DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service 

 

 National Institute for Occupational 

 Safety and Health 

 Robert A. Taft Laboratories

 4676 Columbia Parkway

 Cincinnati, OH 45226-1998 

 Phone: 513-533-6825 

 Fax: 513-533-6826 

 November 14, 2007 

Dr. Paul L. Ziemer 

920 Southernview Drive, N. 

Lafayette, Indiana 47909 

Ms. Wanda I. Munn 

1104 Pine 

Richland, Washington 99354-2136 

Dear Dr. Ziemer and Ms. Munn: 

Enclosed you will find the NIOSH responses to the findings from the Board’s contractor’s 

review of PROC-0092, “Close-out Interview Procedure.” NIOSH responses are provided in the 

appropriate column of the Findings Matrix. I am taking the unusual step of providing this letter 

of response to you as Chairs of the Advisory Board and of the Advisory Board’s Working Group 

on Procedures Review because of the public interest that has already been generated by this 

report. 

I am concerned that the report leaves the impression that the close-out interview process has not 

been effective in assuring that claimant concerns are adequately addressed and that there are 

widespread problems in the conduct of such interviews. Such an impression or perception would 

be incorrect. Although our procedure might indeed benefit from better documentation of actions 

taken when claimants express concerns during a close-out interview, the vast majority of 

claimants who have participated in these interviews have stated explicitly that they are satisfied 

with the interview outcome. 

One particularly troubling assertion, which has been highlighted in the media, is that a final dose 

reconstruction report was completed prior to the conduct of the closeout interview, with the 

implication that important information is regularly and routinely ignored in the dose 

reconstruction process. This is not the case. The Board’s contractor has provided us with the 

identity of this claimant, and we have verified from the date on its cover letter that the dose 

reconstruction was finalized six days after the close-out interview was completed. In this case it 

took several attempts to complete the close-out interview, in part because during one attempt the 

claimant indicated the possibility of an additional cancer diagnosis. The claimant was advised 

(according to the phone log) to provide any medical information to DOL, and the claim was 

placed in “pending” status. Later the claimant provided information that there was not an 

additional cancer, so the claim was removed from “pending” status. Thus information received 

at close-out interview was certainly considered in this claim. 
Page Two - Dr. Paul L. Ziemer and Ms. Wanda I. Munn 

Since this close-out interview occurred more than two years ago, it’s not possible to reconstruct 

the extent of the investigation into the claimant-provided information about involvement in 

incidents. It is likely that staff concluded that the types of records referred to by the claimant 

would be unlikely to contain information such as personnel contamination readings that could be 

utilized in dose reconstructions. In addition, it was likely concluded that doses resulting from 

response to known events (this claimant’s work experience) would be sufficiently modest that 

the overestimates in the dose reconstruction were sufficient to bound the dose for this case. 

Since the calculations in the dose reconstruction did not change, the dates on the first page of the 

dose reconstruction report, which indicate the completion of the dose reconstruction calculations, 

peer review, and approval by OCAS, were the same in the final dose reconstruction as they were 

in the draft. In retrospect it might have been preferable to change the wording in the “Dose from 

radiological incidents” section of the final dose reconstruction to reflect information received in 

the close-out interview. In this case, the OCAS approval date would have been re-set, while the 

dates for completing calculations and peer review would have remained the same as on the draft. 

OCAS is very mindful of the importance of our interactions with claimants, and we strive to 

communicate effectively. Consequently we are carefully evaluating the various findings and 

recommendations in the Board’s contractor’s review, and intend to adopt any that are feasible 

and will improve the process. 

NIOSH responses to the contractor’s review findings are provided on the enclosed Findings 

Matrix. OCAS staff will continue to work with the Working Group on Procedures Review on 

this product, as it does on the other procedure review products. I have provided a copy of this 

letter and enclosure to John Mauro of SC&A (of the Board’s contractor) and look forward to 

discussing this review of PROC-0092. 

Sincerely, 

 

 [Signature on file] 

Larry J. Elliott, Director 

Office of Compensation Analysis and Support 

National Institute for Occupational Safety & Health 

Enclosure 

cc: J. Mauro, SC&A 

 L. Wade, NIOSH, DFO – ABRWH