ID Board's Recommendation Summary DOL response Current Status Accepted/Not/In 

Progress/More Information

(1) Rescind Cir. 15-16 October 2016: #1 

Rescind Circular 15-16, Post-1995 

Occupational Toxic Exposure 

Guidance

DEEOIC agreed to rescind. CLOSED. accepted

October 2016: #2 Add IOM Report's exposure links 

to the SEM.

There are many sources but some 

contradict or are redundant. Request 

that the Board provide more specific 

and relevant information.

follow-up Jan 2018: #1

Expand exposure links in the SEM 

by adding information from the 

IOM Report: IARC, IRIS, and NTP. 

Establish a team in DEEOIC to do 

this.

IARC is already used in SEM heatlh 

effect data. DEEOIC will not add IRIS 

and NTP information without 

investigation of the findings. DEEOIC 

mission is primarily adjudicatory, not 

scientific. If the Board offers more 

specific guidance, DEEOIC will 

consider.

October 2016: #3 Former workers should be hired to 

administer the OHQ.

DEEOIC's contractor for Resource 

Center administration seeks to hire 

former workers where possible.

follow-up January 2018: #2

Hire former DOE workers at the 

RCs to better facilitate the 

administration of the OHQ. 

Request data on the work 

preformed by former workers at 

RCs.

DEEOIC requires that the contractor 

give hiring preference to former 

workers, but cannot require them to 

hire ONLY former workers. Data is 

provided in the response.

(4) Process for IH to 

interview claimant October 2016: #4 Establish a process for the IH to 

interview the claimant.

DEEOIC notes the CEs are the finders 

of fact. Sometimes it may be 

appropriate for the CE to coordinate 

discussion btwn the IH and the 

claimant and "has begun to develop 

procedures" for this. Guidance added 

to PM 15.11.d.

in progress

(5) Policy call notes 

published October 2016: #5 Post policy teleconference notes 

in a public, searchable database.

DEEOIC does not agree. The policy 

teleconference is a place for staff 

discussion. Notes may be confusing 

as they are often on complex issues. 

Publishing may inhibit discussions.

CLOSED. not accepted

Advisory Board on Toxic Substances and Worker Health: Recommendations Summary and Status

Board will give more input/develop more 

specific guidance and input. 

(2) Add IOM info to 

the SEM

(3) OHQ given by 

former DOE workers CLOSED.

more information

partially accepted
(6) Case Files on a 

Public Portal October 2016: #6

Explore feasbility of having the 

case files accessible on a public 

portal.

OWCP as a whole is developing this 

capability. DEEOIC provided an 

update in Nov 2018 that all four 

programs are in various stages of 

developing online claims portals. It is 

easiest for FECA, as their claimant are 

federal. Other programs have 

additional privacy and authentication 

concerns, as claimants are members 

of the public. The DEEOIC hopes to 

give the claimants the ability to 

access their case files electronically in 

FY 2021.

The Board requests an update on the status 

of this request and the procedures being 

developed.

in progress

October 2016: #7

DOL should reorganize its 

occupational physicians into a 

structure similar to the Solicitor's 

office for attorneys.

This is beyond OWCP's boundaries. 

DEEOIC provided additional 

information to enhance the Board's 

understanding.

 follow up April 2017: #5

DEEOIC should enhance its 

scientific and technical capacity to: 

support policies; enhance 

individual decisionmaking; inform 

assessments of contractor experts.

DEEOIC agrees having more resources 

would be useful, and notes that it 

uses contractors for SEM, has a 

medical director and several nurses, 

does quarterly audits of medical 

consultants, has a toxicologist, and 

has CMCs and IH consultants.

follow up January 2018: #8

DEEOIC should enhance its 

scientific and technical capacity, in 

the areas of disease causation, 

epidemiology, and occupational 

medicine.

DEEOIC has scientists on staff and 

utilizes contractors for CMCs, IHs, 

SEM development, and has consulted 

other experts. It will continue to do 

so.

October 2016: #8

Make the entire case file available 

to the IH and CMC. The CE should 

map the file.

DEEOIC disagrees, as it is often 

inefficient, uneconomical to supply 

superfluous documents to CMCs 

when only parts of the medical 

information are relevant to the issue. 

The IH should not have to sift through 

the non-exposure info. The CE is the 

fact finder and puts all evidence 

together for a decision.

follow up January 2018: #3

The entire case file should be 

available to the CMC and the IH, 

and the CE should map the claim.

DEEOIC considers its current referral 

process to be sufficiently robust. 

Referrals to IH include all exposure 

information. Referrals to CMC include 

all medical information relating to the 

relevant condition. Claims examiners 

are the finders of fact.

not accepted

not accepted

CLOSED.

(7) Enhance scientific 

and technical 

capabilities at DOL or 

OWCP/DEEOIC

(8) Entire Case File 

goes to CMC/IH

The Board does not agree, but is not 

pursuing. CLOSED.
(1) 250 days aggregate duration of 

exposure for six asbestos 

conditions

DEEOIC agrees. CLOSED

(2) latency of 15 years for 

malignant mesothelioma, with 30 

days of exposure

DEEOIC agrees on latency (except will 

keep 10 years on asbestosis). 

Requests support for two new job 

categories. Requests support for 2005 

as the date in the presumption.

CLOSED

(3) All claims that do not meet the 

presumptions will be referred to 

IH and CMC

DEEOIC agrees and current policy 

states this. CLOSED

(4) COPD may have contribution 

from asbestos. Evaluate claims 

using a chart of presumptions 

based on disease and job category 

of maintenance/construction is 

given

DEEOIC responds in conjunction with 

April 2017 #3

follow up January 2018 #4

The Board modifies its proposal: 

specifes latency periods; 

"exposure" and "causation" 

presumptions are linguistic and 

presumptions can meet both; 

scientific publications in support 

are provided; agrees to use 1995 

while 2005 support is located.

DEEOIC agrees with latency periods. 

DEEOIC has concerns with the labor 

categories and thinks its current 

policy is more specific. DEEOIC agrees 

to use 1995 as a threshhold date 

pending support for 2005. DEEOIC 

notes that "exposure" and 

"causation" are both required by the 

statute.

follow up February 2019 #2

Exhibit 15-4, recommended 

revisions to wording (1) delete 

"high, medium, low" exposure 

from 15-4.3; (2) presume some 

exposure prior to 1987 and let IH 

determine significance; (3) 

negative presumption on 1987-

1996 should not exist, let IH 

determine significance; (4) "day by 

day" exposure should be retained 

only for IH evaluation; (5) List 

3a(1)(Table3) lacks selected job 

titles. The Board recommends a 

Board committee work with 

DEEOIC to examine SEM job titles 

to add.

DEEOIC (1) agrees and will use 

"significant" exposure; (2) agrees, 

notes that this exists already in 15-

4.3a(2); (3) existing PM guidance 

accomodates this, at 15-4.3a(1); (4) 

agrees, "day by day" removed in May 

16, 2019 transmittal; (5) will consider 

changes, can the Board provide IH or 

epidemiological basis for significant 

asbestos exposure for each job title. 

DEEOIC welcomes additional input on 

SEM job titles.

(9) Asbestos 

Presumption

partially accepted; more 

information

April 2017: #1 Asbestos 

presumption, four subparts

Dr.Markowitz, Mr. Domina, Mr. Mahs, Dr. 

Mikulski, and Dr. Dement worked on a 

response for additional input. 

CLOSED
follow up June 2020 #1

Revise the list of occupations in 

SEM with presumed pre-1995 

asbestos exposure (PM 4.2) to 

reflect current knowledge (as 

discussed in rationale); committee 

of the Board should work with 

DEEOIC

DEEOIC agrees to work with its SEM 

contractor to assess information and 

determine any changes to SEM; but it 

cannot work with a committee of the 

Board.

partially accepted; in progress

(1) Use the term "work related 

asthma" (WRA) to include both 

occupational asthma and workexacerbated asthma

DEEOIC agrees and has modified the 

PM to incorporate the term. CLOSED.

(2) the treating physician's 

diagnosis should be sufficient 

medical evidence of asthma.

DEEOIC agrees. DEEOIC also notes 

that the physician's opinions should 

include appropriate medical rationale 

as required for any diagnosis.

CLOSED.

(3) WRA definition provided in 

relation to specific criteria

(4) the same criteria should be 

used in evaluating WRA claims 

whether the claim is made during 

DOE employment or after. A 

triggering event may be present 

but should not be required.

(1) The Board recommends 

language changes to procedural 

guidance on the existing asthma 

presumption.

DEEOIC will make additional PM 

changes.

(2) The Board offers an alternative 

definition of the term "toxic 

substance."

The current definition is specified in 

regulations, which have the effect of 

law.

CLOSED.

follow up February 2019 #1

PM language is divergent from 

medical guidelines: request that 

physician ID "mechanism" for 

asthma is not feasible; revise "the 

strongest justification" can only be 

met in few cases; recommend new 

wording for Appendix 1.5c(ii)

DEEOIC disagrees, as exposure must 

be tied to a toxic substance under the 

Act, and the PM cannot modify that.

Board recommneded new language to 

Program in January 2020 meeting CLOSED

follow up January 2020 #1

Modify PM Appendix 1, Section 

5c(ii): add "the qualified physician 

must provide a well-rationalized 

explanation for his or her 

conclusions" in place oif current 

language, so that "mechanism of 

disease" is deleted

DEEOIC agrees to modify langauge, 

add "the qualified phisician must 

provide a well-rationalized 

explanation for this conclusion that 

identifies the toxic substance(s) that 

likely caused, contributed to, or 

aggravated the diagnosed asthma," 

and delete "mechanism of disease." 

CLOSED

follow up January 2018 #5

DEEOIC has made modifications to 

the PM that comport in part with the 

recommendation; however a 

trigering event is required.

April 2017: #2 Asthma 

presumption, four subparts

partially accepted (10) Asthma 

Presumption
(1) revise the exposure 

presumptions for COPD with: any 

claimant in an attached list of 

labor categories or who reports 

VGDF exposure for at least 5 

years, should be presumed to 

have exposure sufficient for COPD

(2) CEs should not deny claims 

that do not meet the presumption 

but should be sent to IH and CMC 

evaluation

follow up January 2018: #6

Modify the COPD presumption: 

exposure to VGDF has a health 

effect of COPD; change the 

exposure period necessary from 

20 years to 5 years

DEEOIC cannot use the phrase 

"VGDF" as a toxic substance. DEEOIC 

would welcome input on additional 

specific toxic substances 

encompassing VGDF that could be 

added in SEM with a COPD health 

effect.

April 2017: #4

Revisions to the OHQ 

recommended. Test the revisions 

to determine user-friendly and 

face validity.

DEEOIC has made some revisions as 

recommended. DEEOIC notes that 

the job list provided is for 

construction trades and is not 

generally applicable. VDGF cannot be 

added, but if the Board develops a 

specific list of toxic substances, it will 

be considered.

follow up January 2018 #7 Several OHQ revisions are 

recommended

DEEOIC is reviewing revisions to the 

OHQ and will consider the Board's 

suggestions.

follow up February 2019 #3

Draft OHQ provided too little 

detail and structure to be 

"memory trigger"; some of the 

sections that were deleted provide 

useful information; some new 

sections are too arduous for 

marginal use. Suggested revisions 

provided (six sections with 

subparts).

DEEOIC will make some additional 

changes to the OHQ draft, will not 

make other suggested changes. 

(13) Two Borderline 

BeLPTs equal one 

Positive BeLPT

April 2017 #6

Two borderline BeLPT tests should 

be considered the equivalent of 

one positive BeLPT for 

adjudication under Part B.

DEEOIC disagrees. This is inconsistent 

with the statute, which is specific on 

requirements on BeLPTs.

CLOSED. not accepted

Board may re-visit revised formulation of 

issue

(12) OHQ Revisions Revised OHQ in use. CLOSED.

(11) COPD 

Presumption

DEEOIC will consider but has 

questions about the presumption. 

DEEOIC requests that the Board 

provide information about the labor 

categories. Also DEEOIC cannot 

implement "VGDF" but needs a list of 

toxic substances that represents 

VGDF.

April 2017 #3: COPD 

presumption, two subparts

in progress

more information
(14) Sample of 50 

CMC reports April 2017 #7

DOL should provide the Board 

with sufficient resources to 

conduct a quality assessment of a 

sample of 50 CMC reports on 

denied claims.

DEEOIC's medical director conducts 

quarterly quality control assessments 

of 50 CMC reports. These are 

redacted and posted online. A 

meeting in July 2017 with Board 

members and the DEEOIC medical 

director gave more information on 

this. The Board will look at these 

reports.

The Board notes that the medical director 

already completes these audits. The Board 

also feels that it should also do an external 

review and will discuss further.

partially accepted; in progress

(15) Solvent-Related 

Hearing Loss 

Presumption

June 2017 #1: Solvent-Realted 

Hearing Loss presumption

Presumption for solvent-related 

hearing loss, in several specific 

provisions.

DEEOIC notes it has a current 

presumption for solvent-related 

hearing loss, notes some similarities 

and differences to the Board's 

proposal. DEEOIC requests more 

information: (1) bilateral? (2) 

evidence for reducing the duration 

requirement to 7 years (3) is this in 

combination with noise, and what 

would the exposure level be? and 

labor categories with solvent 

exposure? (4) exposure demarcation 

date. DEEOIC does not agree to solely 

utilizing reported exposures to 

organic solvent mixtures, or that 

solvent exposure be established 

though work history and DDWLP (as 

there is no DDWLP on hearing loss). 

DEEOIC agrees to add two toxic 

substances to the existing hearing 

loss presumption.

The Board remains in favor of 

recommendation based on rationale and 

documentation already provided

(16) Definition of 

"Chronic Respiratory 

Disorder"

June 2017 #2 The Board proposes a definition of 

"chronic respiratory disorder"

DEEOIC agrees and will add this to 

the PM, but it will not be a dispositive 

standard, as it is important to give 

wide latitude to reviewing physicians. 

See PM 18.6. 

CLOSED accepted

(17) PM Revisions June 2017 #3 

The Board proposes a number of 

revisions to the PM relevant to 

Part B conditions, in an attached 

document.

DEEOIC agrees to consider these 

comments and make PM revisions as 

part of the next PM edition. 

CLOSED accepted

(18) Request for 

resources April 2019 #1

The Board requests resources 

(such as an external contractor) to 

assist in systematic evaluation of 

claims to assess and ensure 

objectivity, quality, and 

consistency of IH and medical 

evaluations.

DOL conferred with the Board's Chair 

to explore options, and the Board is 

working on defining the type of 

contractor assistance they need in 

order to provide requirements to 

DOL.

in progress
(19) IH language 

citing absence of 

monitoring data

April 2019 #2

The Board recommends that 

certain language about absence of 

monitoring data be omitted from 

IH report.

DEEOIC disagrees. In the absence of 

monitoring data it is impossible to 

guage individual exposure, so the IH 

team uses an exposure methodology 

that assumes a higher toxic exposure 

than would have been encountered. 

Board's assumption that significant 

exposures occurred absent any 

monitoring is not reasonable.

CLOSED not accepted

(20) Job categories in 

SEM that worked 

throughout DOE sites

November 2019 #1

The Board recommends that the 

SEM identify job categories at DOE 

sites that likely have worked 

throughout the sites, and would 

have had potential exposure to 

many toxic substances.

DEEOIC rejects the recommendation. 

Job categories in SEM are based on 

specific data locations and toxic 

substances. DOL does not make 

broad determinations across 

facilities. Cases are developed on an 

individual basis, using exact duties 

the employee was involved with.

CLOSED not accepted

Add a general, open-ended 

question at the end fo the OHQ, 

such as "did we miss anything" 

with an example

DEEOIC agrees and will add such a 

question.

Send claimants a copy of the OHQ, 

or a simplified version, with 

examples prior to the OHQ 

interview

DEEOIC currently provides guidance 

about the OHQ process, and will work 

to produce a notice or summary 

document to help claimants prepare 

for the OHQ interview.

(22) Parkinson 

Disorders: 

Parkinsonism treated 

the same as 

Parkinson's disease

June 2020 #2

Parkinsonism and aliases should 

be treated the same as 

Parkinson's disease thoughout 

claim adjudication

DEEOIC accepts that Parkinson's 

Disease, Paralysis Agitans, and 

Hemiparkinsonism are acceptable 

aliases for Parkinsonism and will 

modify PM Exhibit 15-4. Idiopathic 

Parkinsonism is already acceptable.

CLOSED partially accepted

(23) Exposures to CS2 

and TCE presumed to 

cause, contribute to, 

or aggravate 

Parkinsonism

June 2020 #3

Carbon disulfide (CS2) and 

trichloroethylene (TCE) should be 

presumed to cause, contribute to 

or aggravate Parkinsonism, with a 

minimum exposure duration of 8 

years

DEEOIC agrees to add CS2 and TCE as 

toxic substances with a Parkinsonism 

effect in SEM. DEEOIC does not agree 

the add an 8 year exposure duration 

to the causation standard.

CLOSED partially accepted

(21) Add open-ended 

question to the end 

of the OHQ and send 

claimants a copy with 

examples prior to 

OHQ interview

April 2020 #1 CLOSED accepted
(24) Exposure 

presumptions for job 

categories that 

worked throughout 

the sites

November 2020 #1

Some workers worked throughout 

various sites and had potential 

exposures to all listed toxic 

substances at those sites.

Assignment of toxic substances 

exposure to job titles is site-specific. 

It is inappropriate to assign borad 

classification of exposure to specific 

labor categories without documenary 

support.

DOL is willing to dialog about specific toxic 

exposures that could be assigned to highly 

mobile workers at particular facilities

not accepted

(25) Develop an 

ongoing independent 

third party-based 

system of reasonable 

frequent periodic 

evaluation of 

individual claim 

reports and aggregate 

audits of IH and 

physician reports

November 2020 #2

Results of these analysis should be 

reported to the Board 

systematically.

DEEOIC agrees to implement changes 

to quality control methodologies to 

enhance evaluation of IH and 

physician reports. In addition to 

efforts al ready in place, DEEOIC will 

redesign the review process to 

supplenment the quarterly reports 

from the medical director.

CLOSED accepted

(26) Include probable 

human carcinogens in 

the SEM 

April 2021 #1

(1) probable human carcinogens 

IARC Group 2A should be linked to 

specific cancer sites in SEM; (2) 

SEM should specify that IARC and 

NTP evaluations have been used 

to assert linkages; (3) data from 

IARC and NTP should be used for 

health effects and linkages of toxic 

substances to concers

DEEOIC agrees to update the SEM 

and program information with 

information and data, including that 

from IARC and NTP, and to continue 

collaborating with the Board on 

evaluating updated health effect date 

from different scientific 

organizations.

CLOSED accepted

(27) Add a 

presumptive standard 

to apply CDC 

guidance in 

establishing COVID-19 

as consequential to 

an accepted workrelated illness

April 2021 #2

Any chronic health condition or 

risk factor listed by the CDC as 

being associated with severe 

COVID-19 should be presumed to 

be more likely to lead to 

symptomatic COVID-19 disease. 

COVID-19 is a consequence of 

those chronic health conditions 

when it follows or coincides with 

the onset of those conditions.

DEEOIC agrees to add a presumptive 

standard for COVID-19 as 

consequential to an accepted workrelated illness.

CLOSED accepted

(28) Asbestos 

presumptions April 2021 #3

(1) DOL should re-evaluate certain 

job titles and add these to the 

SEM list of occupations 

presumptively exposed to 

asbestos; (2) the Board requests 

access to Generic Profiles; (3) DOL 

should clarify how DOE jobs 

corresponding to "Maintenance 

and Repair, General Helper" are 

classified within SEM and whether 

linked to asbestos exposure

DEEOIC agrees to coordinate reevaluation of the noted job titles with 

the SEM contractor and make 

alterations to the list of jobs with 

presumed exposure. DEEOIC will give 

the Board access to General Profiles 

data. DEEOIC will collaborate with the 

SEM contractor to evaluate links 

between the job title and asbestos to 

determine what clarifications are 

neeed in SEM.

CLOSED accepted
(29) Use of the SixMinute Walk Test in 

impairment 

evaluations

April 2021 #4

The 6MWT is an acceptable 

mechanism to measure the 

VO2max for an impairment 

evaluation. The best method is 

listed in the recommendation.

DEEOIC agrees to accept a 6MWT as a 

viable method for calcualting 

VO2max and will provide staff 

guidance on the use of the 

calculation recommneded by the 

Board.

CLOSED accepted

(30) DOL should 

communicate to 

Congress the need for 

a technical 

amendment to the 

EEOICPA recognizing 

that those who have 

three borderline 

BeLPT tests have 

beryllium sensitivity

June 2022 #1

The statutory language of the 

EEOICPA is out of date and needs 

to be updated for current medical 

standards with regard to beryllium 

sensitivity.

DEEOIC has been discussing this topic 

with staff members from the Senate 

HELP Committee and has advised it 

would not have difficulty 

implementing the recommended 

amendment to the EEOICPA if 

enacted.

partially accepted

(31) DEEOIC should 

advise staff and IH 

contractor that claimrelated IH reports 

restrict comparisons 

of claimants' 

exposures to toxic 

substances only to 

cases where sufficient 

IH data exist that are 

relevant to the claim 

and that supports to 

comparisons

June 2022 #2

Comparisons to regulatory 

standards must describe the 

available IH data and specific 

regulatory limit referenced. In the 

absence of specifics, comparisons 

to regulatory standards lack 

support.

DEEOIC agrees to modify how IH staff 

characterize toxic substances 

exposure to eliminate reference to 

exposures that occurred within 

regulatory standards. Evaluation will 

contionue to be informed by 

professional judgment and available 

employee-specific data.

CLOSED accepted