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FEDERAL · 20 CFR

Part 30 — Claims for Compensation Under the Energy Employees Occupational Illness Compensation Program Act of 2000, as Amended

160 sections · Title 20: Employees' Benefits

§ 30.0What are the provisions of EEOICPA, in general?
§ 30.1What rules govern the administration of EEOICPA and this chapter?
§ 30.2In general, how have the tasks associated with the administration of EEOICPA claims process been assigned?
§ 30.3What do these regulations contain?
§ 30.5What are the definitions used in this part?
§ 30.10Are all OWCP records relating to claims filed under EEOICPA considered confidential?
§ 30.11Who maintains custody and control of claim records?
§ 30.12What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?
§ 30.15May EEOICPA benefits be assigned, transferred or garnished?
§ 30.16What penalties may be imposed in connection with a claim under the Act?
§ 30.17Is a beneficiary who defrauds the government in connection with a claim for EEOICPA benefits still entitled to those benefits?
§ 30.100In general, how does an employee file an initial claim for benefits?
§ 30.101In general, how is a survivor's claim filed?
§ 30.102In general, how does an employee file a claim for additional impairment or wage-loss under Part E of EEOICPA?
§ 30.103How does a claimant make sure that OWCP has the evidence necessary to process the claim?
§ 30.105What must DOE do after an employee or survivor files a claim?
§ 30.106Can OWCP request employment verification from other sources?
§ 30.110Who is entitled to compensation under the Act?
§ 30.111What is the claimant's responsibility with respect to burden of proof, production of documents, presumptions, and affidavits?
§ 30.112What kind of evidence is needed to establish covered employment and how will that evidence be evaluated?
§ 30.113What are the requirements for written medical documentation, contemporaneous records, and other records or documents?
§ 30.114What kind of evidence is needed to establish a compensable medical condition and how will that evidence be evaluated?
§ 30.115For those radiogenic cancer claims that do not seek benefits under Part B of the Act pursuant to the Special Exposure Cohort provisions, what will OWCP do once it determines that an employee contracted cancer?
§ 30.200What is the scope of this subpart?
§ 30.205What are the criteria for eligibility for benefits relating to beryllium illnesses covered under Part B of EEOICPA?
§ 30.206How does a claimant prove that the employee was a “covered beryllium employee” exposed to beryllium dust, particles or vapor in the performance of duty?
§ 30.207How does a claimant prove a diagnosis of a beryllium disease covered under Part B?
§ 30.210What are the criteria for eligibility for benefits relating to radiogenic cancer?
§ 30.211How does a claimant establish that the employee has or had contracted cancer?
§ 30.212How does a claimant establish that the employee contracted cancer after beginning employment at a DOE facility, an atomic weapons employer facility or a RECA section 5 facility?
§ 30.213How does a claimant establish that the radiogenic cancer was at least as likely as not related to employment at the DOE facility, the atomic weapons employer facility, or the RECA section 5 facility?
§ 30.214How does a claimant establish that the employee is a member of the Special Exposure Cohort?
§ 30.215How does a claimant establish that the employee has sustained an injury, illness, impairment or disease as a consequence of a diagnosed cancer?
§ 30.220What are the criteria for eligibility for benefits relating to chronic silicosis?
§ 30.221How does a claimant prove exposure to silica in the performance of duty?
§ 30.222How does a claimant establish that the employee has been diagnosed with chronic silicosis or has sustained a consequential injury, illness, impairment or disease?
§ 30.225What are the criteria for eligibility for benefits under Part B of EEOICPA for certain uranium employees?
§ 30.226How does a claimant establish that a covered uranium employee has sustained a consequential injury, illness, impairment or disease?
§ 30.230What are the criteria necessary to establish that an employee contracted a covered illness under Part E of EEOICPA?
§ 30.231How does a claimant prove employment-related exposure to a toxic substance at a DOE facility or a RECA section 5 facility?
§ 30.232How does a claimant establish that the employee has been diagnosed with a covered illness, or sustained an injury, illness, impairment or disease as a consequence of a covered illness?
§ 30.300What administrative process will OWCP use to decide claims for entitlement, and how can claimants obtain judicial review of final decisions on their claims?
§ 30.301May subpoenas be issued for witnesses and documents in connection with a claim under Part B of EEOICPA?
§ 30.302Who pays the costs associated with subpoenas?
§ 30.303What information may OWCP request in connection with a claim under Part E of EEOICPA?
§ 30.305How does OWCP determine entitlement to EEOICPA compensation?
§ 30.306What does the recommended decision include?
§ 30.307Can one recommended decision address the entitlement of multiple claimants?
§ 30.308To whom is the recommended decision sent?
§ 30.310What must the claimant do if he or she objects to the recommended decision or wants to request a hearing?
§ 30.311What happens if the claimant does not object to the recommended decision or request a hearing within 60 days?
§ 30.312What will the FAB do if the claimant objects to the recommended decision but does not request a hearing?
§ 30.313How is a review of the written record conducted?
§ 30.314How is a hearing conducted?
§ 30.315May a claimant postpone a hearing?
§ 30.316How does the FAB issue a final decision on a claim?
§ 30.317Can the FAB request a further response from the claimant or return a claim to the district office?
§ 30.318How will FAB consider objections to NIOSH's reconstruction of a radiation dose, or to OWCP's calculation of the recommended probability of causation, in a Part B claim for radiogenic cancer?
§ 30.319May a claimant request reconsideration of a final decision of the FAB?
§ 30.320Can a claim be reopened after the FAB has issued a final decision?
§ 30.400What are the basic rules for obtaining medical treatment?
§ 30.401What are the special rules for the services of chiropractors?
§ 30.402What are the special rules for the services of clinical psychologists?
§ 30.403Will OWCP pay for home health care, nursing home, and assisted living services?
§ 30.404Will OWCP pay for transportation to obtain medical treatment?
§ 30.405After selecting a treating physician, may an employee choose to be treated by another physician instead?
§ 30.406Are there any exceptions to these procedures for obtaining medical care?
§ 30.410Can OWCP require an employee to be examined by another physician?
§ 30.411What happens if the opinion of the physician selected by OWCP differs from the opinion of the physician selected by the employee?
§ 30.412Who pays for second opinion and referee examinations?
§ 30.415What are the requirements for medical reports?
§ 30.416How and when should medical reports be submitted?
§ 30.417What additional medical information may OWCP require to support continuing payment of benefits?
§ 30.420How should medical bills and reimbursement requests be submitted?
§ 30.421What are the time frames for submitting bills and reimbursement requests?
§ 30.422If an employee is only partially reimbursed for a medical expense, must the provider refund the balance of the amount paid to the employee?
§ 30.500What special statutory definitions apply to survivors under EEOICPA?
§ 30.501What order of precedence will OWCP use to determine which survivors are entitled to receive compensation under EEOICPA?
§ 30.502When is entitlement for survivors determined for purposes of EEOICPA?
§ 30.505What procedures will OWCP follow before it pays any compensation?
§ 30.506To whom and in what manner will OWCP pay compensation?
§ 30.507What compensation will be provided to covered Part B employees who only establish beryllium sensitivity under Part B of EEOICPA?
§ 30.508What is beryllium sensitivity monitoring?
§ 30.509Under what circumstances may a survivor claiming under Part E of the Act choose to receive the benefits that would otherwise be payable to a covered Part E employee who is deceased?
§ 30.510How does OWCP notify an individual of a payment made on a claim?
§ 30.511What is an “overpayment” for purposes of EEOICPA?
§ 30.512What does OWCP do when an overpayment is identified?
§ 30.513Under what circumstances may OWCP waive recovery of an overpayment?
§ 30.514If OWCP finds that the recipient of an overpayment was not at fault, what criteria are used to decide whether to waive recovery of it?
§ 30.515Is a recipient responsible for an overpayment that resulted from an error made by OWCP?
§ 30.516Under what circumstances would recovery of an overpayment defeat the purpose of the Act?
§ 30.517Under what circumstances would recovery of an overpayment be against equity and good conscience?
§ 30.518Can OWCP require the recipient of the overpayment to submit additional financial information?
§ 30.519How does OWCP communicate its final decision concerning recovery of an overpayment?
§ 30.520How are overpayments collected?
§ 30.600May a claimant designate a representative?
§ 30.601Who may serve as a representative?
§ 30.602Who is responsible for paying the representative's fee?
§ 30.603Are there any limitations on what the representative may charge the claimant for his or her services?
§ 30.605What rights does the United States have upon payment of compensation under EEOICPA?
§ 30.606Under what circumstances must a recovery of money or other property in connection with an illness for which benefits are payable under EEOICPA be reported to OWCP?
§ 30.607How is a structured settlement (that is, a settlement providing for receipt of funds over a specified period of time) treated for purposes of reporting the recovery?
§ 30.608How does the United States calculate the amount to which it is subrogated?
§ 30.609Is a settlement or judgment received as a result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that must be reported to OWCP?
§ 30.610Are payments to a covered Part B employee, a covered Part E employee or an eligible surviving beneficiary as a result of an insurance policy which the employee or eligible surviving beneficiary has purchased a recovery that must be reported to OWCP?
§ 30.611If a settlement or judgment is received for more than one medical condition, can the amount paid on a single EEOICPA claim be attributed to different conditions for purposes of calculating the amount to which the United States is subrogated?
§ 30.615What type of tort suits filed against beryllium vendors or atomic weapons employers may disqualify certain claimants from receiving benefits under Part B of EEOICPA?
§ 30.616What happens if this type of tort suit was filed prior to October 30, 2000?
§ 30.617What happens if this type of tort suit was filed during the period from October 30, 2000 through December 28, 2001?
§ 30.618What happens if this type of tort suit was filed after December 28, 2001?
§ 30.619Do all the parties to this type of tort suit have to take these actions?
§ 30.620How will OWCP ascertain whether a claimant filed this type of tort suit and if he or she has been disqualified from receiving any benefits under Part B of EEOICPA?
§ 30.625What does “coordination of benefits” mean under Part E of EEOICPA?
§ 30.626How will OWCP coordinate compensation payable under Part E of EEOICPA with benefits from state workers' compensation programs?
§ 30.627Under what circumstances will OWCP waive the statutory requirement to coordinate these benefits?
§ 30.700In general, what responsibilities do providers have with respect to enrolling with OWCP, seeking authorization to provide services, billing, and retaining medical records?
§ 30.701How are medical bills to be submitted?
§ 30.702How should an employee prepare and submit requests for reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses?
§ 30.703What are the time limitations on OWCP's payment of bills?
§ 30.705What services are covered by the OWCP fee schedule?
§ 30.706How are the maximum fees for professional medical services defined?
§ 30.707How are payments to providers calculated?
§ 30.708Does the fee schedule apply to every kind of procedure?
§ 30.709How are payments for medicinal drugs determined?
§ 30.710How are payments for inpatient medical services determined?
§ 30.711How are payments for outpatient medical services determined?
§ 30.712When and how are fees reduced?
§ 30.713If OWCP reduces a fee, may a provider request reconsideration of the reduction?
§ 30.714If OWCP reduces a fee, may a provider bill the employee for the balance?
§ 30.715What are the grounds for excluding a provider from payment under this part?
§ 30.716What will cause OWCP to automatically exclude a physician or other provider of medical services and supplies?
§ 30.717When are OWCP's exclusion procedures initiated?
§ 30.718How is a provider notified of OWCP's intent to exclude him or her?
§ 30.719What requirements must the provider's response and OWCP's decision meet?
§ 30.720How can an excluded provider request a hearing?
§ 30.721How are hearings assigned and scheduled?
§ 30.722How are subpoenas or advisory opinions obtained?
§ 30.723How will the administrative law judge conduct the hearing and issue the recommended decision?
§ 30.724How does a recommended decision become final?
§ 30.725What are the effects of non-automatic exclusion?
§ 30.726How can an excluded provider be reinstated?
§ 30.800What types of wage-loss are compensable under Part E of EEOICPA?
§ 30.801What special definitions does OWCP use in connection with Part E wage-loss determinations?
§ 30.805What are the criteria for eligibility for wage-loss benefits under Part E?
§ 30.806What kind of medical evidence must the claimant submit to prove that he or she lost wages due to a covered illness?
§ 30.807What factual evidence does OWCP use to determine a covered Part E employee's average annual wage?
§ 30.810How will OWCP calculate the average annual wage of a covered Part E employee?
§ 30.811How will OWCP calculate the duration and extent of a covered Part E employee's initial period of compensable wage-loss?
§ 30.812May a covered Part E employee claim for subsequent periods of compensable wage-loss?
§ 30.815Are there special rules that OWCP will use to determine the extent of a deceased covered Part E employee's compensable wage-loss?
§ 30.900Who can receive impairment benefits under Part E?
§ 30.901How does OWCP determine the extent of an employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at a DOE facility or a RECA section 5 facility, as appropriate?
§ 30.902How will OWCP calculate the amount of the award of impairment benefits that is payable under Part E?
§ 30.905How may an impairment evaluation be obtained?
§ 30.906Who will pay for an impairment evaluation?
§ 30.907Can an impairment evaluation obtained by OWCP be challenged prior to issuance of the recommended decision?
§ 30.908How will the FAB evaluate new medical evidence submitted to challenge the impairment determination in the recommended decision?
§ 30.910Will an impairment that cannot be assigned a numerical percentage using the AMA's Guides be included in the impairment rating?
§ 30.911Does maximum medical improvement always have to be reached for an impairment to be included in the impairment rating?
§ 30.912Can a covered Part E employee receive benefits for additional impairment following an award of such benefits by OWCP?