Division of Compensation Analysis and 

Support

Program Evaluation Report

Document Number: DCAS-PER-041

Effective Date: 7/12/2012

Revision No. 0

OTIB-6 Revision Page 1 of 4

Author: Signature on file Date: 7/12/2012 Dave Allen, HP Team Leader

Approval: Signature on file Date: 7/12/2012 

 J.W. Neton, Associate Director for Science

Supersedes: None

RECORD OF ISSUE/REVISIONS

ISSUE 

AUTHORIZATION 

DATE

7/12/2012

EFFECTIVE 

DATE

7/12/2012

REV. NO. 

0

DESCRIPTION

New document to determine the effect 

on previously completed claims due to 

revision ORAUT-OTIB-0006, Dose 

Reconstruction from Occupational 

Medical X-ray Procedures.

1.0 Description

Revision 4 of the Dose Reconstruction from Occupational Medical X-Ray Procedures

(ORAUT-OTIB-0006) was issued on 6/20/2011. The previous version (revision 3 PC-1) 

was issued on 12/21/2005. Revision 2 was issued 12/29/2003 resulting in minor 

increases in the dose to some organs. This change (and previous changes) was addressed 

in OCAS-PER-002. Revision 3 primarily added dose estimates for x-ray procedures not 

previously addressed. That does not constitute an increase in dose but rather the 

implementation of an estimate previously unnecessary. Revisions 3 PC-1 fixed 

typographical error and added standard language but did not affect the estimated dose.

2.0 Issue Evaluation

Several changes to the estimated dose were made in revision 4. Some of these changes 

resulted in a slight decrease in the estimated dose. The changes that resulted in increases 

in the estimated doses are:

• An increase in the estimated dose from a lateral projection of a lumbar spine x-ray 

for all years for the stomach, bone surfaces, liver, gall bladder, spleen and 

remainder organs.

• Increase in the estimated dose to the ovaries from pelvic x-rays through the end of 

1970.

ORAUT-OTIB-0006 is a complex wide document used for sites in which better 

information is not available. Default frequencies in ORAUT-OTIB-0006 do not include 
Division of Compensation Analysis and 

Support

Program Evaluation Plan

Document Number: DCAS-PER-041

Effective Date: 7/12/2012 Revision No. 0 Page 2 of 4

lumbar spine or pelvic x-ray procedures. Therefore, with no other information, no 

lumbar spine or pelvic x-ray dose would be assigned.

ORAUT-OTIB-0006 does not necessarily affect sites for which site specific information 

is available. However, some site technical basis documents (TBDs) refer the reader to 

ORAUT-OTIB-0006 for estimates of x-ray doses. Therefore, each TBD was reviewed to 

determine if ORAUT-OTIB-0006 was used. In this PER, TBD is used to refer to any 

TBD, TIB, Appendix or any other dose reconstruction methodology. Many TBDs 

indicated ORAUT-OTIB-0006 was to be used but few required a lumbar spine or pelvic 

x-ray. Most assumed a default pre-employment, annual and termination PA chest x-ray 

and were therefore unaffected by this revision. 

Other TBDs indicated that the lumbar spine or pelvic x-ray values were from ORAUTOTIB-0006 but then provided the values to be used in the TBD itself. In those cases, 

current dose reconstructors would use the values in the TBD. Therefore, those TBDs 

must first be revised and then claims associated with those revisions will be evaluated in 

a future PER.

The following TBDs require or allow a lumbar spine or pelvic x-ray, and refer the reader

to ORAUT-OTIB-0006 for the appropriate dose.

• Harshaw – assumes a pelvic x-rays between 1942 and 1944 and again between 

1950 and 1951 for process workers (ORAUT-TKBS-0022 rev 1, page 18).

• Brookhaven National Laboratory– indicates lumbar spine x-rays may have been 

taken but are not an assumed default. ORAUT-OTIB-0006 would be used if

medical records include a lumbar spine x-ray (ORAUT-TKBS-0048 rev 1, page 

48).

• Extrusion Plant – assumes a pre-employment lumbar spine x-ray between 1962

and 1975 for hourly employees and prior to 1986 for laborers (ORAUT-TKBS0056, Rev 0, page 30). ORAUT-OTIB-0079 however, indicates x-rays were 

taken off-site until 1977 and after 1996. Therefore, the default lumbar spine xrays to be accounted for would only be pre-employment x-rays for laborers who

started work between 1977 and 1986.

• Paducah Gaseous Diffusion Plant – indicates lumbar spine x-rays were possible in 

early years and refers reader to Attachment A for the dose. Attachment A in 

earlier versions of the TBD was removed in the current revision. Therefore it is 

assumed readers would refer to ORAUT-OTIB-0006. Earlier versions of the 

Paducah TBD provide higher values than ORAUT-OTIB-0006 but some 

estimates could have been performed using Revision 3 of ORAUT-OTIB-0006 

which has now been revised resulting in an increase in the dose estimate

(ORAUT-TKBS-0019-3, rev. 2, page 14).
Division of Compensation Analysis and 

Support

Program Evaluation Plan

Document Number: DCAS-PER-041

Effective Date: 7/12/2012 Revision No. 0 Page 3 of 4

3.0 Plan for Resolution or Corrective Action

3.1 Determining the population of potential affected claims

Harshaw and the Extrusion Plant had assumed x-ray projections affected by revision 4 

while Brookhaven and Paducah cases were to have lumbar spine x-ray dose applied only 

if records indicated there had been a lumbar spine examination. Therefore, the 

population of potentially affected claims was determined differently for each site.

For Harshaw, all claims with a probability of causation less than 50% were searched to 

determine which had employment during 1942, 1943, 1944, 1950 or 1951. This search 

identified six claims.

For the Extrusion Plant, a search was conducted to identify all claims with a probability 

of causation less than 50% who started their employment at the Extrusion Plant between 

1977 and 1985. This resulted in five claims matching these criteria.

For Brookhaven National Laboratory, lumbar spine x-rays were assigned only if medical 

records indicate a lumbar spine examination was performed. Therefore, a text search of 

all Brookhaven dose reconstruction reports was conducted. The search identified five 

claims with a probability of causation less than 50% and with the word “lumbar” or 

“spine” used in the text of the dose reconstruction report. 

For Paducah, lumbar spine x-rays are only assigned if medical records indicate a lumbar 

spine examination was performed. Therefore, a text search of all Paducah dose 

reconstruction reports was conducted. The search identified 219 claims with a 

probability of causation less than 50% and with the word “lumbar” or “spine” used in the 

text of the dose reconstruction report. 

3.2 Determination of claims affected by TIB revision. 

The six Harshaw claims identified above were reviewed further. It was determined that 

dose for three of the six was recently recalculated as part of the DCAS-PER-0034 review. 

This was done after ORAUT-OTIB-0006 was revised and the recalculated dose included 

all current methods. None of those three resulted in probability of causation above 45%. 

One of the remaining three claims was employed in the accounting department. Pelvic xrays were to be assigned to process area workers so no change would occur to the dose 

estimate. Dose was recalculated for the remaining two claims using all currently 

approved methods. The resulting probability of causation was less than 45% for both 

cases.

Lumbar spine x-rays are assigned only to laborers at the Extrusion Plant. Three of the 

five Extrusion Plant claims identified above had job titles inconsistent with a laborer. 
Division of Compensation Analysis and 

Support

Program Evaluation Plan

Document Number: DCAS-PER-041

Effective Date: 7/12/2012 Revision No. 0 Page 4 of 4

The remaining two claims were diagnosed with cancers that are not affected by the 

revision to OTIB-0006.

Each of the five Brookhaven National Laboratory claims identified above was diagnosed 

with cancers that are not affected by the revision to OTIB-0006.

Of the 219 Paducah claims identified above, 198 were diagnosed with cancers that would 

not be affected by the revision to OTIB-0006. Five of the remaining 21 claims were 

found not to have lumbar spine x-rays assigned. The word “lumbar” or “spine” appeared 

in the text for other reasons. Twelve of the claims were found to have lumbar spine x-ray 

dose assigned that was higher than revision 4 of OTIB-0006. Most of those were the 

result of assigning both an AP view and a lateral view. This was common when lumbar 

spine x-rays were taken. The dose for the lateral view increased in revision 4 but the 

dose for the AP view decreased. The resulting dose estimate decreases slightly if both 

views are assigned. Three claims were assigned x-ray dose based on an organ not 

affected by revision 4 of OTIB-0006. The last claim was found to have been pulled from 

dose reconstruction when it was found that it met the criteria for an SEC. Therefore, 

compensation for this case no longer depended on a dose reconstruction.

As a result of this review, the revision to ORAUT-OTIB-0006 did not result in 

probability of causation of any previously completed claims rising to greater than 50%. 

A listing of those claims evaluated and their final disposition will be forwarded to the 

Department of Labor.