u. 

s. DEPARTMENT OF LABOR EMPLOYMENT STANDARDS ADMINISTRATION

OFFICE OF WORKERS' COMPENSATION PROGRAMS

DIVISION OF ENERGY EMPLOYEES' OCCUPATIONAL

ILLNESS COMPENSATION

200 CONSTITUTION AVE

ROOM C-3321

WASHINGTON DC 20210

TELEPHONE: (202) 693-0081

September 24, 2003

Memorandum for:

From:

fli,stric~ D~ec.tors

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Rachel Leiton

Branch Chief

Policy, Regulations and Procedures

Subject: Handling Disputed Claims

This memorandum is intended to explain the position of the Branch of Policy, Regulations and

Procedures regarding the handling of District Office challenges to a final decision or remand

issued by the FAB.

While it is recognized and accepted that the District Offices are pemlitted to offer challenges to

FAB detemlinations, the issue of how these disputes are to be communicated to the National

Office requires guidance. Moreover, procedures need to be implemented explaining the process

for handling documents related to such disputes.

The Branch does not construe challenges brought by the District Offices to be a normal part of

the adjudication process. Rather, these disputes are viewed as internal DEEOIC procedural

disputes that are separate and distinct from the adjudicatory process. As such, any

documentation relating to a challenge raised by a District Office is to remain out of the official

case file records.

Upon referral of a dispute to the National Office, the District Office should prepare a

memorandum to the Director. The memorandum should explain the basis for the challenge and

include a specific course of recommended action. The memo should be prepared for the

signature of the appropriate District Director. Two copies of the memorandum should be

prepared. One should be affixed to the outside of the case file and the entire case file referred to

the National Office. The other should be maintained in a separate file location maintained by the

District Office. The file should be indexed according to the case file number for ease of

reference.

Because these referrals are considered outside of the nonnal scope of the claims adjudication

process, the District Office should not utilize the WS/WR coding process as outlined in bulletin

03-12. Upon referral, the National Office will maintain a local database for tracking challenges

to F AB detenninations. The District Office can, at its own discretion, track referrals to the

National Office by creating its own referral tracking system. The Branch is going to propose a

separate ECMS coding methodology for tracking these types of disputes and it will be addressed

in a future policy bulletin.

SUPERSEDED
Once the referral is received, the dispute will be reviewed for action by the National Office.

Regardless of the conclusion reached, a written reply will be prepared. This may take the form

of a Modification Order signed by the Director ofDEEOIC or written communication to the

District Director resolving the dispute. With the issuance of a modification order, this will be

prepared on the motion of the Director ofDEEOIC and will become part of the case record. The

text of the modification order will merely reference that it is the prerogative of the Director to

review any case to ensure compliance with the EEOICP A. Any other written communication

regarding the dispute will be affixed to the outside of the case file jacket and returned to the

District Office.

Upon receipt of the case file, the District Office or F AB should take appropriate action as

described. Any communication concerning the dispute, other than a modification order, is to

remain separate from the case file. The District Office should maintain a copy of any response in

the dispute file maintained locally.

SUPERSEDED