[

FOIA 15-00490 (PER-057) CD: 192 CASES FROM GsI (received 9/4/15) version 19/6/15]
I I I I

CLAIMH [PRET-DOSE PERT-DOSE CHANGE PREPOC PERPOC CHANGE PAYABLE | Page/238 Notes
0 $3,833 130.817 2.43 46.98% 78.07% 1.66 YES 100 1
00 23,51 41,339 1.76 21.30% 32.43% 1.52 NOe 23 esis (10 Op+Res both
Tc 27.689 164,759 5.95 30.39% 78.46% 2.58 YES 01 4
2 27.309 62.201 2.28 33.49% 63.81% 1.91 Yes 02 5
3 3.558 | 4817 | 135 | 412% | 5.24% 1.27 No* G residual period only
a 88.636 129.149 1.46 49.23% 72.65% 1,48 YES 03 7
5 L 51849 [ 42.301 ] 0.82 [40.89% [40.00% 0.98 No*** 8 Dose+PoC drop why
6 34.417 63.655 1.85 38.10% 62.95% 1.65 YES 04 9
7 46.873 84.292 1.80 37.52% 64.39% 1,72 YES 05 10
iy 77.704 111,147 1.43 49.22% 70.67% 1.44 YES 06 ii
9 86.865 167.093 1.92 36,23 73.81 2.04 YES 07 12
70 ass | 33.927 | 3.95 | 10.29% [_a27: 415 No* 73-14
ii 82.173 137.136 1.67 36.24% 68.13% 1.88 YES 08 15
2 13.128 25,187 1,92 21.90% 43.29% 1.98 NO* 16-17 +Dow NGSIN DOW AND
13 3.522 | 4817 | 137 | 5.58% 7.26% 1.30 No* 18
14 24.133 46.405 1.92 26.60% 54.58% 2.05 Yes 09 19
15 59.586 139.556 2.34 46.82% 77.44% 1.65 Yes 10 20
16 32.182 85.436 2.65 38.79% 69.31% 1.79 Yes 11 2
7 12.178 77.803 6.39 13.49% 62.16% 4.61 Yes 12 22
18 48.285 113.42 2.35 42.88% 73.24% 171 Yes 13 23
19 27.998 144,448 5.16 40.63% 85.69% 241 Yes 14 24
20 14.608_| 33.718 2.31 14.05% | 36.93% 2.63 No* 25
21 7.091 12.202 172 7.84% | 13.87% La No* 26
22 41,900 102,897 2.46 41.81% 74.26% 1.78 Yes 15 7
23 5.349 7.505 1.40 7.72% 10.41% 1.35 No* 28
24 4,845 6.560 1.35 12.31% 15.91% 1,29 No* 29
25 55.337 132.618 2.40 47.63% 79.06% 1.66 YES 16 30
26 68,100 144,031 241 37.13% 65.75% 1.77 YES 17 31
27 26.832 163.594 6.10 34,10% 84.91% 2.49 YES 18 32
28 35.466 61.253 1.73 35.78% 58.50% 1.63 YES 19 33
29 10.723 40.73 3.80 21.94% 64.39% 2.93 YES 20 34
30 8.582 20.697 2.41 8.83% 19.34% 2.19 NO 35-36
31 38.513 67.844 1.76 2.84% 8.68% 3.06 NO 37
32 9,043 12.246 1.35 9.42% 12.22% 1.30 NO* 38-39 [3] doses



Four GSI cases reviewed by DR Subcommittee 10/29/14

changed. 13

DR. MAURO: Right, right. 14

MR. KATZ: And that's a fact. And i5that can be dealt
with, right? 16

DR. MAURO: And I'll take it a step 17further. I would
say all the issues have been 18resolved during the Work
Group meetings. And 19the only thing that's sort of
still to rub is 20that, when getting down to the final
version of 2l1Appendix BB where we were asked to look at
it, 22

py. BL

there was some language in there and there are 1 some
issues that are discussed in manner that 2we still want
to sort of like polish the apple 3a little bit. 4

MR. KATZ: But I guess my point for S5Wanda and the
Subcommittee to consider is, as 6far as the
Subcommittee is concerned, these 7cases are reviewed.
They are effectively 8 reviewed by the results of the
TBD-6000 Work 9Group work as well. And the findings
hold that 10there were problems with these methods. So

llthat's not going to change by any -- what John 12is
talking about -- any cleaning up of the final 13 issued
TBD. 14

And so I think this Subcommittee is 15through with
these, because it did find what it 16found and that
holds up. 17

DR. MAURO: Yeah. 18

MR. KATZ: Yeah. 19

DR. MAURO: Absolutely. 20

MR. KATZ: So we don't need to hold 2lup -- I'm
concerned, I don't want to hold up the

p. 82

roll up for these things that are in abeyance 1lwhen
really they're all closed. 2

DR. MAURO: I’ve got [to] say, I 3agree that these have
all been resolved. And 4the testament to that is
contained in the 5transcripts of the Work Group
meeting. 6

The only thing you really don't have 7is, you know,
this process where the Work Group 8meeting then closes

14


Four GSI cases reviewed by DR Subcommittee 10/29/14

One was to say that, well, you know, 20unless we have a
real worker, where we know 21there was an incident and
he was involved, we 22

p. 73

lwe actually have a case where we're going to try 2
reconstruct the doses because of this 3mishandling.
That would be for the worker that 4would have, in
theory, have taken the source 5away and brought it home
with him. 6

So that was one aspect of it. It 7was agreed that until
we have to deal with the 8real worker that was in fact
in his CATI or there 9was some evidence that was the
case. 10

The other side of it had to do with llthe mishandling
of radium sources in general, l2whereby they may have
been left open, there may l3have been inadequate
barriers while the radium 14source was used for non-
destructive testing. 15

And both Bob Anigstein and Dave 16Allen both set up
models to say, okay, let's 17postulate that such
mishandling occurred. It 18was left out without
adequate control. And 19they simulated, and there was
agreement by the 20Work Group with Paul that, well,
yes, we'll 2lassume that the workers were working in
the 22

p. 74

Ithis open source without adequate controls of 2
somewhat of a barrier around it. 3

So it was part of a simulation. And 4the doses were
calculated. And it was found 5that those doses did not
contribute, were 6considered in the scenario that was
used to 7reconstruct the doses. Because, as you know, 8
all doses at this facility are based on, 9basically,
simulations of external exposure 10and internal
exposure. There are no, during 1lcertain time periods,
during the radium period 1l2where this issue has come
up, there are really 13no dosimetry records of any
type. So l4everything is based on these simulations. 15
And this issue with the Work Group 16with Paul has been

10


filename: DM_ReplyToJVance_1.30.16.rtfd

Dr. McKeel — I’m responding for Rachel.

1 What process does DEEOIC use to triage PER-057 GSI cases through
the FAB? In other worlds, how is it decided which cases go to the FAB in

a particular temporal order (first to last)? For example, is it the order in which
NIOSH returns the reworked ("reworks") DR's and OCAS-1 letters to DOL? Or,
do DEEOIC and FAB use some other metric? | would like to reassure those
waiting for compensation based on PER-057 and AppBB Rev 1 that the claims
payment process used by DEEOIC and FAB is fair and impartial.

We did triage the original list of cases we received from NIOSH to determine
next steps (e.g. further development, referral to NIOSH etc.). Once any
development is undertaken and/or case is referred to NIOSH and returned,
the RD is issued. Once a recommended decision is issued to the claimant,
this cohort of cases is not treated differently than other cases pending a final
decision. Various metrics are applied based on DEEOIC operational planning
to ensure all cases are processed in a timely manner. In the case of GSI case
with receipt of a properly completed waiver of objections — the DEEOIC
operational plan requires timely processing within 30 days of the waiver.
Our most recent operational timeliness reporting (FYQ1 — 2016) for all cases
shows FAB processing cases with a 96.44% success rate on this goal.

Issue final decision on claims in cases in
which a right to hearing or review of the
writen record has beer waived within:

30 days of receipt of the Waiver 2193
Total 2274
Target 90% 96.44%
Average Days 24

We continue to monitor performance of FAB to ensure it exceeds
expectations for finalizing recommended decisions in a timely and equitable
fashion, including those related to the GSI PER-057.

McKeel question: Has a record of decision been made on all 100 PER-057
short list of probably compensable cases been made as of January 30, 2016?



Taz i671 [77.279 150 38.06% 62.82% 16s YES78 173
143 4.740 3019 0.66 2.179 1.88% 0.87, No* 174__ [Batt TBDEK appBB
144 24.915 121.452 487 21.94% 68.58% 3.13 YES 79 175
145 59.077 71.015, 1.20 37.20% | 48.80% 131 “176-177 _GsiresidUal}DOWS)
146 1.767 8.688 4.92 17.19% 41.99% 2.44 178 lVy Low Doses why?
147 5.502 2.621 0.48 9.03% 6.27% 0.69 179 lVy Low Dose +PoC
148 2.139 9.848 460 461% | 25.62% 3.56 No* 180__ [Battelle AppBB rO?
149 24.050 49.237 2.05 33.79% 66.97% 198 YES 80 181
150 43.106 159.817 3.71 30.58% 88.25% 2.89 YES 81 182 __ [huge increments
isi 1.423 1.183 | 0.83 0.73% 0.83% 114 NOo* 183 Battelle AppBB rO ?
152 77.935 108.160 139 48.27% 68.95% 1.43 YES 82 184
153 20.193 123.086 6.10 30.11% 81.37% 2.70 YES 83 185 [huge jumps -why?
154 14,949 25.489 1.71 13.30% 30.20% 2.27 NO* 186-187 GS+DOWresidual 6
155 org] 21.051 3.29 12.68% 43.67% 3.44 NOo* 188-189
155 orgza 10.846 2.67 3.64% | 13.25% 3.64 No* 188-189
155 orgab 10.846 267 3.64% | 39.77% 10.93 No* 188-189 _|giant PoC increase!
T55a combo 31,897 2.67 15.86% 51.13% 3.22 Yes 84 189 __ |giant PoC increase!
1556 combo 31,897 2.67 15.86% 66.07% 4.17 YES 84 189 |giant PoC increase!
1560rg1 23.272 «148.934 6.40 33.99% 85.19% 251 YES 85 190 feast ‘Orgl dosePoC
156 0rg2_ «15.974 2.621 0.16 19.93% 69.57% 3.49 YES 85 190 Dose2 huge DROP!
Ts56 combo 39.246 _151.555 3.86 47.15% _95.19% 2.02 YES 85 191 HIGHEST PoC! So fai
157 23.343 128.219 5.49 15.09% 61.69% 4.09 YES 86 192 [huge increments!
158 18.528 34,055 | 1.84 21.91% 2.00 NOo* 193 near limit review
159 18.661 32.575 175 26.12% 51.25% 1.96 YES87 __194-195 Gsi+DOW 7
160 27.427 163.035 5.94 46.81% 89.62% 1.91 YES 88 196
161 4.770 13.587 2.85 5.96% 23.61% 3.96 NOo* 197 lLow dose + PoC why|
162 9,841 40.954 4.16 10.30% 41.45% 4.02 NO* 198 Low dose +PoC why
163 9,408 35.545 3.78 13.26% 44.47% 3.35 NOo* 199 review near limit
164 9.205 34591 3.76 10.78% | 34.90% 3.24 No*** 200-201 GSI+DOW8: yrs?
165 12535 37.035 2.95 19.50% 53.01% 2.72 YES 89 202 GSI + DOWinc. 9
166 7.794 0.483 0.06 8.50% 12.36% 145 No* 203 Battelle AppBB ro? [_
167 2.362 0,000 0.00 9.76% 0.00 | Now** | 204 Zero Dose+PoCerror
168 org1 4.596 22.167 4.82 5.18% 32.30% 6.24 NO 205-206 [Battelle AppBB r0 ?
168 org2 6.020 24.773 4.12 9.04% 42.44% 4.69 NO 205-206 {Battelle AppBB r0 ?
168 combo 10.616 46.940 4.42 13.75% 61.03% 444 YES 90 206 Battelle AppBB FO ?
169 5,502 74.471 1354 9.03% 60.68% 6.72 YES 91 207___ Highest DPoC incr.
170 16.183 96.754 5.98 23.91% 75.11% 3.14 YES 92 208 | [



Four GSI cases reviewed by DR Subcommittee 10/29/14

the loop. 9

MR. KATZ: No, I know. But you 10have an updated TBD
that changes these methods, 1lwhich in and of itself
indicates the methods I2were adequate. 13 <=McKeel inadequate?”
DR. MAURO: Correct. Very good. 14

MR. KATZ: That's why I'm just I5suggesting to the
Subcommittee that it actually l@close these so that
these don't be left out of 17that roll up report. 18
DR. MAURO: I understand. And I 19agree. 20

ACTING CHAIR MUNN: And let me make 21the comment that
these items run through Page 22

p. 83

10 of this particular matrix that we are l observing
now. And with only one or a few 2exceptions, the
statements that we had been 3making here are broad
enough to cover virtually 4all of these items and the
wording in our SC&A S5response column pretty closely
reflects that. 6

There are only one or two exceptions 7to that. And I
would suggest that we take a 8couple of minutes here
and let the Members of 9the Subcommittee go through
these individually 10and take a look at the summary of
findings and 1lthe current SC&A response and point out
any I2items that you feel need specific addressing 13
here beyond what we have done already. 14

Let's take just a couple of minutes I5to do that,
through Page 10, please. 16

MR. FARVER: Wanda, for this 17Finding 239.1, it's a
finding. So what I’m 18writing in there is the Work
Group has revised 19the TBD. The Subcommittee agrees to
close the 20finding. But SC&A will -- well, we've
reviewed 21the TBD but I'm going to go back and add the
date 22

p. 84

of the review when we’ve actually issued a lreport. 2
So it's closed. But SC&A has got 3the action of going
back and including the data 4in the report. Is that
adequate? 5

ACTING CHAIR MUNN: It is from my 6perspective. 7

MR. FARVER: Okay. And similar 8wording will probably

15


Daniel McKeel letter to Dr. Kotelchuck (DRSC) and DCAS Director Hinnefeld

Two of the 4 GSI dose reconstructions on the 10/29/14 DRSC agenda, which
were performed under Appendix BB Rev 0 (June 2007), were reviewed by SC&A
years ago in a white paper. So many methodological finding errors were detected
by SC&A (~2010 as | recall) as to call into question the results of all GS] DR
performed to that earlier date. This led to David Allen/DCAS's October 2010
“Path Forward for GSI” white paper in which NIOSH proposed ten revamped DR
methods. To this date, FOIA/PA act rules have prevented me from these exact
cases. | urge SC&A and the DRSC to carefully scrutinize the PER-057 GSI
cohort so that all 196 claimants, including the 34 on the short list with PER-057
POCs greater than 50% that have not yet been compensated, are treated fairly.

Sincerely,

- Daw McKeel May 11, 2016

Attachments (n=8):

= DM_ReplyTo|Vance_1.30.16
L DOLowcp_FinalCircular_08-O2gsi.grab

“h. FOIALS-490cd_PERG57-GSib. pdf ?, 2016

‘DL Leiton_12gsi_NosurvivorNAMES.pdf j
SL RE! PER-057 GSI_Vance_1.29.16.pdf lan 28

+ Sample PER-057 summary dose reconstruction development report from
Dan McKeel’s FOIA 15-00490 records (PDF)

+ PER-024 for 4 early GSI cases using ORAUT-OTIB-0004

+ DRSC transcript 10/29/2014 of Munn review of 4 GSI cases

Contact information

Daniel W. McKeel, Jr., M.D.

General Steel Industries (GSI), Dow Madison IL
and Texas City Chemical SEC co-petitioner

Southern IL Nuclear Energy Workers (SINEW)
cofounder


Four GSI cases reviewed by DR Subcommittee 10/29/14

p. 69

NEAL R. GROSS courT REPORTERS AND TRANSCRIBERS 1323 RHODE ISLAND AVE., N.W. (202) 234-
4433 WASHINGTON, D.C. 20005-3701 www.nealrgross.com

MR. KATZ: Oh, okay. 1

DR. MAURO: This is John. The 2reason I was off is I was
having a little trouble 3getting on Live Meeting and I
was trying to get 4some help with Laurie Loomis and for
some reason 5I'm being blocked. 6

So I do have the files in front of 7me, the two of
them, one called "Remaining Case 8Files" and the other
called "DCAS Sites." So 9I have those matrices in front
of me, but I'm 10not on Live Meeting with you. But I
think I 1l should be able to follow along. 12

MR. KATZ: Thanks, John. 13

ACTING CHAIR MUNN: John, we're 1l4working on the "DCAS
Sites" and we've completed 15the other matrices. And
we're now in the DCAS l6sets and we are dealing with
the first items 17there that are involved with General
Steel. 18

And those GSI items, starting with 19the 239, are
referencing the activities in the 20Work Group with
respect to Appendix BB and where 2lwe are with that.
And that's what the 22

p-. 70

1

MR. KATZ: Wanda, this is Ted. I'm 2sorry. But can we go
back? I think, really, 3why don't you let John address,
starting with 4220.2. 5

ACTING CHAIR MUNN: Fine. 6

MR. KATZ: Because I think that 7could use John's
explanation. 8

ACTING CHAIR MUNN: Very good. 9

DR. MAURO: 220.2. 10

MR. KATZ: Right, right. The very ll beginning, John. 12
DR. MAURO: I'm right there at the I3 very beginning. It
starts with 220. 14

MR. KATZ: 220.1 is PFG and that 15Doug handled ably.
But 220.2 is sort of, would 16be much easier for you to
handle than -- 17

DR. MAURO: Okay. I noticed that I8we have an SC&A


33 3.036 22.418 2.48 15.98% | 42.56% 2.66 No* 40 type CA?
34 18.105 | 22.644 125 0.21% 0.86% 4.10 No* a1 Office wrker?
35 77-809 | 126.57 1.63 26.68% | 49.57% 1.86 No* a2 SCA must review
36 49.521 118.556 2.39 47.29% 73.28% 1.55 Yes 21 43-44 I Dose N/A?
37 5.601 14.657 2.62 11.28% | 33.92% 3.01 No 45
38 11.855 21.444 181 15.04% 21.46% 1.43 No* 46-47 Gi DOW)
39 76.161 120.094 1.58 27.52% 50.74% 1.84 Yes 22 48
40 8,249 27.754 3.36 17.72% 50.63% 2.86 YES 23 49-50 [J ext. doses
ar 61.866 144.712 2.34 47.43% 76.73% 1.62 YES 24 51
az 8.322 26.668 3.20 11.49% | 38.33% 3.34 No 52:53
a 0.866 1.07 1.24 0.92% 1.13% 123 No* 54 | residual period only
a4 29305 144,833 4.94 38.30% 84.41% 2.20 YES 25 35
45 18.907 | 53.241 2.82 16.49% | 38.51% 2.34 No* ‘56-57 | Organ(s) CA type?
46 21.669 113.558 5.24 28.18% 77.51% 2.75 YES 26 38
a7 36.587 63.575 1.74 41.21% 61.70% 1.50 YES 27 59
48 8.341 30.974 3.71 19.26% 59.66% 3.10 YES 28 60
49 11.787 36.121 3.06 25.95% 68.93% 2.6 YES 29 61

[50 5568 | 23535 | 4.23 | 7.12% | 32.56% 4.57 No* 62-63 | Low PoC organ job?
51 50.960 129.590 2.54 39.07% 75.55% 1.93 YES 30 64
52 6.90 | 27.921 | 405 | 11.60% | 39.78% 3.43 No 65
53 21.179 $6,372 2.66 33.48% 63.72% 1.90 YES 31 66
54 16.126 69.206 4,29 41.75% 70.34% 1.68 YES 32 67
35 44368 69.637 157 38.89% 67.95% 175 YES 33 68
36 51.188 47.703 0.93 44.43% 78.28% 1.76 YES 34 69
37 0919 | 1.244 135 1.62% | 2.19% 1.35 No* 70 __ |residual period only
38 92.132 126.899 1.38 39.82% 56.76% 1.43 YES 35 7-72
59 84.078 124.035, 1.48 37.88% 60.47% 1.60 YES 36 73
60 22.586 139,457 6.17 23.81% 78.97% 3.32 YES 37 74
a aia9 | 1.955 | 1.70 | 1.39% | 2.20% 1.58 No* 75___ [residual period only
62 53.269 113.871 2.14 42.04% 72.47% 1.72 YES 38 76
63 aa.oi9 | 77.271 | 1.76 | 13.13% | 35.37% 2.69 No* 7 Tow PoC for dose
64 15.111 68.756 455 11.87% 58.69% 4.94 YES 39 78
65 8.378 21.595 2.58 9.15% | 27.49% 3.00 No* 79-80__ flow PoC yrs organ?
66 16.658 | 45.736 275 16.53% | 45.11% 273 No* 81-82 [review near limit
7 7.145 0.198 137 0.29% 0.40% 138 No* 83 ___|residual period only
68 93.321 33.950 0.90 44.75% 5.93% 1.25 YES 40* 84__|internal drop-WHY?.
6 14.217 67.074 472 43.04% 86.20% 2.00 YES 41 a5



PER 24 : General Steel Industries TBD Approval % | -
Document Number: OCAS-PER-0024 Rev-00

About this Document: New document to determine which previously completed claims require
evaluation for the effect of approving a GSI TBD.

Approved: September 25, 2007

Summary: There were 4 Genera! Steel Industries claims completed with a probability of
causation below 50% prior to the approval of the TBD. These were completed using ORAUT-OTIE
0004. Since the new document describes a higher dose for some of the dose estimate, it is
necessary to revise these dose estimates to determine the effect. NIOSH is requesting that these
claims be returned for a new dose estimate. A new dose reconstruction will be completed for eac
of the claims using the latest revision to the General Stee! Industries TBD.


107 16028 75.877 473 27.19% 72.48% 2.66 YES 66 134
108 5.506 11,741 2.13 16.21% | 38.53% 238 NO BS
109 6508 9.886 152 12.13% [19.86% 1.64 No* 136 low dose+Poc why?
110 6.725 15.612 2.32 5.62% 14.52% 2.58 NOo* 137 low dose+PoC why?
111 15.959 22.988 1.44 18.44% 33.09% 1,79 NO 138-139 _|Big wrk period list
112 21.563 18.279 0.85 23.78% 27.24% 115 ‘No* 140 Dose drop PoC+15%
113 30.725 30.398 0.99 39.19% 53.70% 1.37 YES 67* 141___ Dose drop PoC>50%
114 56.368 115.987 2.06 41.77% 66.27% 159 YES 68 14az
115 16.150 17.282 1.07 12.65% 19.66% 1,55 ‘No* 143 vy low dose+PoC
116 3.001 11.683 3.89 5.09% | 25.29% 497 No* 144 |vylow dose+Poc
117 72.701 107.225 1.47 47.55% 70.13% 1.47 YES 69 145
118 9.969 28.353 2.84 13.96% 39.18% 2.81 NO 146
119 25.222 27.994 111 23.33% 30.56% 131 NO* 147 IOffON work periods
1200rgi | 2.986 3.189 1.07 2.17% 1.68% 0.77 NO* 148-149 [Organ 1of2 Cs #120
120 org2 [2.425 2589 107 0.97% 1.06% 1.09 Not 148-149 residual period only
121 is.013 | 23.851 159 11.18% | 21.81% 195 NO 150 [Battelle AppBB rO ?
122 13.298 67.065 5.04 34.99% 80.34% 2.30 YES 70 151__ [huge increments
13 8.876 18.335 207 26.49% 53.00% 2.00 YES 71 152
124 $1132 99.248 194 39.16% 63.20% 1.61 YES72 153
1s 7.542 | 24.389 3.23 10.69% | 39.63% | 3.71 No* 154 low pre dose +PoC
126 49.125 129.378 2.63 40.19% 72.87% 1.81 YES 73 155
127 15.094 6.886 0.46 17.72% 12.86% | 0.73 No** 156 __Dose+PoC dropped
128 27.949_| 166.091 5.94 47.30% 90.49% 191 YES 74 157 Highest PoC so far
129 5.502 0.357 0.06 9.03% 0.61% 0.07 Nno** 158 residual period only
FE 1.230 0378 0.31 1.95% 0.76% 039 No** 159 _ [Battelle TED AppBB
131 0.230 0.039 0.17 0.27% 0.05% 0.19 o** 160 Battelle residual per
132 6.339 27.741 4.38 7.70% 37.06% 4.81 NO 161 [Battelle residual per
133 9.787 11.678 19 14.69% | 25.34% 72 No 162 __ [Battelle AppBB r0?
134 5.506 22.498 4.98% | 25.70% 5.16 No* 163 [AppBB op+residual
135 5.447 7.608 7.02% 9.57% 1,36 NO 164 residual period only
136 46.694 | 58.255 125 31.27% | _43.86% 7.40 No*** ~ 165-166 _ GSI+DOWresidual 4
137 5.131 16.898 3.29 43.15% 80.55% 1.87 YES 75 167 ]low dose Ig PoC rise
138 76.145 | 105.391 138 48.53% 67.75% 1.40 YES 76 168
139 26.041 | 142.182 5.46 43.48% 86.20% 198 Yes 77 169___ huge increments
140a 24.931 85.291 3.42 1.22% 10.26% 8.41 No* 170 Lg Dose vy low PoC
140b dupe 24.931 85,291 3.42 1.22% 10.26% 8.41 NOo* 171 DUPE of Page 170
141 7,057 25.411 3.60 10.70% 39.07% 3.65 NO 172 l



Four GSI cases reviewed by DR Subcommittee 10/29/14

suggested action to close on my 19matrix. 20
ACTING CHAIR MUNN: Yes. And we 21lactually have said
that we would do that but 22

pr 2

lexplanation here. And we're asking you for a 2little
more enlightenment. 3

DR. MAURO: I'll do the best I can. 4I did call Bob
Anigstein, who was really the Sauthor of all of this,
to see if he would join 6us. In fact, probably the
smart thing to do, 7quite frankly, is for me rather
than try to fake 8it -- 9

MR. KATZ: John, if you look, if you 10just give it a
look. I mean, this is, you were I]there for the whole,
you know, all that work on 12GSI. And this is -- 13
DR. MAURO: I have been. 14

MR. KATZ: It just needs some 15explanation for the
Board Members who aren't on 16the Work Group [so they]
can follow along. 17

DR. MAURO: I'm reading real quick. 18Give me a second.
Because I've been over this 19before, but I can tell
you I didn't look closely 20because I thought it was
closed and I thought 21that we were going to be moving
on. But let me 22

Por 72

1

Yeah, there was quite a bit of 2extensive discussion
regarding the radium lost 3sources. There's no doubt
about it. And the 4way it was put to bed was it was
judged, first, Sthere was no explicit information that
there 6was in fact this radium source. 7

It was through interviews with 8workers that they
believed that there was a 9source that was mishandled.
And there was some 10indication that was in fact a real
scenario. I1l1And the agreement was that, well, granted
that 12there may have been such an incident. What do 13
you do with this, when you have a word-of-mouth 14
position, and that maybe it occurred, maybe it IS5didn't
occur? And the way in which it was left l6is that, you
know -- that, of course, would be 17for a particular
worker -- a couple of things I8were done. 19


covered employment and were incorrectly identified for consideration as
part of the PER” is astounding and very disturbing.

McKeel question: If employment misidentification by NIOSH is true
and accurate as the Cleveland office reports, then huge amounts of taxpayer
money have been wasted by DOL and NIOSH incompetence. It is primarily
DOL’s job to make certain of legitimate employment BEFORE referring a
claim to NIOSH for dose reconstruction. That employment misidentification
should happen in 15 of 100 cases is a truly astonishing indictment of HHS/
CDC/NIOSH/DCAS and of DOL monitoring what they do.

McKeel further comment: | am sure that all of these other EEOICPA
implementing agencies will want to respond to your rather drastic charge. If
such is the case, then gross malfeasance of doing their job should be
charged and action taken to relieve those responsible of their jobs! | will
have to bring this matter up with NIOSH (DCAS Director Hinnefeld and
others) if your follow up answer does not allay my apprehension.

[Q2, point 7 comment & questions] My comment is that ALL 100
CASES on the PER-057 short list of 100 claims with PER POCs =/>50% had
previous NIOSH dose reconstructions. | verified this personally by reviewing
all 194 summary dose reconstruction development reports | received as part
of CDC FOIA 15-00490. Exactly 100 PER-057 cases had the following data:
(1) pre-PER total radiation dose in Rems, (2) pre-PER POC percentage, (3)
PER-057 total radiation dose in Rems, and (4) PER-057 POC percentage.
Thus, the 100 PER-057 cases could not have included your point 7 cases
described as “15 cases had RD (unfamiliar term to me) without mod orders
(what are “mod orders”?) as they were new claimants.”

McKeel question: | challenge the statement in entirety and assert that
15 cases on the NIOSH short list sent to DOL on 3/11/15 could NOT have
been “new claimants.” DO YOU AGREE?

3. Can DEEOIC project a target date for when all 100 PER-057 short list
claims (those with PER POCs =/>50%) will be finally adjudicated by the FAB and
DOL?

We are unable to provide a specific target date for completion due to the
numerous factors that arise in these decisions, as you can see above. In


U.S. Department of Labor ~ Office of Workers' Compensation Programs...pational IIIness Compensation (DEEOIC) - EEQICPA CIRCULAR NO. 08-02 2/29/16, 5:45 AM

location is variously described as being on 20% or 215¢ streets because
20tm street serves as the major transportation route to the plant, but it
also has a Madison Street address.

PETER M. TURCIC
Director, Division of Energy Employees
Occupational Illness Compensation

Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners,
Technical Assistants, Customer Service Representatives, Fiscal Officers,
FAB District Managers, Operation Chiefs, Hearing Representatives,
District Office Mail & File Section

http: //www.dol.gov/owcp/energy/regs/compliance /PolicyandProcedures/finalcircularhtml/EEOICPACircular08-02.htm Page 2 of 2


Four GSI cases reviewed by DR Subcommittee 10/29/14

MR. FARVER: Observation 1. When 20we reviewed TBD-6000,
Appendix BB, we weren't 21real happy with the external
exposure rate, 22

p. 65

1The Work Group has completed their review, and 2the
new Appendix BB has been drafted and 3approved. 4

Well, we should have reviewed that S5by now. It says
that, "until we've had an 6opportunity to review the
Site Profile." 7

Now, just for my general 8information, is that
something we would do as 9part of the Work Group, our
person on the Work 10Group, you know, would be assigned
to review the Il profile? 12

MR. KATZ: Doug, I mean, it would be I3helpful actually
to get John Mauro on the line 14for these. But I can
just tell you that, yeah, 15I guess this was written --
this is sort of -- 16I don't know when this was
written, the SC&A 17response. But it's old. 18

MR. FARVER: It's old? 19

MR. KATZ: Yes, that's the problem. 20So that work has
all been done. The TBD 21Appendix for this site has
been updated and 22

p. 66

I these were substantive changes to methodology. 2So0
that's how these things were resolved. 3

MR. FARVER: Right. And, you 4know, it's my fault. I
didn't have this marked 5as an SC&A action, probably
because it's under 6observation. But I should have and
I hope we 7don't come across any findings that I messed
up 8like that. 9

ACTING CHAIR MUNN: I think that's 10unlikely. 11

MR. STIVER: Doug, this is Stiver. 12Bob Anigstein just
got finished up reviewing 13the latest revision to GSI
and I think it's now I4in NIOSH's hands to try to
resolve some of this I5stuff. 16

So it's the kind of thing that our 17 review was just
recently -- I believe it was an 18action that was
taking place last month. 19

MR. KATZ: No, Bob's review is not 20o0ut and published
yet. 21


Four GSI cases reviewed by DR Subcommittee 10/29/14

Subcommittee Board members present at the 10/29/14 DRSC meeting were
(Acting Chair) Wanda Munn, Bradley Clawson, John W. Poston, Sr. and David
Richardson. Doug Farver of SC&A recorded the DRSC Findings. John Mauro of SC&A
took part in the GSI cases discussed on pages 61-89. The meeting commenced at
10:30 AM ET and adjourned at 1;25 PM without participants having a lunch break.

Dan McKeel, the GSI SEC-105 co-petitioner with a known long-term interest in the
GSI cases under review listened to the GSI portion of the meeting but was not
allowed to comment.

The main purpose of this white paper is to strongly object to the process the DRSC
used to consider the 4 GSI cases. The evidence | will use to support my position
includes an analysis of the following documents:

(a) E-mails between myself and the DRSC Chairperson in absentia 10/29/14,
Dr. David Kotelchuck;

(b) E-mails between myself and the DFO Ted Katz prior to and following the
10/29/14 DRSC;

(c) The case matrix that contained the SC&A Findings on the four GSI cases
(pages 1-11 of 25), and;

(d) The 141 page verbatim transcript by Neal R. Gross, Court Reporters and
Transcribers, 1323 Rhode Island Ave., N.W., Washington, DC 2005-3701 of the DRSC
meeting of the ABRWH held on October 29, 2014.

Itis important to note that DRSC chairman David Kotelchuck was absent during this
DRSC meeting due to a family emergency. Board member Wanda I. Munn served as
Acting Chair. Ms. Munn is a member of the TBD-6000 work group that deliberated
on revision 1 (June 6, 2014) of Appendix BB Rev 0 (June 25, 2007) for seven years.
This same WG, of which Mr. Clawson and Dr. John Poston are members, also
recommended in 2012 that GSI SEC-105 be denied to the full Board. The full Board
concurred with the WG’s and NIOSH’s recommendations to deny SEC-00150 by a

9 yes to 8 no vote close margin on 12/11/12. The HHS Secretary issued her letter to
deny GSI SEC-00105 ina letter dated 3/6/13.

The DRSC has scheduled another meeting on 2/10/16 to hold further discussions on
the second report to the HHS Secretary. A copy of the Executive Summary of this
paper will be forwarded to the chairman, Dr. David Kotelchuck by e-mail prior to
this meeting.


U.S. Department of Labor Office of Workers’ Compensation Programs
Division of Energy Employees Occupational
Illness Compensation

Washington, DC 20210

DEC 16 2015

Daniel W. McKeel, Jr., MD

RE: Freedom of Information Act Request — Tracking Number 791760
Dear Dr. McKeel:

This letter is in response to your November 17, 2015 Freedom of Information Act (FOIA)
request, which was assigned to the Division of Energy Employees Occupational Illness
Compensation (DEEOIC) on November 19, 2015. This request has been assigned FOIA
tracking number 791760. Please refer to this tracking number in any future correspondence
relative to this FOIA request.

Under FOIA, you requested the names of 13 persons, who were part of the National
Institute for Occupational Safety and Health (NIOSH) Program Evaluation Report
PER-057 General Steel Industries (GSI) cohort of 100 probably compensable claims, for
whom Department of Labor had been unable to locate a legally eligible survivor. You stated
that you would like to help locate potentially eligible survivors of these deceased
employees.

The Privacy Act precludes the release of any record which is contained ina system of
records by any means of communication to any person or to any other agency, except
pursuant to a written request or with the written consent of the individual to whom the
record pertains. The Privacy Act protections apply to Energy Employees Occupational
Illness Compensation Program Act (EEOICPA) claimants. However, an individual's
privacy interests cease upon his or her death.

After following all appropriate procedures to locate all known and potentially-eligible
survivors, DEEOIC has been unable to locate survivors for 12 deceased employees who
were part of the PER-057 GSI cohort. DEEOIC has conducted careful individual reviews
regarding each of these 12 deceased GSI employees’ cases, but we are unable to locate
survivors and have no information to indicate that there is a survivor who is compiling the
initial information to file an EEOICPA survivor's claim. Therefore, after careful
consideration of the special circumstances involved in this matter, ] have decided to release
the list of names of the 12 deceased GSI employees for whom we have been unable to locate


U.S. Department of Labor

OWCP/DEEOIC

P90020/Rm. C3321

200 Constitution Avenue, N. W.
Washington, D.C. 20210

Daniel W. McKeel, Je, MD

Oo a

$ 000.48°

Revo Jzfafis

ums }



some cases, a review of employment revealed the employee did not work at
the covered location for GSI, or the employee passed away and we have
new survivor claims, or the medical changed and the new dose
reconstruction is more complicated. All of these issues require different
amounts of time to process, and so we do not feel comfortable providing
specific target dates for completion of all of the listed cases. In addition, we
have a lot of other cases in the queue, some of which may require expedited
processing or prioritization for any number of reasons (including terminal
claimants). We are processing the GSI cases as quickly and efficiently as
possible along with all of our other cases requiring resolution.

MCKEEL RESPONSE to question 3
Your answer [more...]



U.S. Department of Labor - Office of Workers' Compensation Programs...pational Illness Compensation (DEEOIC) - EEO|CPA CIRCULAR NO. 08-02 2/29/16, 5:45 AM

EEOICPA CIRCULAR NO. 08-02 November 1, 2007

SUBJECT: This Circular clarifies coverage for the General Steel
Industries facility in Granite City, Illinois.

A recent review of documentation pertaining to General Steel Industries
in Granite City, Illinois has resulted in additional information
regarding the location of this designated atomic weapons employer (AWE).
The address of the AWE known as “General Steel Industries” is 1417 State
Street in Granite City, Illinois. The building at 1417 State Street is
part of what was later known as Granite City Steel’s “South Plant.” For a
claim to receive consideration under the Energy Employees Occupational
Illness Compensation Program Act (EEOICPA), it must be established that
the employee worked at the 1417 State Street address, or within the South
Plant generally.

General Steel Industries performed weapons-related work from 1953 to
1966. During that period, however, “Granite City Steel” coexisted as a
separate company in Granite City, IL. This has led to some confusion
because Granite City Steel is shown as an “also known as” name for this
AWE. The purpose of this circular is to clarify the facility definition
by providing specific information about the address of the AWE, which was
not previously identified. This circular is for clarification purposes
only and does not change actual EEOICPA coverage for this facility in any
way.

This particular General Steel Industries plant ceased operations in 1972
and was then purchased by Granite City Steel. Granite City Steel was
itself a subsidiary of National Steel Corporation. Since Granite City
Steel and National Steel Corporation are “subsequent owners or operators”
of the 1417 State Street AWE facility (which had residual radioactive
contamination until remediation in 1993), they are validly characterized
under the category of “also known as.” To be an AWE employee, the worker
must have been employed by and at General Steel Industries or employed by
a subsequent owner/operator (Granite City Steel) at the General Steel
Industries’ location at 1417 State Street.

Granite City Steel’s other plant in Granite City is not covered. Its

hitp:/ /www.dol.gov/owcp/energy/regs/compliance /PolicyandProcedures/finalcircularhtmnl /EEOICPACIrcularO8-02.htm Page 1 of 2


171 13.939 10.875 0.78 9.16% 14.30% 1.56 NOo* 209 Low Dose drop PoC
172 9.980 24.826 2.49 12.09% 35.04% 2.90 NOo* 210 Low Dose+PoC why?)
173 36.072 40.119 ait 31.31% 55.95% 1.79 YES 93 211
174 4,303 13,142 3.05 5.02% | 20.32% 4.05 No* 212 [Low Dose+Poc why?)
175 0.230 0.131 0.57 0.36 0.21% 0.58 No* 213 |AppBB r0? Residual
176 orgi 5.966 31,842 5.34 7.35% 43.24% 5.88 NO 214
176 org2 3.816 16.091 4.22 4.75% 25.45% 5.36 NO 214

176 combo| _ 9.782 47.933 4.90 11.75% __57.69% 4.91 YES 94 215 [Orgi + Org2 type CA
v7 29.179 85.507 2,93 31.88% 68.72% 2.16 YES 95 216
178 3.917 5.304 1.35 5.37% 5.92% 1.10 No 217 __ [residual period only
179 6.458 14.762 2.29 7.00% 22.01% 3.14 NOo* 218 Battelle AppBB r0?
180 26.726 163.767 6.13 27.65% 78.00% 2.82 YES 96 219 [huge dose increase
181 1.679 2.273 1.35 3.96% 5.22% 1,32 NO. 220 residual period only
182 98.439 174.616 4177 48.15% 71.08% 1.48 YES97 221-222 _|Vy high dose OrgCA>|

183 orgl 4.342 5.880 1.35 6.28% 8.14% 1.30 NO 223 Low Org + CA?
183 org2 3.544 4.799 135 11,14% 15.80% 1.42 NO 223 Low Org + CA?
183 org3 3.544 4.799 1,35 151% 2.03% 134 NO 224 Low Org + CA?
183 org4 3.419 4.629 1.35 5.38% 7.02% 1.30 NO 224 Low Org + CA?
183 orgS 3.544 4.779 1.35 1.18% 2.03% 1.72 NO 225 lLow Org + CA?
183 org6 3.544 4.799 1.35 12.40% 16.12% 1,30 NO 225 Low Org + CA?
183 org7 3.544 4.799 135 12.40% 16.12% 1.30 No 226 ___|Low Org + CA?

183 combo _25.481_—_34.484 1.35 41.15% 51.43% 1.25 YES 98 226 Batt.AppBB residual
184 7.249 25.316 3.49 10.31% 38.96% 3.78 NO* 227 [Battelle AppBB r0?
185 180.963 254.276 141 42.16% | 48.49% Lis No**** | 228 PoC Error giant dose
186 6.921 1.161 0.17 30.12% 10.53% 0.35 Nnott** 229 Fails face validity
187 9.509 30.171 3.17 25.06% 65.19% 2.60 ves99 ~ 230-231 |
188 22.768 49.266 2.16 18.66% 23.81% 1.28 No*** 232 Fails face validity

189 org1 0.367 1,511 4.12 4.59% 20.22% 4.41 Nno** 233 Battelle AppBB r0?
189 org2 | 0.388 1532 3.95 3.99% | 20.36% 5.10 Nno** 233 [Battelle AppBB ro?

189 combo 0.775 3.043 3.93 8.40% 36.46% 434 Nno** 234 Battelle AppBB rO?

190 8.639 13.662 1,58 22.48% 47.58% 2.12 NO* 235 review near limit
191 org 0.361 0.491 1.36 0.33% 0.47% 1.42 ‘NO* 236 __ [Battelle AppBB rO?
191 org2 0.843 7.670 9.10 1.14% 8.25% 7.24 No* 236 Battelle AppBB r0?

191 combo 1.204 8.161 6.78 1,47% 8.68% 5.90 NOo* 237 Battelle AppBB rO?

192 5.502 2.621 0.48 9.03% 6.27% 0.69 No*tt® 238 Battelle AppBB FO?
[End of Cases Lend of cb



Dragon, Karen E. (CDC/NIOSH/EID)

From: NIOSH Docket Office (CDC)

Sent: Thursday, May 12, 2016 9:25 AM

To: Sundin, David S, (CDC/NIOSH/DCAS)

Ce: Dragon, Karen E. (CDC/NIOSH/EID)
Subject: FW: McKeel new submission: GS! Docket 140
Attachments: McKeel_GSI-DRSC_letter_5.11.16. pdf

This came in through the Docket e-mail box.

From: Daniel McKeel [mailto::

Sent: Wednesday, May 11, 2016 5:23 PM

To: NIOSH Docket Office (CDC) <niocindocket @cdc.gov>
Ce:

Subject: McKeel new submission: GS! Docket 140

NIOSH Docket Office,

Please consider posting to GS! Docket 140 the attached PDF file as a new submission: Daniel W. McKeel, Jr., M.D.,
“Case Selection Criteria for NIOSH PER-057 pertaining to the General Steel Industries (GSI) Facility by SC&A and the
PRSC." This information has been submitted as a PER-057 agenda item for the ABRWH Procedures Review
subcommittee (PRSC) meeting scheduled for Monday, May 16, 2016.

Thank you very much
Dan McKeel 5/11/16
Daniel W. McKeel, Jr., MD

GSI, Dow IL and TCC SEC co-petitoiner
SINEW cofounder


RE: PER-057 GS! compensation payments 1/29/16, 1:35 PM

-4 cases are presently with NIOSH and we’re waiting for the NRs (One has a newly deceased employee —working to
get survivor claim)

-1 case under development for referral NIOSH (checking status as to delay)

-1 cases were denied by RD -dose reconstruction was 49.02% (I did have on of our HPs validate the results and he
was unable to identify any change to outcome)

-15 cases had no covered employment and were incorrectly identified for consideration as part of the PER
-15 cases had RD without mod orders as they were new claimants

3. Can DEEOIC project a target date for when all 100 PER-057 short list claims (those with PER POCs =/>50%) will
be finally adjudicated by the FAB and DOL?

We are unable to provide a specific target date for completion due to the numerous factors that arise in these
decisions, as you can see above. In some cases, a review of employment revealed the employee did not work at
the covered location for GSI, or the employee passed away and we have new survivor claims, or the medical
changed and the new dose reconstruction is more complicated. All of these issues require different amounts of
time to process, and so we do not feel comfortable providing specific target dates for completion of all of the listed
cases. In addition, we have a lot of other cases in the queue, some of which may require expedited processing or
prioritization for any number of reasons (including terminal claimants). We are processing the GSI cases as quickly
and efficiently as possible along with all of our other cases requiring resolution.

From: Daniel McKeel

Sent: Tuesday, January 26, 2016 12:39 PM

To: Leiton, Rachel - OWCP; Vance, John - OWCP
Ce:

Subject: PER-057 GSI compensation payments

Rachel Leiton, DEEOIC Director, DOL OWCP
Dear Ms. Leiton,

NIOSH issued PER-057 for the GSI IL site on March 11, 2015. That groundbreaking document showed that dose
recalculations by NIOSH for 100 denied part B claims using Appendix BB Rev 1 (issued June 6, 2014) had POCs elevated
above the 50% compensation limit.

Just before the March 11, 2015 issue date for PER-057, DOL weekly updated Statistics by State and Site showed that 78
GSI cases had received EEOICPA compensation. Two of these cases were for part E claims; the rest were for part B.

From 3/11/15 through 1/24/2016, DOL had compensated a total 227 GSI claims and 125 GSI cases, a gain of 47 paid
cases under PER-057. Through a recent FOIA, you provided me with the names of 12 other GSI part B decedents, who
have no known survivor that were on the PER-057 list of 100 probably compensate cases. That leaves 100 minus 59
cases paid or deceased with no survivor equals 41 GSI cases that remain on the probably complensable, not yet paid,
carryover list from PER-057. DOL 1/24/16 statistics indicate that 9 GSI cases are at NIOSH awaiting DR or OCAS-1 forms

https: //mail.aol.com/webmail-std/en-us/PrintMessage Page 2 of 3


RE: PER-05S7 GSI compensation payments 1/29/16, 1:35 PM

From: Vance, John - OWCP <Vance.John@dol.gov>
To: 'Daniel McKeel'
Cc: Leiton, Rachel - OWCP <Leiton.Rachel@dol.gov>
Subject: RE: PER-057 GSI compensation payments
Date: Fri, Jan 29, 2016 9:48 am

Dr. McKee! — I'm responding for Rachel.

5K What process does DEEOIC use to triage PER-057 GSI cases through the FAB? In other worlds, how is it decided
which cases go to the FAB in a particular temporal order (first to last)? For example, is it the order in which NIOSH returns
the reworked ("reworks") DR's and OCAS-1 letters to DOL? Or, do DEEOIC and FAB use some other metric? | would like
to reassure those waiting for compensation based on PER-057 and AppBB Rev 1 that the claims payment process used
by DEEOIC and FAB is fair and impartial.

We did triage the original list of cases we received from NIOSH to determine next steps (e.g. further development,
referral to NIOSH etc.). Once any development is undertaken and/or case is referred to NIOSH and returned, the RD
is issued. Once a recommended decision is issued to the claimant, this cohort of cases is not treated differently
than other cases pending a final decision. Various metrics are applied based on DEEOIC operational planning to
ensure all cases are processed in a timely manner. In the case of GSI case with receipt of a properly completed
waiver of objections — the DEEOIC operational plan requires timely processing within 30 days of the waiver. Our
most recent operational timeliness reporting (FYQ1 — 2016) for all cases shows FAB processing cases with a 96.44%
success rate on this goal.

Issue final decision on claims in cases in
which a right to hearing or review of the
written record has been waived within:

30 days of receipt of the Waiver 2193
Total 2274
Target 90% 96.44%
Average Days 24

We continue to monitor performance of FAB to ensure it exceeds expectations for finalizing recommended
decisions in a timely and equitable fashion, including those related to the GS! PER-057.

oe Will DEEOIC please provide me with a plausible reason why adjudication of the 41 residual cases on the PER-057
short list is taking so long and is progressing at such a slow rate?

| asked to the Cleveland District Office to report out manually on the status of the claims, Here is the information provided -
-There were 100 total cases
- 52 mod orders to reopen previously denied cases with new recommended decisions issued

-12 cases where survivors were not located (Working with to get contact information — he’s working
one-on-one with the assistant Director in CLE on the matter)

https://mail.aol.com/webmail-std/en-us/PrintMessage Page 1 of 3


Four GSI cases reviewed by DR Subcommittee 10/29/14

We reviewed the file. Everything 9is fine. This is a
little different. We're 10just going to close this one.
I would suggest Ilclosing this one. But it's a little
different. 12It's not a TBD issue. 13

ACTING CHAIR MUNN: Yes. That's l4correct. It is
different. This is very 15 specific to this claim itself
and we should léaddress that separately. Thank you,
Doug. 17

DR. MAURO: Doug, this is an 180bservation number you're
looking at right now? 19

ACTING CHAIR MUNN: No, it's 310.1. 20

DR. MAURO: Oh, okay. 21

ACTING CHAIR MUNN: General Steel, 22

p. 87

from the 13th set. 1

DR. MAURO: Okay. Yeah, okay. 2

ACTING CHAIR MUNN: And the 3contractor has suggested
that this action is 4complete and can be closed. Do I
hear any Sconcern or comment with respect to that 6
suggestion? 7

(No response.) 8

ACTING CHAIR MUNN: If not then the 9Subcommittee
accepts the recommendation of 10SC&A. II

MR. KATZ: Doug, was that a QA, are 12 you saying? A OA
issue? 13

ACTING CHAIR MUNN: It looks like 14it is. 15

MR. FARVER: I'll have to go dig up 16the case. I mean,

I've got it here. You just I7have to -- 18
ACTING CHAIR MUNN: It says 1966 19correction, one year
alone was -- it looks as 20though the run was made and

no change. 21
MR. FARVER: Okay, yeah. I 22

p.. 88

probably would classify this as a QA error. It Iwas,
"used value listed in Appendix BB for year 21966 and
divided it by two to account for the 3fact that the
employee left GSI in the middle 4o0f the year. However,
the values listed for 5that year already account for
the fact that the 6contract ended in June." 7

So they divided by two when they 8really weren't

Ay


Four GSI cases reviewed by DR Subcommittee 10/29/14

this time. As Doug has already said, 20we've done this
long, long ago. 21
ACTING CHAIR MUNN: Alright. We 22

p.63

1Steel, Finding 220.1. This item is now closed. 2

MR. FARVER: Okay. The next one is 3220.2. 4

ACTING CHAIR MUNN: CATI report 5concern. 6

MR. FARVER: I'm going to ask John 7Mauro if he has any
input on this General Steel 8case. 9

ACTING CHAIR MUNN: Are you there, 10John? Are you with
us? I

(No response.) 12

MR. FARVER: He may not be. 13

ACTING CHAIR MUNN: It looks like 1l4we may have lost
him. 15

MR. FARVER: Okay. In any case, it 16has to do with some
information in the CATI 17report about the Betatron
area. And in the 18response from July, the issues have
been 19evaluated by the Work Group and there's an 20
agreement in principle that the methods used in 21the
dose reconstructions adequately addresses 22

p.64

lmanagement of the radium source. 2

So it was handled in the Work Group. 3And based on the
work that was done in the Work 4Group, I believe they
have put this issue to Srest. 6

ACTING CHAIR MUNN: It has been 7discussed at great
issue, at great length. And 8it has been agreed that
was the general process 9and there is no outstanding
issue in this l0regard, to my knowledge, in the Work
Group. 11

If there are concerns from the other 12 Subcommittee
Members please express them now, l30therwise we will
accept the SC&A 14recommendation to close. 15

(No response.) 16

ACTING CHAIR MUNN: Hearing none, 17Finding 220.2 for
General Steel is now closed. 18And we move on to
Observation 1. 19


Four GSI cases reviewed by DR Subcommittee 10/29/14

The relevant text from the 141 page 10/29/14 DRSC meeting official verbatim
transcript by is recorded on pages 61-89.

p- 61

1 item from our list. We'll try to remember that 2 for the
agenda next time, to check to make sure 3 that's occurred.
4

I'm sure they will keep us on point 5 with that. Thank you
very much. And that 6 being the case, any other comments
about the 7 work we've done so far? Are we ready to take 8
over the DCAS Site Matrix? 9

MR. FARVER: Yes, let me -- I'm 10 going to go back to that
matrix and put a little 11 note in there about Simonds Saw,
because 12 otherwise I might forget. 13

ACTING CHAIR MUNN: Yeah, let's do 14 give ourselves a
couple of seconds here for Doug 15 to take care of his
administrative burden. 16

(Pause.) 17

MR. FARVER: Okay. That will take 18 care of it. That will
remind me. 19

ACTING CHAIR MUNN: Great. Thank 20 you very much. It looks
like our first item is 21 from the 10th set, General Steel,
220.1,22

p. 62

1

MR. FARVER: Correct. And the 2first one is Case 220,
General Steel. The 3issue is [that] occupational
medical dose 4should have included PFG exams. 5

If you remember, a long time ago we 6were still
concerned that AWEs may have had PFG 7exams. And since
then, we have discussed this 8and have put it to rest.
And I believe it's 9even in the documentation now that
they are not 10to be included for AWEs. I know it is.
I've llread it before. But I can't quote it to you off
12the top of my head. So this is an old issue that 13
was really addressed long ago. 14

ACTING CHAIR MUNN: Yes. The 15Subcommittee has long ago
made its 16determination in this regard. This is just
an l7outline that we need to agree upon, and if you 18
have any comments or concerns, please express 19it at


survivors. Accordingly, as requested, below are the names of the GSI cases where no
survivors have been located:

I believe that DEEOIC has been responsive to your request. There are no fees associated
with this response, and this letter completes our action concerning your request.

You may file an appeal of this decision with the Solicitor of Labor within 90 days from
the date of this letter. The appeal must state, in writing, the grounds for the appeal,
including any supporting statement or arguments. In order to facilitate processing of
the appeal, please include your mailing address and daytime telephone number, as well
as a copy of the initial request and this letter. The envelope and letter of the appeal
should be clearly marked “Freedom of Information Act Appeal.” Any amendment to
the appeal must be made in writing and received prior to a decision. The appeal should
be addressed to the Solicitor of Labor, Division of Management and Administrative
Legal Services, U.S. Department of Labor, 200 Constitution Avenue, N.W., Room
N-2420, Washington, D.C. 20210. Appeals may also be submitted by email to
foiaappeal“dol.gov. Appeals submitted to any other email address will not be
accepted.

Sincerely,

Roctl Pfortore

Rachel P. Leiton
Director, Division of Energy Employees
Occupational IlIness Compensation


70 5.270 17.983 3.41 45.33% 80.45% 177 YES 42, 86 ___Jlow dose high PoC?
7 7,950 30.143 3.79 10.39% [40.98% 3.94 No* 87-88 __ [review near limit
72 16.963 31,320 1.85 27.21% 49.74% 1.83 No* 89 must review 49.74%
3 13.831 42,342 3.06 30.53% — 69.41% 2.27 YES 43 30-91
74 6.828 35,237 5.16 2.43 YES 44 92___ [huge jumps why?
75 51.048 105,039 2.06 1.61 YES 45 33
76 26.967 163.698 6.07 3.08 YES 46 94 highest dose jump
[77 J 9.348 | 37.796 | 404 | 3.66 No* 95-96 [review near limit
78 74.111 106.600 1.44 1.40 YES 47 7
79 26.216 120,777 4.61 2.70 YES 48 38
80 35.451 | 53.327 1.50 2.66 No* 99 low PoC organ CA?
81 25.390 8.626 0.34 047 No* 100-101 _|PER PoC major drop,
82 49.040 128.051 2.61 1.83 YES 49 102
83 86.929 127,828 1.47 1.49 YES 50 103
[84 27.079 | 32856 | 121 | 1.76 No* 104-105
85 7.291 23.566 3.23 2.20 YeS51 _ 106-107
86 45.458 $6,307 1.24 1.29 YES 52 108
87 2051 | sos | 248 | 2.84 No* 109-110 |Dose+Poc low why?
8 64,948 99,398 153 1.88 YES 53 iii
39 49.792 121.058 2.43 1.89 YES 54 iz
90 73.084 164,504 2.25 1.70 YES SS co ae | [
oT 5.837 | 25.219 | 432 | 4.36 No** 114-115 low preGsisDOWw 3)
32 12.470 16.208 1.30 1.47 YES 56 16
93 9.034 | 41693 | 462 | 4.22 No* 717-118 [low pre review CA?
Eg 24.179 139,297 5.76 2.27 YES 57 119 |vy large increments
95 27.329 $8,116 2.13 177 YES 58 120
36. 22.711 137.348 6.05 3.74 YES59 121 |vy large increments
97 24.291 158.551 6.53 3.18 YES 60 122 |vlarge increments
98 23.755 __ 138.600 5.83 2.34 YES 61 123 __ |vylarge increments
99] 23755 | 4441 | o19 | 2.42 no** 124 [huge dose drop why
100 739,090 5.80 2.29 ‘YES 62 125 [lage increments
101 116.071 5.21 3.92 YES 63 126 __ [vy large increments
102 71.289 89.463 1.25 1.46 YES 64 127
103 9.611 27.580 2.87 2.94 No* 128-129 _|Must review 49%+
104 10.851 9577 0.88 0.79 No*** 430-131 _ GSI-Weldon Sprngs_Dose+PoC drop 21%
105 43.225 108.875 2.52 35.90% 68.76% 1,92 YES 65 332 l
106 6.611 | 15.165 | 2.29 0.00% 0.02% BLANK notes 133__ Is this CLL=ERROR?



Four GSI cases reviewed by DR Subcommittee 10/29/14

latest version of 16Appendix BB. But, of course, I
could always 17take another look at it. But it
certainly is 18in the transcripts. 19

ACTING CHAIR MUNN: I think that's 20probably all we
need, John. 21

DR. MAURO: Okay. 22

p. 77

Imuch. And we have taken the action to identify 2that
particular finding 220.2 as closed. 3

DR. MAURO: That's what I would say 4is the reason it
was closed. And I think that Srationale still holds. 6
ACTING CHAIR MUNN: Yeah, I think 7we're clear on that.
Thank you for the 8elucidation. It's very helpful. 9
Now we're on to Observation 1, I 10believe. 11

MR. FARVER: Correct. 120bservation 1 has to do with the
default 13external exposure rate for non-Betatron 14
workers. John, do you know if this has been -- 15

DR. MAURO: Oh, now we're getting l6into the -- they're
getting a lot easier now. 17

All of this has been revised. 18Let's talk with
Observation 1, regarding this 19.72 mR per hour. This
whole issue has been 20reviewed, revised. It is now
addressed 21explicitly in Appendix BB. The issue has
been 22

p. 78

1. resolved in principle. We do have some comments, which
I would consider to be of 2marginal importance in terms
of just 3clarifying, which you haven't seen yet. You 4
will see that within a week, I would imagine. 5When I
say you, I mean NIOSH and the Work Groups. 6

So this is a Site Profile issue that 7I believe has
been resolved in principle. And 8you're really just
waiting to see through the 9issues resolution process
out of Appendix BB. 10The plan hasn't changed. All this
-72 mR per Ilhour business, you know, has been revised.
And 12the whole Appendix BB approach has been 13
substantially revised. 14

ACTING CHAIR MUNN: Fine. Thank IS you, John. The
response that we have is that 1l6the item is in abeyance

12


Four GSI cases reviewed by DR Subcommittee 10/29/14

until the Site Profile 17review is available. And we're
hearing, I 1&8think, that's going to take place
imminently. 19

DR. MAURO: Yes. 20

ACTING CHAIR MUNN: And my 2lobservations on this
observation, and 22

p. 79

1. Observation 2 as well, is that these will be
resolved by the actions that are going to be 2
forthcoming between now and the next meeting of 3this
Subcommittee. I’m assuming that we can 4leave these two
observations as they are, 5pending our status at the
next meeting will have 6changed, I think, most of
these. 7

Is there any suggestion that we 8proceed in any other
fashion? 9

(No response.) 10

ACTING CHAIR MUNN: If not, then 11let's move on to the
next finding, number 239.1. 12

DR. MAURO: Same thing. 13

ACTING CHAIR MUNN: This is 14modeling of photon doses
to the personnel. 15

DR. MAURO: I mean, we're dealing l@with, again, a
complete rewrite, revision, 17except for the item
that’s closed, the second 18o0ne where it deals with
PFG. Of course, we can 19close that for the same reason
we closed it 20previously. 21

ACTING CHAIR MUNN: Correct. 22

p. 80

1. DR. MAURO: But everything else, I Ilbelieve, is still
in a state of -- in abeyance, 2agreed in principle, you
know, and we're 3waiting on the close out of any
residual issues 4as a result of SC&A's review of the
latest S5version of Appendix BB. 6

MR. KATZ: John, I think, actually, 7these things can be
closed for the DR 8Subcommittee. The reason why I think
that is, 9regardless of what further discussion there
may 10be on the revised Appendix, what is agreed upon 11
is that the old methods were not adequate and 1l2were

13


Four GSI cases reviewed by DR Subcommittee 10/29/14

Submission to NIOSH Docket 140
by Daniel W. McKeel, Jr., MD

“The Four GSI Completed Dose Reconstructions
Reviewed by the Dose Reconstruction Subcommittee
With Wanda Munn as Acting Chair on 10/29/2014”

(version 1.0, Feb. 8, 2016)

Executive Summary

The purpose of this paper is to comment on four General Steel Industries cases that
were discussed superficially at the October 29, 2014 meeting of the Dose
Reconstruction Subcommittee (DRSC) of the ABRWH. I contend the DRSC failed to
review these 4 GSI cases with the same rigor used for all other DRSC completed DR
case reviews, The documents ] will cite strongly suggest the DRSC Acting Chair,
Wanda Munn, together with the designated federal official Ted Katz, deliberately
by-passed normal DRSC operational procedures of discussing each SC&A Finding
and observation individually, in order to ensure these 4 GSI cases were included in
the second DRSC “roll up” report to the HHS Secretary. As a result, I believe that
including these four GSI cases in the statistics for the DCAS Sites 10 to 13" Sets in
the roll-up report to the HHS Secretary represents a scientifically dishonest and
misleading rendition of how these cases were mishandled by DRSC. Two of these
cases were flagged by SC&A as early as 2009. Dan McKeel had an extensive e-mail
correspondence with DFO Ted Katz, and former and present DRSC chairs Mark
Griffon and David Kotelchuck, trying to find out whether and when DRSC would
review the four GSI cases.

(1) Perfunctory reading of the SC&A Findings Matrix. Acting Chair Munn
invoked the unusual and scientifically unacceptable procedure of having DRSC
participants silently read through Pages 1 through 11 of 25) of the SC&A Findings
matrix instead of having the usual in depth oral discussion of each Finding
separately. It took Dan McKeel 8 minutes and 57 seconds to silently read through
the 11 pages. Ms. Munn allowed only about two minutes for this task. Thus, the
DRSC participants could NOT have read through these findings and resolutions in
the time Ms. Munn allotted to them. And, as the relevant transcript shows
(ATTACHMENT A), nota single ABRWH member had any comments during this
silent reading or anywhere in the 11 pages of GSI-related 10/29/14 DRSC transcript
in spite of several typos (ex. “aggress” instead of “agrees”). Almost all of the NIOSH
and SC&A responses avoided the actual issue altogether and resorted instead to
stating the TBD-6000 work group had discussed all of these matters and resolved



Daniel McKeel letter to Dr. Kotelchuck (DRSC) and DCAS Director Hinnefeld

PLEASE NOTE 1: GS! PER-024 involved four earliest GSI DR using technical
guidance ORAUT-OTIB-0004 that is now considered obsolete. Three of 4 of
these presumptive “GSI” cases were also ineligible Granite City Steel workers
who never worked at the GSI/South Plant 1417 State St. location (see DOL Final
Circular 08-02). | am not aware the PRSC or SC&A have ever reviewed GSI
PER-024. | obtained redacted case summaries via a FOIA request.

PLEASE NOTE 2: Dan McKeel tracks both NIOSH and DOL weekly EEOICPA
GSI in Illinois worksite statistics. Since 3/11/15 when PER-057 was issued and
78 GSI cases had been paid, an additional 66 GSI cases have been paid by
DOL. That leaves 34 GSI not paid from the PER-057 list of 100 with PER POC’s
greater than 50%. SC&A and the PRSC need to investigate these cases in detail.

Part 2 -- Status of 4 GSI cases with full findings reviews postponed by
DRSC in October 2014 because cases were to be processed under
Appendix BB Rev 1 and PER-057

Director Hinnefeld's reply of 5/5/16 amply confirms my analysis below in several
respects. The overarching mandate is the dose reconstruction subcommittee
must review only "completed dose reconstructions.”

The 4 GSI DRSC set 10-13 cases that Stuart now confirms were on the PER-057
short list of 100 with PER POCs greater than 50% that were transmitted to DOL
on March 11, 2015, did have an initial NIOSH dose reconstruction which was
denied. Only three had reworks, Why did the 4th case not have a rework? Was
this due to death, wrongful employment, or some other factor?

The Dose Reconstruction subcommittee (DRSC) of the ABRWH was scheduled
to review the findings in these 4 cases at the subcommittee meeting on 10/29/14
while Wanda Munn was the acting chairperson (Dr. Kotelchuck was unable to
participate). At that meeting, instead of discussing each finding on each of the 4
cases, the usual DRSC practice, Ms. Munn, with DFO Ted Katz’ ready
concurrence and approval, had subcommittee members merely read the ten
pages of relevant findings matrix material, the actual findings, silently to
themselves (a highly unusual practice) with no itemized discussion. DRSC
members were asked to pose questions if they had any to make. Thus, the actual
findings and their resolutions were not read into the official public ABRWH
transcript record that is posted under Docket 140 on the DCAS website.

Dr. Kotelchuck's analysis was to state the prime DRSC mandate was fulfilled
because the 4 GSI cases were later discussed by the Board (| assume including
the TBD-6000 WG) based on Appendix BB Rev 1 (issued 6/6/16). However, that
never has happened to my knowledge. NIOSH or the Board or SC&A have never
reviewed or discussed the four GSI cases in any paper based on Appendix BB
Rev 1 that | am aware of. PER-057 is based on dose reconstruction development
[recalculation]) reports that fail to meet full formal dose reconstruction criteria.



Four GSI cases reviewed by DR Subcommittee 10/29/14

supposed to divide by two. They 9didn't need to. 10
So, yes, I would probably classify Ilthat as a QA
concern. I will put that wording 12somewhere in there.
13

ACTING CHAIR MUNN: Thank you for 1l4catching that from
the suggestion. 15

MR. FARVER: Now, I believe that's l6the only other
outstanding finding that's 17different than the other
issues we've talked I8about. In which case, I'll go
back and add that 19wording to the findings and
observations, but 20I won't take the Subcommittee's
time now to do 2lthat. 22

p. 89

ACTING CHAIR MUNN: Thank you, 1Doug. That’1ll be great.
Thank you much. 2

MR. FARVER: That would take us to 3Page 10, Page 11.
Well, Hooker. Tenth set, 4Hooker, 221.1. 5

ACTING CHAIR MUNN: And I believe 6John said he has
something to contribute here. 7

DR. MAURO: Yeah, there's an 80verarching matter, and
then we can go through 9each item quickly to decide
whether they could 10be closed notwithstanding the
overarching 11 issues. 12 [end of GSI pages]

The Hooker process has some 13history... [more on
Hooker Electrochemical site in New York]

18


MCKEEL Comment to your answer to McKeel question 1

Your answer only partly addresses my concern and overall is very confusing.
| believe this is because you were speaking in generalities that don’t
necessarily apply specifically to GSI PER-057. [more...]

2. Will DEEOIC please provide me with a plausible reason why adjudication
of the 41 residual cases on the PER-057 short list is taking so long and is
progressing at such a slow rate?

| asked to the Cleveland District Office to report out manually on the status of the
claims. Here is the information provided -

-There were 100 total cases

- 52 mod orders to reopen previously denied cases with new recommended
decisions issued

-12 cases where survivors were not located (Working with to

get contact information — he’s working one-on-one with the assistant
Director in CLE on the matter)

-4 cases are presently with NIOSH and we’re waiting for the NRs (One has a
newly deceased employee —working to get survivor claim)

-1 case under development for referral NIOSH (checking status as to delay)
-1 cases were denied by RD -dose reconstruction was 49.02% (I did have on
of our HPs validate the results and he was unable to identify any change to

outcome)

-15 cases had no covered employment and were incorrectly identified for
consideration as part of the PER

-15 cases had RD without mod orders as they were new claimants

MCKEEL RESPONSE to question 2


of the 12 deceased no survivor PER-057 claimants in response to a FOIA
request from me. | shared those names with ! . |was unable to
learn exactly what steps DOL had taken to determine the absence of legal
heirs that could have, or have filed survivor part B EEOICPA claims.

[Q2, point 4 comment & question] You state “4 cases are presently
with NIOSH and we're waiting for the NRs (One was a newly deceased
employee -working to get survivor claim.”

McKeel Questions:

(a) What are NRs?

(b) Were all 100 PER-057 GSI claimants alive on 3/11/15 when NIOSH
issued PER-057? If not, how many total short list of 100 PER-057
compensable cases (based on PER POC) have died since 3/11/15?

[Q2, point 5 questions] This sentence is incomplete and needs
clarification.

(a) Is the phrase “for referral NIOSH” lacking the word “to” before the
word NIOSH?

(b) What does “under development” mean with respect to a case that
was part of PER-057 issued 3/11/15?

(c) Who is checking “status as to delay” and does this mean reason
why there has been a delay?

(d) Grammar is confusing “1 cases” and “were denied” should read “1
case.. was denied”, and (e) | don’t understand the term “denied by RD -the
PER POC had to be over the 50% compensation limit to even get on the
PER-057 short list of 100 cases that were defined as of 3/11/15 by having
Appendix BB Rev 1 and PER-057 POCs =/>50%. This point makes me wonder
whether the Cleveland office CEs fully understand what a PER document
represents? The feedback ! F and | have gotten from Many GSI
and Dow PER-057 and PER-058 claimants was that manny CEs and CE
supervisors at both DOL and NIOSH were unaware of the full ramifications of
a NIOSH Program Evaluation Report (PER) or the preferred way these
documents were to be implemented.

[Q2, point 6 comment & questions] My comment is the “fact” that 15
cases, according to you via the Cleveland DOL District Office, “had no


Daniel McKee] letter to Dr. Kotelchuck (DRSC) and DCAS Director Hinnefeld

program. During these interviews, claimants are asked targeted questions about
site operations. So, for example, a person who had worked only at Granite City
Steel, but never at the GSI or the "South Plant” covered 1417 State Street
location in Granite City, IL 62040, would probably not know about the two 24-25
MEV Betatrons at GSI. So NIOSH could/should be able to detect an ineligible
worker whose interview indicated he/she knew little or nothing about work site
practices at GSI, including using the twin Betatrons and twin radium and cobalt-
60 sources at GSI to perform MCW uranium and commercial steel NDT
inspections. For that to happen 15 times out of 100 in hard to imagine.

McKeel believes the fact that 100 PER-057 cases he reviewed under CDC
FOIA 15-00490 indeed had an initial dose reconstruction with a pre-PER POC
less than 50% and a PER-057 POC greater than 50% meant that 15 cases could
NOT possibly have been new claims under PER-057. FOIA 15-00490 was
submitted by McKeel on 3/11/15, the same day the report was issued and the
100 cases PER-057 list was forwarded by NIOSH to DOL.

A sample is attached representing one of 192 "summary dose
reconstruction development reports", the term the CDC/ATSDR FOIA office and
Lita Aquino chose, which McKeel received on a CD-ROM as the final response to
FOIA 15-00490, Those summary DRDR reports contained the following
information from NIOSH/DCAS on each of the 192 cases: (a) a pre-PER total
dose in Rem, (b) a pre-PER POC percentage to two decimal places, (c) a PER-
057 recalculated total dose in Rem based on Appendix BB Rev 1; and (d) a PER-
057 POC percentage, based on Appendix BB Rev 1 and IREP data inputs.

Dan McKeel stated his opinion that a 52% accuracy rate for NIOSH
determining cases that were to be returned to them under PER-057
for reworks is unacceptable by any criteria. Many of his emails were addressed
to DCAS health physicists David Allen and Jim Neton who wrote, owned and
reviewed PER-057. Neither person explained the high case selection error rate.

Neither DOL nor NIOSH answered McKeel's questions fully. for this reason,
mckeel requests that SC&A examine all 48 cases that DOL flagged as not
meeting NIOSH rework criteria that were on the list of 100 per-057 cases with
per POCs exceeding 50%. An alternate suggestion is for SC&A to review 20%
of the 192 cases, or 38 cases, to include 5-7 cases in each of the following
groups represented among the claims the comprise NIOSH PER-057:

(a) cases with pre-PER and PER POC's less than 50%;

(b) cases with pre-PER and PER POC's greater than 50%;

(c) cases from the 52 that DOL stated would be reworked by NIOSH;

(d) cases from the 12 decreased/no survivor known cohort to determine
whether the date of death was prior to or after 3/11/15, the date PER-057 was
issued;

(e) cases from the 15 with wrong employment (Not GSI workers);

(f) cases from the 15 "new cases" that, presumably, never had an initial
denied claim based on a full NIOSH dose reconstruction under Appendix BB Rev
0 (June 2007).



Four GSI cases reviewed by DR Subcommittee 10/29/14

closed. That is, it was 17decided that both the issue
for the person 1l8himself who might have handled that
would be 19dealt with on a case-by-case basis. 20

And second, other people that might 2lhave been in the
vicinity of, let's say, an 22

p. 75

lthose doses were taken into consideration 2through the
modeling effort that was done 3independently by both
SC&A and NIOSH. 4

So that's where that issue stands. 5Now, that all being
said, that was in 6discussions that were held during
the TBD-6000 7Appendix BB Work Group meeting. Now,
where we 8stand as of today, is that NIOSH has in fact
9issued an Appendix BB revised that reflects 10five
years’ worth of work. 11

SC&A, Bob Anigstein, has reviewed 12it, has completed
his review and we're probably 13a day away from
delivering our review of this 1l4revised Appendix BB.
And so NIOSH hasn't yet 15seen, we do have some
comments. Now, the l6degree to which I reviewed that,
this issue is 17not an issue in the latest version of
Appendix I18BB. 19

MR. KATZ: Okay, thanks. 20

DR. MAURO: That's the best I can 21ido. I wish I could
do better. 22

Pp. 76

lhelpful. And I think the point you make, that 2should
be clear, is that the methods have been 3changed as a
result of this extensive review. 4

DR. MAURO: Absolutely. 5

MR. KATZ: So that's how this 6finally gets put to bed.
7

DR. MAURO: Yeah. And, of course, 8I think that,
certainly to close the loop again, 9some type of note
perhaps from Paul to this 10effect, because that was
agreed upon and it's llactually in the transcripts of
the meeting. 12

But I could tell you, from reading 13the report, the
latest review, I can say that 14I don't recall seeing
this particular question I5explicitly addressed in the

11


PER_057 15 0490b.HTM

~-  @ file://}Volumes/Macintosh%20HD2 /GSI-PER-O5 7_15-00490b.HTML

Kings Count...rds 9.15.15

(BND)

Claim

Total assigned dose

(oI)
Dose Categories ~~ Current Dose (rem) PER Dose (rem) ]
Exterral | 33.657.” | 130.817
—— i :
Internal | 29.043 i N/A
———— | pa ae os oe
Total | 53.833 130.817
aa : | eee eee
PoC
' - PoC
“Cureent D3 "| aG.98%
-- "18,07%
External Dose
tits) bys)
Table 8“ ‘values assigred fer yeas
foRGe

Table 13 “Residual Sxriad” dase valucs assigned for years

hove)

Dose fer years [!2!_ Jand was pro-rated for partial year of site operations.



Daniel McKee! letter to Dr, Kotelchuck (DRSC) and DCAS Director Hinnefeld

Dear Mr. Hinnefeld (DCAS) and Dr. Kotelchuck (DRSC ABRWh),

| ask DFO Ted Katz to please distribute this e-mail and the attached letter with
attachments to all members of the Procedures Review subcommittee (PRSC)
and to members of the Dose Reconstruction subcommittee (DRSC) of the
ABRWH. The PRSC has on its agenda for the May 16, 2016 meeting the
selection by SC&A of GSI cases for the PRSC to review under PER-057 (2 page
NIOSH/DCAS report issued 3/11/16 that encompassed 196 GSI cases).

Part 1 -- SC&A selection of PER-057 cases for review

THIS PART OF THE MEMO CONTAINS INFORMATION VITAL TO SELECTING
PER-057 CASES FOR REVIEW BY THE DRSC ON MAY 16TH. To my
knowledge, SC&A has not been included in these discussions | have had with
DCAS (Director Hinnefeld) and DOL (DEEOIC Director Leiton and John Vance).

Last September (2015) Rachel Leiton informed Dan McKeel that 12 GSI PER-
057 claimants were deceased and that DOL had not found a survivor for them.
Under a FOIA request, Ms. Leiton provided McKeel with the names (only) of
those 12 deceased presumed survivorless GSI claimants.

John Vance then informed McKeel the DOL Cleveland Office had provided the
following information on the group of 100 PER-057 GSI claims with PER POCs
greater than the 50% compensation limit:

a) Only 52 of the 100 PER-057 cases qualified for reworks and would be
returned to NIOSH;

b) 12 cases had died for whom DOL could not find a survivor;

c) 15 more cases had the wrong (incorrect) employment and did not qualify as
General Steel Industry employees. That is, they were INELIGIBLE to be
compensated under PER-057;

d) 15 more cases were "new claims". Meaning unclear to Dan McKeel.

None of these data made any sense to Dan McKeel who submitted a list of
questions that were answered only in part by Rachel Leiton and John Vance.
Rachel Leiton informed McKeel that DOL had gone to all reasonable lengths to
answer his questions informally, and therefore he needed to make FOIA requests
for any additional information. One of the unanswered questions was the full
protocol DOL used to locate survivors. Another incompletely answered question
was how could DOL make such an egregious error in misclassifying 15 of 100 or
15% of the PER-057 probably compensable 100 cases. This seemed like an
unacceptable error rate. DCAS and Director Hinnefeld stated that determining
employment status was solely up to DOL, and that NIOSH performed a dose
reconstruction if DOL certified the person worked at an eligible site.

Dan Mckeel's position is that NIOSH/DCAS, according to the DCAS website,
routinely conducts employment interviews of all claimants as part of the DR


Four GSI cases reviewed by DR Subcommittee 10/29/14

MR. STIVER: It's not -- excuse me, 22
p. 67

lprocess of being finalized. 2

MR. KATZ: Right. It will be out 3soon, I expect. But
it's not out. 4

MR. STIVER: Let me see if I can get 5John Mauro back on
the line here. Hang on just 6a minute. 7

MR. FARVER: I'm putting a note in 8here that we need
to, that SC&A needs to review 9this per these issues.
10

ACTING CHAIR MUNN: Both Il observations are -- this is
well underway. 12

MR. KATZ: Well, yeah, I mean, 13 right. Let's wait, I
guess, to see if we can 14get John on the line. 15
ACTING CHAIR MUNN: Yeah, it would 16be helpful. 17

MR. FARVER: Because I see, for the 18next case, it's a
finding that to close it out 19we need to review the
TBD. 20

MR. KATZ: Yeah, in effect, all of 21these, I think.
John will tell you all of these 22

p. 68

lwith the TBD that were then addressed by the 2Work
Group and resolved by the Work Group and 3resulted in
very substantive changes to the 4TBD. 5

ACTING CHAIR MUNN: Yes, they were 6and are substantive.
7

MR. KATZ: Right. 8

ACTING CHAIR MUNN: And we will -- 9the PER is a given.
10

MR. FARVER: Okay. I'm going to llput it in there. It's
going to show up as a 12couple of findings that I'm
still going to keep 130pen, pending an SC&A review,
which we should Il4have done before but we will do -- 15
MR. KATZ: Well, yeah, I'm not sure 1l6that you're going
to leave these open actually I7here, because the review
of the methodology I8related here has already been done
by the Work 19Group. But let's wait for John. 20

ACTING CHAIR MUNN: Yeah, and -- 21

DR. MAURO: I'm here. 22


Four GSI cases reviewed by DR Subcommittee 10/29/14

follow most of these 9findings, and I'll add the title
and the date 10even to the observations just for
completeness. 11

ACTING CHAIR MUNN: That's l2appropriate. Let's give the
other Members an l3 opportunity to read through these
briefly. 14

DR. MAURO: I suspect that there I15will be a PER after
this Appendix BB and any 16final cleanup of the issues
resolution, which 17should occur very quickly. Then
there will 18certainly be a PER and a lot of cases will
be 19reviewed. 20

ACTING CHAIR MUNN: I would 2l anticipate that. 22

p. 85

DR. MAURO: Yes. |

(Pause.) 2

ACTING CHAIR MUNN: I'll give you 3another 30 seconds or
so, then we'll roll this 4up. 5

(Pause.) 6

ACTING CHAIR MUNN: Alright. This 7discussion that we've
had takes us through the 8end of Page 10. If there is
anyone on the 9Subcommittee who has any concern with
our 10dealing with these items in this way, please II
just let us know. Anyone who feels rushed and 12wants
more time, please let us know. 13

(No response.) 14

ACTING CHAIR MUNN: Hearing none. 15Yes, Doug, please
proceed as we have indicated. 16And we will consider,
for purposes of this 17Subcommittee, that the GSI items
shown on this I8matrix through Page 10 are now closed.
19

That brings us to Finding 221.1, 20Hooker. Exposure
period may exceed 5 percent 2lof the worker's time. 22

p. 86

DR. MAURO: This is John. I could lhelp out again here.
2

MR. FARVER: John, before you do 3that, I just want to -
- again, this more 4bookkeeping -- but if you go to the
top of Page 59, there's one General Steel finding about
the 6photon doses, and it was because a file was not 7
included, a NIOSH file. 8

16


Four GSI cases reviewed by DR Subcommittee 10/29/14

them “in principle.” SC&A recommended that multiple Findings be “placed in
abeyance until SC&A reviewed the TBD which we received on July 3, 2014.”

(2) Silent reading means the actual GSI case errors by NIOSH using GSI
Appendix BB Rev 0 were not placed on the record. There was NO (zero) discussion
of the real facts in each case.

(3) Dan McKeel attended or listened to and usually participated actively in
making comments to the initial TBD-6000/6001 and Appendix BB, and to the
subsequently formed TBD-6000 work groups (WG). His recollection of the WG
discussions alluded to by SC&A in this matrix do NOT match his notes on the actual
WG meeting discussions,

(4) The issue date of Rev 1 (revision number one) of GSI Appendix BB to
TBD-6000 was June 6, 2014. Rev 0 of Appendix BB was dated 6/25/2007. SEC-105
co-petitioner Dan McKeel submitted his critique of Appendix BB Rev 1 on 7/21/14.
Itis unclear why it took 27 days for NIOSH to transmit the Rev 1 document to SC&A.

(5) Of particular interest and importance to SC&A’s oft repeated 10/29/14
findings matrix statement under SC&A Response that “...we recommend that this
item remain in abeyance until SC&A has an opportunity to review the revised
site profile, which we received on July 3, 2014" is the fact that SC&A had ample to
time to submit its review of Rev 1 before the DRSC met on Oct. 29, 2014, The time
elapsed between 7/3/14 and 10/29/14 is 118 days.

(6) The 11 pages of the 10/29/14 SC&A Findings matrix provided to Dan
McKeel by DFO Ted Katz is included as ATTACHMENT B to this document.

(7) Ted Katz overruled the Findings which SC&A recommended be placed in
abeyance until SC&A reviewed Appendix BB Rev 1 should, instead be closed. This
was scientifically improper for several reasons: (a) the action on Mr. Katz’ part
exceeds his duties as DFO; he is NOT a scientific member of the DRSC; (b) Most
SC&A responses to the 10/29/14 GSI Findings Matrix pages 1-11 are predicated on
a later examination by SC&A and report to DRSC based on the SC&A review of Rev 1
that was not released until 5 days after the DRSC met on 10/29/14. Further, it
should be noted the DRSC has not completed its 2TM4 roll-up report of Sets 10 through
13 to the HHS Secretary. This is an agenda topic for the February 10, 2016 DRSC
meeting. Most disturbing is the fact that, to my knowledge, the DRSC never
addressed any of the GSI Findings on pages 1-11 of the DRSC Findings Matrix
subsequently to this date 2/10/16.

Summary of Executive Summary. For multiple reasons stated herein, these
four GSI cases have not been reviewed by DRSC with sufficient rigor, by usual DRSC
review methods that are applied to other sites, and therefore should not be included
as “reviewed” in the summary statistics the ABRWH and DRSC plans to report ot the
HHS Secretary. Dan McKeel plans to share these concerns with multiple officials at
HHS, including the HHS Secretary directly.



RE: PER-057 GSI compensation payments 1/29/16, 1:35 PM
to be signed.

Thus, in 10 months and 14 days (10.5 months), DOL had adjudicated 59 or 59% of the 100 GSI PER -057 cases or 5.6
cases/month total, including the 12 deceased no survivor cases, | assume all 59 of these cases have been reviewed by
the FAB. Actual payments to the 47 paid GS| PER-057 claims have been at the monthly rate of 4.5 cases/month. This
payment rate seems very slow to me.

As part of my following PER-057, | have obtained 194 summary dose reconstruction 1 to 3 page-long reports from NIOSH
by the FOIA process. The summaries | received from CDC/NIOSH included pre-PER-057 and PER-057 total radiation
doses in Rem and POC percentages. Personal identifying information was omitted, including from the 12 deceased
claimants DOL identified. In addition, | reviewed two allegedly complete NIOSH dose reconstruction development reports,
both unredacted, which had many more files and file types (Word .doc, html, Excel .xls spreadsheets) compared to the
summary DRDR from the CDC FOIA.

My related questions to the above background information that prompt this letter are as follows:

Ty What process does DEEOIC use to triage PER-057 GSI cases through the FAB? In other worlds, how is it decided
which cases go to the FAB in a particular temporal order (first to last)? For example, is it the order in which NIOSH returns
the reworked ("reworks") DR's and OCAS-1 letters to DOL? Or, do DEEOIC and FAB use some other metric? | would like
to reassure those waiting for compensation based on PER-057 and AppBB Rev 1 that the claims payment process used
by DEEOIC and FAB is fair and impartial.

2. Will DEEOIC please provide me with a plausible reason why adjudication of the 41 residual cases on the PER-057
short list is taking so long and is progressing at such a slow rate?

3, Can DEEOIC project a target date for when all 100 PER-057 short list claims (those with PER POCs =/>50%) will
be finally adjudicated by the FAB and DOL?

Thank you for considering my request.
Sincerely,

--Dan McKeel January 26, 2016 Tuesday
Daniel W. McKeel, Jr., MD.

GSI, Dow IL and TCC SEC co-petitioner
SINEW cofounder

https://mail.aol,com/webmail-std/en-us/PrintMessage Page 3 of 3


Your answer from Cleveland District office staff is puzzling, partly because
you use jargon terms such as “mod” and “NRs” and “denied by RD” with
which | am not familiar, and ask for you to please clarify. In addition, your
reply cites facts that are difficult to accept as possibly being applicable to the
100 PER-057 GSI cases with PER POCs =/>50% after being assessed using Rev
1 of GSI Appendix BB issued June 6, 2014. All 100 PER-057 cases had a
previous dose reconstruction and were denied.

| will address your answer points in order:

[Q2, Point 1] SINEW records compiled by ‘ _ law firm for
the GSI and Dow Illinois plant EEOICPA claimants show that 95% resided in
Illinois in the Cleveland District office Service area. The other 5% of GSI and
Dow IL claimants lived in Missouri in the Denver District office service area.

* My question to point [1] is: Were all of the PER-057 short list of 100
probably compensable claims submitted from Illinois residents?

[Q2, Point 2] McKeel Question: | do not see how only 52 orders to
reopen previously denied cases with new recommended decisions issued
could possibly be accurate. The NIOSH PER-057 document, compiled by
David Allen and Jim Neton in Stuart Hinnefeld’s DCAS division, specifically
applied to 196 cases. Of those 100 PER-057 claims were determined to have
been denied initially. NIOSH recalculated the total internal. external and
occupational radiation doses in Rem and assigned a new POC prior to issuing
the PER-057 document on March 11, 2015. Through FOIA | obtained all 100
PER-057 case “dose reconstruction development summary reports” (aterm
the CDC FOIA office in Atlanta used) that were generated prior to releasing
PER-057. NIOSH, according to DCAS Director Hinnefeld, forwarded the
PER-057 short list of 100 cases to Dept. of Labor on 3/11/15. | personally
verified that ALL 100 cases consisted of a pre-PER and a PER-057 total
radiation dose in Rems, and of a pre-PER and PER-057 POC expressed as a
percentage with two decimal points (Ex. 50.96%). ALL 100 cases on the
PER-05S7 short list had POCs that equalled or exceeded the compensation
limit of 50.00%.

[Q2, Point 3 comment] Rachel Leiton and DOL provided me the names