2006 CFR Title 20, Volume 1

Title 20--Employees' Benefits CHAPTER I--OFFICE OF WORKERS'&fnl;COMPENSATION PROGRAMS,&fnl;DEPARTMENT OF LABOR PART 30--CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED
	30.0	What are the provisions of the EEOICPA, in general?
	30.1	What rules govern the administration of the EEOICPA and this chapter?
	30.2	In general, how have the tasks associated with the administration of the EEOICPA claims process been assigned?
	30.3	What do these regulations contain?
	30.5	What are the definitions used in this part?
	30.10	Are all OWCP records relating to claims filed under the EEOICPA considered confidential?
	30.11	Who maintains custody and control of claim records?
	30.12	What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?
	30.15	May EEOICPA benefits be assigned, transferred or garnished?
	30.16	What penalties may be imposed in connection with a claim under the Act?
	30.17	Is a beneficiary who defrauds the government in connection with a claim for EEOICPA benefits still entitled to those benefits?
	30.100	In general, how does an employee file an initial claim for benefits?
	30.101	In general, how is a survivor's claim filed?
	30.102	In general, how does an employee file a claim for additional impairment or wage-loss under Part E of EEOICPA?
	30.103	How does a claimant make sure that OWCP has the evidence necessary to process the claim?
	30.105	What must DOE do after an employee or survivor files a claim?
	30.106	Can OWCP request employment verification from other sources?
	30.110	Who is entitled to compensation under the Act?
	30.111	What is the claimant's responsibility with respect to burden of proof, production of documents, presumptions, and affidavits?
	30.112	What kind of evidence is needed to establish covered employment and how will that evidence be evaluated?
	30.113	What are the requirements for written medical documentation, contemporaneous records, and other records or documents?
	30.114	What kind of evidence is needed to establish a covered medical condition and how will that evidence be evaluated?
	30.115	For 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?
	30.200	What is the scope of this subpart?
	30.205	What are the criteria for eligibility for benefits relating to beryllium illnesses covered under Part B of EEOICPA?
	30.206	How does a claimant prove that the employee was a ``covered beryllium employee'' exposed to beryllium dust, particles or vapor in the performance of duty?
	30.207	How does a claimant prove a diagnosis of a beryllium disease covered under Part B?
	30.210	What are the criteria for eligibility for benefits relating to radiogenic cancer?
	30.211	How does a claimant establish that the employee has or had contracted cancer?
	30.212	How 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?
	30.213	How 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?
	30.214	How does a claimant establish that the employee is a member of the Special Exposure Cohort?
	30.215	How does a claimant establish that the employee has sustained an injury, illness, impairment or disease as a consequence of a diagnosed cancer?
	30.220	What are the criteria for eligibility for benefits relating to chronic silicosis?
	30.221	How does a claimant prove exposure to silica in the performance of duty?
	30.222	How does a claimant establish that the employee has been diagnosed with chronic silicosis or has sustained a consequential injury, illness, impairment or disease?
	30.225	What are the criteria for eligibility for benefits under Part B of EEOICPA for certain uranium employees?
	30.226	How does a claimant establish that a covered uranium employee has sustained a consequential injury, illness, impairment or disease?
	30.230	What are the criteria necessary to establish that an employee contracted a covered illness under Part E of EEOICPA?
	30.231	How does a claimant prove employment-related exposure to a toxic substance at a DOE facility or a RECA section 5 facility?
	30.232	How 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?
	30.300	What process will OWCP use to decide claims for entitlement and to provide for administrative review of those decisions?
	30.301	May subpoenas be issued for witnesses and documents in connection with a claim under Part B of EEOICPA?
	30.302	Who pays the costs associated with subpoenas?
	30.303	What information may OWCP request in connection with a claim under Part E of EEOICPA?
	30.305	How does OWCP determine entitlement to EEOICPA compensation?
	30.306	What does the recommended decision contain?
	30.307	To whom is the recommended decision sent?
	30.310	What must the claimant do if he or she objects to the recommended decision or wants to request a hearing?
	30.311	What happens if the claimant does not object to the recommended decision or request a hearing within 60 days?
	30.312	What will the FAB do if the claimant objects to the recommended decision but does not request a hearing?
	30.313	How is a review of the written record conducted?
	30.314	How is a hearing conducted?
	30.315	May a claimant postpone a hearing?
	30.316	How does the FAB issue a final decision on a claim?
	30.317	Can the FAB request a further response from the claimant or return a claim to the district office?
	30.318	Can the FAB consider objections to HHS's reconstruction of a radiation dose or to the guidelines OWCP uses to determine if a claimed cancer was at least as likely as not related to employment?
	30.319	May a claimant request reconsideration of a final decision of the FAB?
	30.320	Can a claim be reopened after the FAB has issued a final decision?
	30.400	What are the basic rules for obtaining medical treatment?
	30.401	What are the special rules for the services of chiropractors?
	30.402	What are the special rules for the services of clinical psychologists?
	30.403	Will OWCP pay for the services of an attendant?
	30.404	Will OWCP pay for transportation to obtain medical treatment?
	30.405	After selecting a treating physician, may an employee choose to be treated by another physician instead?
	30.406	Are there any exceptions to these procedures for obtaining medical care?
	30.410	Can OWCP require an employee to be examined by another physician?
	30.411	What happens if the opinion of the physician selected by OWCP differs from the opinion of the physician selected by the employee?
	30.412	Who pays for second opinion and referee examinations?
	30.415	What are the requirements for medical reports?
	30.416	How and when should medical reports be submitted?
	30.417	What additional medical information may OWCP require to support continuing payment of benefits?
	30.420	How should medical bills and reimbursement requests be submitted?
	30.421	What are the time frames for submitting bills and reimbursement requests?
	30.422	If an employee is only partially reimbursed for a medical expense, must the provider refund the balance of the amount paid to the employee?
	30.500	What special statutory definitions apply to survivors under EEOICPA?
	30.501	What order of precedence will OWCP use to determine which survivors are entitled to receive compensation under EEOICPA?
	30.502	When is entitlement for survivors determined for purposes of EEOICPA?
	30.505	What procedures will OWCP follow before it pays any compensation?
	30.506	To whom and in what manner will OWCP pay compensation?
	30.507	What compensation will be provided to covered Part B employees who only establish beryllium sensitivity under Part B of EEOICPA?
	30.508	What is beryllium sensitivity monitoring?
	30.509	Under 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?
	30.510	How does OWCP notify an individual of a payment made on a claim?
	30.511	What is an ``overpayment'' for purposes of EEOICPA?
	30.512	What does OWCP do when an overpayment is identified?
	30.513	Under what circumstances may OWCP waive recovery of an overpayment?
	30.514	If OWCP finds that the recipient of an overpayment was not at fault, what criteria are used to decide whether to waive recovery of it?
	30.515	Is a recipient responsible for an overpayment that resulted from an error made by OWCP?
	30.516	Under what circumstances would recovery of an overpayment defeat the purpose of the Act?
	30.517	Under what circumstances would recovery of an overpayment be against equity and good conscience?
	30.518	Can OWCP require the recipient of the overpayment to submit additional financial information?
	30.519	How does OWCP communicate its final decision concerning recovery of an overpayment?
	30.520	How are overpayments collected?
	30.600	May a claimant designate a representative?
	30.601	Who may serve as a representative?
	30.602	Who is responsible for paying the representative's fee?
	30.603	Are there any limitations on what the representative may charge the claimant for his or her services?
	30.605	What rights does the United States have upon payment of compensation under EEOICPA?
	30.606	Under 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?
	30.607	How 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?
	30.608	How does the United States calculate the amount to which it is subrogated?
	30.609	Is 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?
	30.610	Are 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?
	30.611	If 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?
	30.615	What type of tort suits filed against beryllium vendors or atomic weapons employers may disqualify certain claimants from receiving benefits under Part B of EEOICPA?
	30.616	What happens if this type of tort suit was filed prior to October 30, 2000?
	30.617	What happens if this type of tort suit was filed during the period from October 30, 2000 through December 28, 2001?
	30.618	What happens if this type of tort suit was filed after December 28, 2001?
	30.619	Do all the parties to this type of tort suit have to take these actions?
	30.620	How 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?
	30.625	What does ``coordination of benefits'' mean under Part E of EEOICPA?
	30.626	How will OWCP coordinate compensation payable under Part E of EEOICPA with benefits from state workers' compensation programs?
	30.627	Under what circumstances will OWCP waive the statutory requirement to coordinate these benefits?
	30.700	What kinds of medical records must providers keep?
	30.701	How are medical bills to be submitted?
	30.702	How should an employee prepare and submit requests for reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses?
	30.703	What are the time limitations on OWCP's payment of bills?
	30.705	What services are covered by the OWCP fee schedule?
	30.706	How are the maximum fees defined?
	30.707	How are payments for particular services calculated?
	30.708	Does the fee schedule apply to every kind of procedure?
	30.709	How are payments for medicinal drugs determined?
	30.710	How are payments for inpatient medical services determined?
	30.711	When and how are fees reduced?
	30.712	If OWCP reduces a fee, may a provider request reconsideration of the reduction?
	30.713	If OWCP reduces a fee, may a provider bill the employee for the balance?
	30.715	What are the grounds for excluding a provider from payment under this part?
	30.716	What will cause OWCP to automatically exclude a physician or other provider of medical services and supplies?
	30.717	When are OWCP's exclusion procedures initiated?
	30.718	How is a provider notified of OWCP's intent to exclude him or her?
	30.719	What requirements must the provider's reply and OWCP's decision meet?
	30.720	How can an excluded provider request a hearing?
	30.721	How are hearings assigned and scheduled?
	30.722	How are subpoenas or advisory opinions obtained?
	30.723	How will the administrative law judge conduct the hearing and issue the recommended decision?
	30.724	How can a party request review by OWCP of the administrative law judge's recommended decision?
	30.725	What are the effects of non-automatic exclusion?
	30.726	How can an excluded provider be reinstated?
	30.800	What types of wage-loss are compensable under Part E of EEOICPA?
	30.801	What special definitions does OWCP use in connection with Part E wage- loss determinations?
	30.805	What evidence does OWCP use to determine a covered Part E employee's average annual wage and whether he or she experienced compensable wage-loss under Part E of EEOICPA?
	30.806	May a claimant submit factual evidence in support of a different determination of average annual wage and/or wage-loss than that found by OWCP?
	30.810	How will OWCP calculate the average annual wage of a covered Part E employee?
	30.811	How will OWCP calculate the duration and extent of a covered Part E employee's initial period of compensable wage-loss?
	30.812	May a covered Part E employee claim for subsequent periods of compensable wage-loss?
	30.815	Are there special rules that OWCP will use to determine the extent of a deceased covered Part E employee's compensable wage-loss?
	30.900	Who can receive impairment benefits under Part E of EEOICPA?
	30.901	How 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?
	30.902	How will OWCP calculate the amount of the award of impairment benefits that is payable under Part E?
	30.905	How may an impairment evaluation be obtained?
	30.906	Who will pay for an impairment evaluation?
	30.907	Can an impairment evaluation obtained by OWCP be challenged prior to issuance of the recommended decision?
	30.908	How will the FAB evaluate new medical evidence submitted to challenge the impairment determination in the recommended decision?
	30.910	Will an impairment that cannot be assigned a numerical percentage using the AMA's Guides be included in the impairment rating?
	30.911	Does maximum medical improvement always have to be reached for an impairment to be included in the impairment rating?
	30.912	Can a covered Part E employee receive benefits for additional impairment following an award of such benefits by OWCP?