Chapter E-800 Wage-Loss Determinations

1. Purpose and Scope. This chapter contains the procedures to be used by the claims examiner (CE) for the initial development, review, and calculation of wage-loss determinations under Part E of the EEOICPA. The CE determines whether wage loss, as a result of contracting a covered illness, needs to be developed for a covered Part E employee or survivor claim. In addition the CE determines the amount of any such wage loss that is compensable under Part E of the EEOICPA. This chapter also describes some relevant terminology and definitions, the necessary employment evidence to establish wage loss, the necessary medical evidence to establish the causal relationship between the covered illness and the period of wage loss, period of wage loss and percentage of loss calculations, survivor claims involving wage loss, recommended decisions and final decisions in relation to wage-loss determinations, and filing for additional wage loss.

2. Policy. The CE is responsible for processing wage-loss determinations and ensuring that benefits are appropriately paid under the provisions of 42 U.S.C. 7385s, 7385s-2(a)(2), 7385s-3, and 7385s-5.

3. Definitions.

a. Average Annual Wage (AAW) refers to four times the average quarterly wages of a covered Part E employee as reported to the Social Security Administration for the 12 quarters immediately prior to but not including the 1^st quarter of wage loss. Any quarters during which the employee was unemployed preceding the quarter during which he or she first experienced wage loss due to a covered illness that was caused by exposure to a toxic substance at a DOE facility or RECA section 5 facility are excluded (see subparagraph f below). The calculated AAW is the baseline wage against which the CE measures a subsequent calendar year wage earned by a covered Part E employee. Exhibit 1 provides a worksheet for AAW calculation.

b. A calendar year is defined as the twelve-month period from January through December.

c. The Consumer Price Index (CPI) is a measure of the average change over time in the prices paid by urban consumers for a market basket of consumer goods and services. The CPI is the most widely used measure of inflation. It provides information about price changes in the nation’s economy to government, business, labor, and private citizens and is used as a guide to making economic decisions. The CPI is often used to adjust benefit payments (for example, Social Security and Federal Employee Compensation Act payments) and income eligibility levels for government assistance, and to automatically provide cost-of-living wage adjustments.

d. Normal retirement age is the age at which an employee may receive unreduced Social Security retirement benefits. This age varies by date of birth and is set by section 216(1) of the Social Security Act, 42 U.S.C. 416(1). In general, persons born during or before 1937 are eligible for unreduced Old Age, Survivors, and Disability Insurance (OASDI) (i.e. Social Security) retirement benefits at age 65. The eligibility age increases in two-month increments for persons born between 1937 and 1960 until it reaches 67, which is the age at which persons born during or after 1960 become eligible for unreduced OASDI retirement benefits.

(1) The normal retirement age is age 65 for a covered Part E employee born on 1/1/38 or earlier. For a covered Part E employee born on 1/2/38 or later, please refer to the chart on the next page for the normal retirement age respectively:

If the Birth Date is...	The Normal Retirement Age is...
1/2/38 thru 1/1/39	65 years and 2 months
1/2/39 thru 1/1/40	65 years and 4 months
1/2/40 thru 1/1/41	65 years and 6 months
1/2/41 thru 1/1/42	65 years and 8 months
1/2/42 thru 1/1/43	65 years and 10 months
1/2/43 thru 1/1/55	66 years
1/2/55 thru 1/1/56	66 years and 2 months
1/2/56 thru 1/1/57	66 years and 4 months
1/2/57 thru 1/1/58	66 years and 6 months
1/2/58 thru 1/1/59	66 years and 8 months
1/2/59 thru 1/1/60	66 years and 10 months
1/2/60 and later	67 years

e. A quarter is defined as the three-month period of January through March, April through June, July through September, or October through December.

f. A quarter during which the employee was unemployed is defined as any quarter during which $700 (in constant 2005 dollars) or less in wages were reported for the covered Part E employee to the Social Security Administration, unless the quarter is one for which the employee’s wages were not otherwise reported to the Social Security Administration or the employee was retired. This definition is relevant in the calculation of AAW. If the CE determines that the adjusted value is $700 or less, then the employee is considered to have been unemployed during that quarter and it will not be included in the calculation of the average annual wage.

g. How to Calculate $700 in Constant 2005 Dollars. In order to calculate the value of $700 into constant 2005 dollars for any given year, the CE must identify the year(s) in question. All years after 2005 require the use of the Inflation Calculator on the Bureau of Labor Statistics’ website http://www.bls.gov/cpi/home.htm to adjust the earnings to reflect their values to 2005 dollars.

To calculate the value of $700 in constant 2005 dollars from the years of 1942 through 2005, please refer to the chart below in which the calculations were performed on July 15, 2005:

1942	1943	1944	1945	1946	1947	1948	1949
$58.66	$62.26	$63.34	$64.78	$70.18	$80.26	$86.74	$85.66

1950	1951	1952	1953	1954	1955	1956	1957
$86.74	$93.57	$95.37	$96.09	$96.81	$96.45	$97.89	$101.13

1958	1959	1960	1961	1962	1963	1964	1965
$104.01	$104.73	$106.53	$107.61	$108.69	$110.13	$111.57	$113.37

1966	1967	1968	1969	1970	1971	1972	1973
$116.61	$120.21	$125.24	$132.08	$139.64	$145.76	$150.44	$159.79

1974	1975	1976	1977	1978	1979	1980	1981
$177.43	$193.62	$204.78	$218.10	$234.65	$261.29	$296.56	$327.15

1982	1983	1984	1985	1986	1987	1988	1989
$347.30	$358.46	$373.93	$387.25	$394.45	$408.84	$425.76	$446.27

1990	1991	1992	1993	1994	1995	1996	1997
$470.39	$490.18	$504.94	$520.05	$533.37	$548.48	$564.68	$577.63

1998	1999	2000	2001	2002	2003	2004	2005
$586.63	$599.59	$619.74	$637.38	$647.46	$662.21	$679.85	$700.00

Note that the values listed in the above chart are fixed and must be used. Neither the District Office nor the Final Adjudication Branch is to recalculate for these values.

h. A quarter during which the employee was employed (for purposes of determining AAW) is a quarter in which the adjusted value is $701 or more in constant 2005 dollar values. The $701 value is reached when the $700 value in constant 2005 dollars as calculated above is exceeded by $1; at such point the employee is considered to have been employed during that quarter and it will be included in the AAW calculation.

i. A year of wage loss is defined as a calendar year in

which the covered Part E employee’s earnings were less than that employee’s average annual wage, as a result of the covered illness that is due to the covered Part E employee’s exposure to a toxic substance at a facility covered by the program. Prior to making this finding, the CE must convert the yearly earnings to determine their values during the calendar year in which the covered Part E employee first experienced wage loss due to a covered illness as outlined below.

4. Wage-Loss Determinations. The years of wage loss occurring up to and including either the calendar year that a covered Part E employee reaches normal retirement age under the Social Security Act or the last calendar year of wage loss prior to the submission of the claim, whichever occurs first, may be compensable under Part E of the EEOICPA, if it is determined to be due to a covered illness. In making this determination the CE calculates the average annual wage of the covered Part E employee for the 12 quarters that preceded the quarter during which the employee first experienced wage loss due to exposure to a toxic substance at a DOE facility or a RECA section 5 facility (excluding any unemployment). The CE then compares the period of lost wages (in calendar years) to the average annual wage to determine the percentage of wages that were lost for the period(s) claimed. This is discussed in further detail later in this chapter.

a. The CE needs to be cognizant of certain issues while reviewing the case for potential development of wage loss. The claimant will not be able to claim wage loss on the EE-1 form or the EE-2 form, so the CE develops for wage loss when applicable.

(1) Instances where the CE does not develop for wage loss include:

(a) The employee is not a covered Part E employee if he or she worked for an atomic weapons employer or for a beryllium vendor (unless the employee was employed during a period in which the facility was designated as a DOE facility for remediation and the employee worked on the remediation).

(b) The covered Part E employee experiences wage loss (as a result of contracting a covered illness) only after his or her normal Social Security retirement age.

(c) The covered Part E employee dies no more than 10 years before his or her normal Social Security retirement age and does not experience any wage loss prior to his or her death (for survivor claims).

5. Developing for Wage Loss. Wage loss claims are not made on the EE-1/2, so the CE must develop for wage loss when applicable. Wage loss determinations do not delay the issuance of a recommended decision to accept other claim elements.

a. Development Letter. The CE develops for wage loss by sending a letter asking if the covered Part E employee lost wages as a result of the covered illness. If wage loss is claimed, the letter asks the claimant to provide the dates/period(s) of wage loss and to identify the first quarter in which the employee began losing wages as a result of the covered illness. In addition to listing the first quarter of wage loss, the claimant is asked to list the first day of lost wages from work. Evidence of wages three years prior to that first day of wage loss is requested. Further factual employment evidence that supports the claimed wage loss is also requested, along with medical evidence supporting a causal relationship between the covered illness and the wage loss claimed.

6. Evidence Establishing a Wage Loss Claim. In the determination of AAW and annual earnings for wage loss, the CE in general relies upon the earnings information that has been reported to the Social Security Administration, but may also rely upon additional earnings information submitted by or requested from the claimant. Other evidence, if it is sufficiently reliable, may be accorded greater weight than information obtained from SSA. In addition to determining wage loss values from such evidence, the CE also obtains the requisite medical evidence establishing that the wage loss in question was causally related to the Part E covered illness.

a. Evidence of Earnings to Establish Wage Loss. To determine AAW and annual earnings for wage loss the CE relies on the following evidence:

(1) Social Security Earnings Record may be received from the claimant if available or the CE may submit a signed SSA-581 form from the claimant to the Social Security Administration to gather this information. (Please see EEOICPA BULLETIN NO.02-14 for obtaining Social Security records). This report includes a detailed earnings summary for the covered Part E employee by quarter for each year.

(a) For the maximum amount of taxable earnings, under the Social Security Administration for a specific year between 1937 and 2005, please refer to the chart below:

Year(s)	Maximum Earnings	Year(s)	Maximum Earnings	Year(s)	Maximum Earnings
1937-1950	$3,000	1980	$25,900	1994	$60,600
1951-1954	$3,600	1981	$29,700	1995	$61,200
1955-1958	$4,200	1982	$32,400	1996	$62,700
1959-1965	$4,800	1983	$35,700	1997	$65,400
1966-1967	$6,600	1984	$37,800	1998	$68,400
1968-1971	$7,800	1985	$39,600	1999	$72,600
1972	$9,000	1986	$42,000	2000	$76,200
1973	$10,800	1987	$43,800	2001	$80,400
1974	$13,200	1988	$45,000	2002	$84,900
1975	$14,100	1989	$48,000	2003	$87,000
1976	$15,300	1990	$51,300	2004	$87,900
1977	$16,500	1991	$53,400	2005	$90,000
1978	$17,700	1992	$55,500
1979	$22,900	1993	$57,600

(b) For any year in which the covered Part E employee reaches the maximum amount of taxable earnings under the Social Security Administration and worked for only one employer, the CE chooses the quarter in which the earnings is the highest in value. This amount is used to represent the wages earned for those quarter(s) that are reduced and/or unaccounted for (i.e. not listed) as a result of reaching the maximum amount of taxable earnings under the Social Security Administration. An example of this estimation is as follows:

1953 EARNINGS REPORTED BY SOCIAL SECURITY

$1,200 $1,300 $1,100 $3,600

1^STQtr 2^ndQtr 3^rdQtr 4^thQtr Total

The covered Part E employee has earned the maximum earnings of $3,600 for the year of 1953. The quarter which lists the highest value in earnings for this year is the 2^nd quarter with $1,300. When calculating AAW and/or when determining a yearly wage for wage loss purposes, the CE estimates that the value of earnings earned in the 3^rd (i.e. reduced) and 4^th (i.e. unaccounted for) quarters of 1953 is $1,300 in each. Therefore the CE finds that the covered Part E Employee earned a total $5,100 in wages (i.e. $1,200 + $1,300 + $1,300 + $1,300) for the year of 1953 instead of the reported $3,600.

(c) For any year in which the covered Part E employee is employed by multiple employers, according to the Social Security Administration, each of the employers withholds Social Security taxes on the wages without regard to what the other employers may have withheld. Therefore the covered Part E employee can potentially meet the maximum amount of taxable earnings under the Social Security Administration from each employer for the same year in question. The method of approximating the value of the reduced and/or un- accounted for (i.e. not listed) quarter(s) as discussed above is used for the same year in question only if the maximum earnings have been met for that employer(s). Hence this is done separately on an employer by employer scenario. An example of this estimation is as follows:

1954 EARNINGS REPORTED BY SOCIAL SECURITY

(Company A) $1,200 $1,300 $1,100 $3,600

1^STQtr 2^ndQtr 3^rdQtr 4^thQtr Total

(Company B) $600 $650 $500 $1,750

1^STQtr 2^ndQtr 3^rdQtr 4^thQtr Total

In 1954 the covered Part E employee worked for Company A and Company B. The employee earned the maximum taxable earnings of $3,600 from Company A, but only $1,750 from Company B. In order to determine the covered Part E employee’s complete amount of wages earned for the year of 1954, the CE approximates a value of earnings of $5,100 from Company A (see prior example for rationale) and adds this to the $1,750 earned from Company B. This results in an approximation of $6,850 earned in wages by the covered Part E employee in the year of 1954, instead of the reported $5,350. The reason why the CE does not make an approximation of the employee’s complete amount of wages earned from Company B is because the maximum taxable earnings had not been reached for that employer for the year in question.

(2) Tax Returns may provide proof of the covered Part E employee’s wages in instances where the employer did not report accurate and complete earnings to the Social Security Administration or when the covered Part E employee worked for an employer where there was no reporting of income to the Social Security Administration (i.e. some state, county, or city agencies).

(3) Pay Stubs may provide proof of the covered Part E employee’s wages.

(4) Union records may provide proof of the covered Part E employee’s wages.

(5) Pension records may provide proof of the covered Part E employee’s wages.

(6) Document Acquisition Request (DAR) for PPay and Salary Records include an employee’s pay, salary, any workers’ compensation claim or other documents affecting wage. Examples of records from the DOE database could include but are not limited to Official Personnel Files of Contractor Employees, Contractor Job Classification, Employee Awards Files, Notification of Personnel Actions, Classification Appraisals, Wage Survey Files and Unemployment Compensation Records (please see Chapter E-400 Establishing DOE Employment and Exposure).

b. Medical Evidence to Establish Wage Loss. In addition to the factual evidence of a covered Part E employee’s earnings, the claimant must submit medical evidence that is of sufficient probative value to establish, to the CE’s satisfaction, that the period of wage loss at issue is causally related to the covered Part E employee’s covered illness.

The CE develops the case for a causal relationship between the wage loss and the covered Part E employee’s covered illness by requesting medical evidence from the claimant which can include the following:

(1) Doctor’s office notes which indicate that the covered Part E employee had stopped working due to the covered illness;

(2) Return to work slips signed by a doctor;

(3) A doctor’s signed statement explaining the causal relationship between the covered illness and the period(s) of wage loss.

(4) In addition, where there is evidence of a serious disabling medical condition, the CE may obtain an opinion from a District Medical Consultant (DMC) regarding the period of illness-related disability.

7. Calculation of Average Annual Wage. After the CE receives and reviews the necessary employment and medical evidence (see sections 5 and 6 above), the CE calculates the AAW of a covered Part E employee. See Exhibit 1 for AAW worksheet calculator.

a. Retirement and AAW Calculation. If a covered Part E employee is retired prior to his or her normal retirement age, he or she is not considered unemployed under Part E of the EEOICPA. Even though as a result of the retirement the covered Part E employee has no wages reported to the Social Security Administration, this is not excluded from the calculation of the AAW. The CE determines that the AAW of a covered Part E employee is $0 if he or she was retired (prior to his or her normal retirement age) during the entire 12 quarters immediately preceding the quarter during which he or she first experienced wage loss due to exposure to a toxic substance at a DOE facility or RECA section 5 facility, as appropriate. If the employee earned wages during any of the 12 quarters and then retired before the end of the 12 quarters, those earned wages are included in the AAW calculation. If the employee was retired after having reached normal retirement age based upon his/her year of birth and worked earning wages, no compensation is due that employee due to his/her retirement.

b. Maximum Amount of Taxable Earnings. If the employee’s earnings meet the Social Security Administration’s maximum amount of taxable earnings for that year (see chart and discussion in section 6 above), those earnings are not reflected on the Social Security Administration statement. In order to determine wages in this situation, the CE estimates the earnings of the reduced and/or unaccounted for (i.e. not listed) quarter(s) to determine an approximation of the covered Part E employee’s complete amount of wages earned for the year in question. This applies when calculating AAW and when determining periods of wages lost. For the most up to date information, the CE can find the maximum amount of taxable earnings under the Social Security Administration for a specific year by going on the internet at the Social Security Administration website: http://ssa.gov/ and clicking on “Earnings and Employment.”

c. Calculating AAW in General. To calculate the average annual wage, the CE first adds up the earnings from the 12 quarters (include the estimation of reduced and/or unaccounted for SSA quarters discussed in section 6 above as appropriate) immediately prior to, but not including, the quarter (qtr) where the covered Part E employee first experiences a reduction in earnings (wage loss).

1^st qtr wage

2^nd qtr wage

3^rd qtr wage

4^th qtr wage

5^th qtr wage

6^th qtr wage

7^th qtr wage

8^th qtr wage

9^th qtr wage

10^th qtr wage

11^th qtr wage

12^th qtr wage

* Wage loss qtr

Stop

The CE then divides the total sum of wages from the 12 quarters by 12, to obtain the average wages for only 1 quarter (i.e. average quarterly wages).

Total sum of wages

from 12 quarters = Average Quarterly Wages

12 quarters

The CE then multiplies the average quarterly wages by 4, in order to calculate the average annual wage. The reason for multiplying by 4 is that there are 4 quarters in 1 year.

Average Quarterly Wages X 4 = Average Annual Wage

d. The CE takes into consideration all evidence submitted by the claimant to support wage loss (please see section 6 above). If there is evidence of earnings based on records other than SSA, the CE adds any additional income earned by the employee during those same quarters as supported by the submitted evidence.

e. The following is an example of calculating the average annual wage.

EARNINGS REPORTED BY SOCIAL SECURITY

K = (1) thousand

$10K $10K $11K $11K $11K $11K $12K $12K $12K $12K $13K $13K $11K

| | | | | | | | | | | | |

3^rd 4^th 1^st 2^nd 3^rd 4^th 1^st 2^nd 3^rd 4^th 1^st 2^nd 3^rd

1990 1991 1992 1993 *1st

quarter of wage

loss claimed

due to a

covered illness

138,000 x 4 = $46,000 = Average Annual Wage

f. The following page presents an example of calculating the average annual wage where there is more than one quarter of unemployment present:

EARNINGS REPORTED BY SOCIAL SECURITY

K = (1) thousand

$10K $10K $0 $11K $11K $11K $400.$12K $0 $12K $13K $13K $11K

| | | | | | | | | | | | |___

| | | | | | | | | | | | |

3^rd 4^th 1^st 2^nd 3^rd 4^th 1^st 2^nd 3^rd 4^th 1^st 2^nd 3^rd

1990 1991 1992 1993 *1st

** ** ** quarter of wage

** = Quarter of unemployment loss claimed

due to a

covered illness

103,000 x 4 = $45,777.78 = Average Annual Wage

(12-3)

8. Determination of Percentages of Loss. The CE compares the average annual wage of a covered Part E employee with his or her earnings in later calendar years to ascertain the calendar years during which the employee experienced wage loss. The CE begins with the calendar year that includes the quarter in which the wage loss commenced, and concludes with the last calendar year of wage loss, based upon the wage-loss period(s) claimed by the claimant. See Exhibit 3 for worksheet for determining percentage of wage loss and award amount.

a. The CE performs an adjustment calculation for each calendar year that wage loss is claimed by the claimant. The CE performs this calculation by clicking on the Inflation Calculator on the Bureau of Labor Statistics’ website http://www.bls.gov/cpi/home.htm. The CE sees a calculator with 4 fields, two of which a dollar value of $10,000 or less can be keyed into, and two in which a calendar year can be chosen via a drop down box, and does the following:

(1) In order to use the calculator, the CE must first reduce the actual earnings by either a factor of 10 or 100. For example, if the earnings to be deflated are $40,000 for 1994, the CE enters $4,000;

(2) The CE scrolls and clicks on the calendar year of those earnings in the 2^nd field (i.e. 1994);

(3) The CE scrolls and clicks on the calendar year in which the wage loss began in the 4^th field (i.e. 1993);

(4) The CE then clicks on the “calculate” button, and the adjusted value based on the figure entered in item 1 (adjusted by factor of 10 or 100) will be listed in the 3^rd field (i.e. 3,900.130).

(5) The CE then multiplies by the factor that it was initially reduced by (i.e. by 10, 100, etc.) to obtain the correct/appropriate value (i.e. $39,001.30).

This calculation represents the conversion of a dollar amount from one calendar year to another calendar year. The trend is that over time the value of the dollar is reduced, which is why it becomes inflated to overcome the reduction. For example $1000 in the year 1950 had a stronger buying power/worth than $1000 in the year 2005.

b. Compensation in the amount of $15,000 for each adjusted calendar year of earnings is paid to the employee when the CE compares and determines that the adjusted calendar year of wages is less than or equal to 50 percent of his or her average annual wage.

(1) An example of this instance is when an employee’s average annual wage is $46,000 and the adjusted calendar year of earnings in 1999 has been calculated to be $22,551.00. The employee is awarded $15,000 for that calendar year (1999) because $22,551.00 is approximately 49% of the average annual wage of $46,000 (22,551 ÷ 46,000 = .49). Consequently, the employee lost 51% of his/her wages and is entitled to $15,000 for that year. (Please refer to the ADJUSTED CALENDAR YEAR EARNINGS TO 1993 chart in section 8d below).

c. Compensation in the amount of $10,000 for each adjusted calendar year of earnings is paid to the employee when the CE compares and determines that the adjusted calendar year of wages is more than 50 percent but not more than 75 percent of his or her average annual wage.

(1) An example of this instance is when an employee’s average annual wage is $46,000 and the adjusted calendar year of earnings in 1997 has been calculated to be $29,710.30. The employee is awarded $10,000 for that calendar year (1997) because $29,710.30 is approximately 65% of the average annual wage of $46,000. (Please refer to the ADJUSTED CALENDAR YEAR EARNINGS TO 1993 chart in section 8d below).

d. The following is an example of determining percentages of loss which includes the following items:

(1) A summary of earnings reported by the Social Security Administration for the years from 1993 through 2002;

(2) A chart listing the adjusted calendar years earnings into 1993 dollars from 1993 (claimed beginning period of wage loss as a result of a covered illness) through the year of 2002 (claimed ending period of wage loss) http://www.bls.gov/cpi/home.htm;

(3) A graph which visually shows a comparison of the adjusted earnings to the average annual wage and whether it results into compensation and by how much;

(4) A table which consolidates all the data from sections (1), (2), and (3) with an average annual wage of $46,000.00.

EARNINGS REPORTED BY SOCIAL SECURITY

K = (1) thousand

(Unadjusted

$44K $40K $38K $35K $33K $30K $26K $27K $29K $32K Values)

| | | | | | | | | |

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

* *

*Claimed Beginning *Claimed Ending

Period of Wage Loss Period of Wage Loss

ADJUSTED CALENDAR YEAR EARNINGS TO 1993

1993	1994	1995	1996	1997
$44,000.00	$39,001.30	$36,030.20	$32,233.90	$29,710.30

1998	1999	2000	2001	2002
$26,595.10	$22,551.00	$22,656.80	$23,661.80	$25,703.20

* See Exhibit 2 for worksheet to calculate adjusted earnings

DETERMINATION OF PERCENTAGES OF WAGE LOSS

The graph and chart shown on the next page indicates that the AAW is $46,000 and shows the calculation of wage loss benefits based upon the percentage of loss for each compensable year, 1997 and 1999.

As the graph and chart indicates, for the year 1997, the percent of the AAW for this employee amounted to 65%. Since the employee earned between 50 to 75% of his/her wages, he/she is entitled to $10,000 for that year.

The year 1999 was calculated to show earnings that were 49% of the AAW, which equals a 51% loss of wages. Since the employee experienced wage loss in excess of 50%, he/she is entitled to $15,000 in compensation for that year.

100% ___________________________ Average Annual Wage = $46,000

75% ___________________________

_ =$10,000 *for 1997 adjusted calendar year

50% ______________/|\__________

_ |

/|\= $15,000*|***for 1999 adjusted calendar year

25% | |

| |

0 % ___|___________|___________

AVERAGE ANNUAL WAGE: $46,000.00

Year	Actual Earnings	Adjusted Earnings	Percent of Average Wage	Compensation
1993	$44,000.00	$44,000.00	96%	$0
1994	$40,000.00	$39,001.30	85%	$0
1995	$38,000.00	$36,030.20	78%	$0
1996	$35,000.00	$32,233.90	70%	$10,000.00
1997	$33,000.00	$29,710.30	65%	$10,000.00
1998	$30,000.00	$26,595.10	58%	$10,000.00
1999	$26,000.00	$22,551.00	49%	$15,000.00
2000	$27,000.00	$22,656.80	49%	$15,000.00
2001	$29,000.00	$23,661.80	51%	$10,000.00
2002	$32,000.00	$25,703.20	56%	$10,000.00
Total Compensation for Wage Loss				$80,000.00

9. Survivor Claims Involving Wage Loss. The CE must first determine that the survivor is entitled to benefits under Part E of the EEOICPA (please refer to the Chapter E-600 Establishing Survivorship). When the survivor is found to be entitled to survivor benefits under Part E of the EEOICPA, he or she may also be entitled to additional compensation for wages lost by the employee as a result of the covered illness. The CE undertakes the same medical and employment development and average annual wage calculation for the adjudication of the survivor claim, just as if the employee had filed a claim. The difference is that the monetary benefit provided to a survivor is different from that provided to an employee.

a. Percentages of loss. If the covered Part E employee dies as a result of the covered illness prior to his or her normal Social Security retirement age, the CE performs the adjustment calculation for each year of wage loss claimed through and including the year of death. For the years after the employee’s death, the CE assumes that the employee’s wages were less than or equal to 50% of the average annual wage for each year after the year of the employee’s death through the calendar year of normal retirement age. In these cases, if the employee’s death occurred between 10 and 19 years before his or her normal retirement age, the survivor is entitled to $25,000 in compensation. If the employee’s death occurred 20 years or more before the employee’s normal retirement age, the survivor is entitled to $50,000 in compensation. These sums of entitlement are in addition to the $125,000 survivor entitlement.

(1) The CE also considers any years of wage loss incurred by the covered Part E employee up to and including the year of his or her death in addition to the years after the death through the calendar year of his or her normal Social Security retirement age, when determining percentages of loss (i.e. time periods of 10 and 19 years, or 20 years or more).

(2) In some instances, the employee may have lost wages prior to his or her death and then died of the covered illness before normal Social Security retirement age. In this situation, the CE calculates the period of wage loss and adds any calendar years in which wages were less than or equal to 50% of the employee’s AAW ($15,000 in compensation) to the number of calendar years between the employee’s death and the employee’s retirement in order to determine the survivor’s entitlement. See Chapter E-600 for additional discussions of survivorship and wage loss.

b. If the covered Part E employee files a claim for benefits but then dies solely as a result of a non-covered illness prior to the issuance of a recommended decision to accept or the payment of compensation, an eligible survivor may choose to receive the compensation, including any wage-loss compensation that the employee would have been awarded.

10. Recommended Decisions and Final Decisions. The CE determines first if the employee has contracted a covered illness due to exposure to a toxic substance at a DOE facility or RECA section 5 facility prior to making a determination on wage loss. The CE can develop for the wage loss simultaneously with the development of other aspects of the case, but this development should not delay the issuance of a recommended decision to award medical or impairment benefits. If wage-loss development is required and the case is with the Final Adjudication Branch (FAB) for their review, the secondary CE designated to the FAB (see Chapter E-1100.8) continues to develop the case for any potential wage loss and issues a recommended decision once such development is complete.

11. Additional Filings for Wage-Loss Compensation. A covered Part E employee who has been previously awarded compensation for wage loss may file a claim, Form EE-10 for additional calendar years of wage loss subsequent to any calendar years for which he or she was previously paid compensation. The covered Part E employee may file an EE-10 form on a yearly basis for each year of wage loss alleged, or for an aggregate of calendar years in which wage loss is alleged until after one year has elapsed since the last award for wage-loss compensation. The EE-10 must be supported by sufficient employment and medical evidence of another calendar year of compensable wage loss to establish that the claimant is entitled to the benefits.

a. No compensation for wage loss will be payable for any calendar year of wage loss beyond the calendar year in which the employee reached his or her normal retirement age set forth in section 216(1) of the Social Security Act, 42 U.S.C. 416(1).

b. Maximum Aggregate Compensation. Under Part E of the EEOICPA the amount of compensation provided, excluding medical benefits, may not exceed the total amount of $250,000 per accepted covered employee, including both employee and survivor benefits.

(1) The CE is not required to develop for additional medical conditions once the compensation for a survivor has been paid unless the employee filed a claim for a condition that has yet to be decided, and there is an indication that the survivor may be entitled to reimbursement for medical expenses for the condition claimed by the employee before his or her death.

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