Ask the Experts: Denial Reviews Under EEOICPA

Has Your EEOICPA Claim Been Denied?

Filing for benefits can be a long and frustrating process that tests the resolve of even the most resolute. It is made worse when after all the waiting you are informed that your case was denied. Is there even anything you can do or are you just out of luck? I assure you that most cases are not hopeless.

When the Department of Labor (DOL) issues a decision they send out two letters. The “Recommended Decision” is not a finalized decision and your case is still open. This letter has a list of what the DOL needs to approve a claim. This is usually in a paragraph towards the end of the letter and recently has been given the title “What we need from you.” The “Final Decision” has the same list, but in this case, your claim will need to be reopened.

Typically, the DOL will list one of three reasons for not approving a claim:

  1. Proof of Employment
  2. Lack of Sufficient Exposure
  3. NIOSH

Denials can be difficult and in many cases, they are the proverbial “straw that broke the camel’s back.” Numerous people just give up on getting an approval, but after a review, they were just a letter or a single piece of further clarification away from approval. If you have received a denial and would like to get a review to see if you are closer than you think to an approval, we can help!

To read this full article in our Fall 2021 edition of Atomic Health News, click here.