disease or lung cancer of a claimant that is accompanied by written documentation that meets the definition of that term under

subsection (b)(5) shall be considered to be conclusive

evidence of that disease.

(ii) DESCRIPTION OF PHYSICIANS.—A physician referred to under clause (i) is a physician who—

(I) is employed by—

(aa) the Indian Health Service; or

(bb) the Department of Veterans Affairs;

and

(II) has a documented ongoing physician patient relationship with the claimant.

SEC. 6. DETERMINATION AND PAYMENT OF CLAIMS.

(a) ESTABLISHMENT OF FILING PROCEDURES.—The Attorney

General shall establish procedures whereby individuals may submit claims for payments under this Act. In establishing procedures

25

under this subsection, the Attorney General shall take into account

and make allowances for the law, tradition, and customs of Indian

tribes (as that term is defined in section 5(b)) and members of Indian tribes, to the maximum extent practicable.

(b) DETERMINATION OF CLAIMS.—

(1) IN GENERAL.—The Attorney General shall, in accordance with this subsection, determine whether each claim filed

under this Act meets the requirements of this Act. All reasonable doubt with regard to whether a claim meets the requirements of this Act shall be resolved in favor of the claimant.

* * * * * * *

(c) PAYMENT OF CLAIMS.—

(1) * * *

(2) OFFSET FOR CERTAIN PAYMENTS.—(A)***

(B) A payment to an individual, or to a survivor of that individual, under this section on a claim under section 4(a)(2)(C)

shall be offset by the amount of—

(i) any payment made pursuant to a final award or

settlement on a claim (other than a claim for workers’ compensation), against any person, or

(ii) any payment made by the øFederal Government¿

Department of Veterans Affairs,

* * * * * * *

(4) PAYMENTS IN THE CASE OF DECEASED PERSONS.—

(A) * * *

* * * * * * *

(D) APPLICATION OF NATIVE AMERICAN LAW.—In determining those individuals eligible to receive compensation

by virtue of marriage, relationship, or survivorship, such

determination shall take into consideration and give effect

to established law, tradition, and custom of the particular

affected Indian tribe.

(d) ACTION ON CLAIMS.—

(1) IN GENERAL.—The Attorney General shall complete the

determination on each claim filed in accordance with the procedures established under subsection (a) not later than twelve

months after the claim is so filed. For purposes of determining

when the 12-month period ends, a claim under this Act shall

be deemed filed as of the date of its receipt by the Attorney General. In the event of the denial of a claim, the claimant shall

be permitted a reasonable period in which to seek administrative review of the denial by the Attorney General. The Attorney

General shall make a final determination with respect to any

administrative review within 90 days after the receipt of the

claimant’s request for such review. In the event the Attorney

General fails to render a determination within 12 months after

the date of the receipt of such request, the claim shall be

deemed awarded as a matter of law and paid.

(2) ADDITIONAL INFORMATION.—The Attorney General may

request from any claimant under this Act, or from any individual or entity on behalf of any such claimant, any reasonable

additional information or documentation necessary to complete

26

the determination on the claim in accordance with the procedures established under subsection (a).

(3) TREATMENT OF PERIOD ASSOCIATED WITH REQUEST.—

(A) IN GENERAL.—The period described in subparagraph (B) shall not apply to the 12-month limitation under

paragraph (1).

(B) PERIOD.—The period described in this subparagraph is the period—

(i) beginning on the date on which the Attorney

General makes a request for additional information or

documentation under paragraph (2); and

(ii) ending on the date on which the claimant or

individual or entity acting on behalf of that claimant

submits that information or documentation or informs

the Attorney General that it is not possible to provide

that information or that the claimant or individual or

entity will not provide that information.

(4) PAYMENT WITHIN 6 WEEKS.—The Attorney General shall

ensure that an approved claim is paid not later than 6 weeks

after the date on which such claim is approved.

(5) NATIVE AMERICAN CONSIDERATIONS.—Any procedures

under this subsection shall take into consideration and incorporate, to the fullest extent feasible, Native American law, tradition, and custom with respect to the submission and processing

of claims by Native Americans.

* * * * * * *

(i) USE OF EXISTING RESOURCES.—The Attorney General

should use funds and resources available to the Attorney General

to carry out his or her functions under this Act. Not later than 180

days after the date of enactment of the Radiation Exposure Compensation Act Amendments of 1999, the Attorney General shall issue

revised regulations to carry out this Act.

* * * * * * *

SEC. 8. LIMITATIONS ON CLAIMS.

(a) IN GENERAL.—A claim to which this Act applies shall be

barred unless the claim is filed within ø20 years after the date of

the enactment of this Act¿ 22 years after the date of enactment of

the Radiation Exposure Compensation Act Amendments of 1999.

(b) RESUBMITTAL OF CLAIMS.—After the date of enactment of

the Radiation Exposure Compensation Act Amendments of 1999,

any claimant who has been denied compensation under this Act

may resubmit a claim for consideration by the Attorney General in

accordance with this Act not more than 3 times. Any resubmittal

made before the date of enactment of the Radiation Exposure Compensation Act Amendments of 1999 shall not be applied to the limitation under the preceding sentence.

SEC. 9. ATTORNEY FEES.

Notwithstanding any contract, the representative of an individual may not receive, for services rendered in connection with the

claim of an individual under this Act, more than ø10 per centum¿

2 percent of a payment made under this Act on such claim. Any

27

such representative who violates this section shall be fined not

more than $5,000.

* * * * * * *

SECTION 417C OF THE PUBLIC HEALTH SERVICE ACT

SEC. 417C. GRANTS FOR EDUCATION, PREVENTION, AND EARLY DETECTION OF RADIOGENIC CANCERS AND DISEASES.

(a) DEFINITION.—In this section the term ‘‘entity’’ means any—

(1) National Cancer Institute-designated cancer center;

(2) Department of Veterans Affairs hospital or medical center;

(3) Federally Qualified Health Center, community health

center, or hospital;

(4) agency of any State or local government, including any

State department of health; or

(5) nonprofit organization.

(b) IN GENERAL.—The Secretary, acting through the Administrator of the Health Resources and Services Administration in consultation with the Director of the National Institutes of Health and

the Director of the Indian Health Service, may make competitive

grants to any entity for the purpose of carrying out programs to—

(1) screen individuals described under section 4(a)(1)(A)(i)

or 5(a)(1)(A) of the Radiation Exposure Compensation Act (42

U.S.C. 2210 note) for cancer as a preventative health measure;

(2) provide appropriate referrals for medical treatment of

individuals screened under paragraph (1) and to ensure, to the

extent practicable, the provision of appropriate follow-up services;

(3) develop and disseminate public information and education programs for the detection, prevention, and treatment of

radiogenic cancers and diseases; and

(4) facilitate putative applicants in the documentation of

claims as described in section 5(a) of the Radiation Exposure

Compensation Act (42 U.S.C. 2210 note).

(c) INDIAN HEALTH SERVICE.—The programs under subsection

(a) shall include programs provided through the Indian Health

Service or through tribal contracts, compacts, grants, or cooperative

agreements with the Indian Health Service and which are determined appropriate to raising the health status of Indians.

(d) GRANT AND CONTRACT AUTHORITY.—Entities receiving a

grant under subsection (b) may expend the grant to carry out the

purpose described in such subsection.

(e) HEALTH COVERAGE UNAFFECTED.—Nothing in this section

shall be construed to affect any coverage obligation of a governmental or private health plan or program relating to an individual

referred to under subsection (b)(1).

(f) REPORT TO CONGRESS.—Beginning on October 1 of the year

following the date on which amounts are first appropriated to carry

out this section and annually on each October 1 thereafter, the Secretary shall submit a report to the Committee on the Judiciary and

the Committee on Health, Education, Labor, and Pensions of the

Senate and to the Committee on the Judiciary and the Committee

28

on Commerce of the House of Representatives. Each report shall

summarize the expenditures and programs funded under this section as the Secretary determines to be appropriate.

(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized

to be appropriated for the purpose of carrying out this section

$20,000,000 for fiscal year 1999 and such sums as may be necessary

for each of the fiscal years 2000 through 2009.

Æ