Division of Compensation Analysis and 

Support

Program Evaluation Report

Document Number: DCAS-PER-087 

Effective Date: 1/18/2019 

Clarksville and Medina Modification Centers Page 1 of 2

Author: 

 Dave Allen, HP Team Leader

 Signature on file Date: 1/18/2019 Supersedes: none 

Approval: 

 J. W. Neton, Associate Director for Science

Signature on file Date: 1/18/2019 

RECORD OF ISSUE/REVISIONS

ISSUE 

AUTHORIZATION 

DATE

EFFECTIVE

DATE

DESCRIPTION

1/18/2019 1/18/2019 New document to determine the effect of 

issuing revision 3 to ORAUT-TKBS0039 (Clarksville and Medina TBD) on 

previously completed claims.

1.0 Description

Revision 3 of the Technical Basis Document (TBD) for the Clarksville and Medina 

Modification Centers (ORAUT-TKBS-0039) was issued on 1/4/2017. Prior to that, dose 

reconstructions utilized methods found in earlier revisions of the TBD with the first 

(revision 0) being issued on 11/14/2006. Prior to that, dose reconstructions utilized 

complex wide methods or other documents. 

The effect of issuing revision 3 of the TBD on all previously completed claims is the 

subject of this PER. 

2.0 Issue Evaluation 

Increases in dose due to revision 3 of the TBD include the following issues. 

Dose to the liver, gallbladder, spleen, pancreas, bone surfaces, stomach and remainder 

organs all increased for lumbar spine x-ray examinations due to a change in the surrogate 

organ selected for that view. Also, dose may increase for some workers of the lower 

torso due to establishing a correction factor for workers who held weapon pits in their 
Division of Compensation Analysis and

Support

Program Evaluation Report

Document Number: DCAS-PER-087 

Effective Date: 1/18/2019 Page 2 of 2

laps in the sitting position. Lastly, unmonitored external shallow dose increase for all 

years due to the incorporation of ORAUT-OTIB-0086 into this TBD. 

Earlier revisions to the TBD primarily resulted in decreases (or no change) to doses 

estimated. The largest change being removal of some exposures due to the inclusion of 

Clarksville in the Special Exposure Cohort. Prior to revision 0 of the TBD, complexwide methods were primarily used. 

With of variety of methods used in the past, no populations of claims were excluded from 

evaluation based on them being unaffected by the latest changes. All claims associated 

with the Clarksville or Medina sites were considered. 

3.0 Plan for Resolving Corrective Action 

A search of the NIOSH Claims Tracking System (NOCTS) database was combined with 

a text search of the dose reconstruction reports of previously completed claims. The 

NOCTS search queried employment at either site while the text search queried the 

keywords “Clarksville” or “Medina”. The combined search resulted in a total of 172 

claims.

The population of claims was reduced by first removing 51 claims for which the dose 

reconstruction had resulted in a probability of causation of greater than 50%. Next, 17 

claims were removed because they had been “pulled” from dose reconstruction primarily 

due to inclusion in the special exposure cohort. An additional 32 claims were removed 

because their information indicated they would qualify for compensation under the 

special exposure cohort and no estimate for medical benefits would be necessary for 

other cancers. Another 11 claims were removed for which the keyword search flagged a 

word that was not actually associated with the site or the claim was duplicated between 

different searches. Lastly, 11 claims were removed that are being evaluated under a PER 

for the Pantex site. The evaluation under that PER will consider all changes to the dose 

reconstruction methods, not just changes to the Pantex site.

Dose for the remaining 50 claims was recalculated using revision 3 of the TBD as well as 

all other applicable procedures. All 50 claims resulted in a new probability of causation 

below 45%. 

NIOSH will provide the Department of Labor with the list of all the claims evaluated 

under this PER. Since none resulted in a probability of causation greater than 50%, 

NIOSH will not request the return of any claims.