Overturning a Denied EEOICPA Claim

Elizabeth Brooks

By Elizabeth Brooks, Independent Advocate for Nuclear Workers & Survivors
With Energy Employee Claims Specialists

Why did my claim get denied?

There are many reasons your claim could have been denied. Some reasons may include incomplete verification of employment, lack of medical evidence, insufficient information regarding exposure to toxic substances, or the condition you were diagnosed with could not be linked to your workplace exposure. Because there are many challenges associated with reversing a denied claim, we encourage you to reach out to your Authorized Representative (AR) to assist in the reopening process.

What does the denial overturn process look like?

Your AR will pinpoint reasons for the denial and help with collecting supporting documents to rewrite the request for an overturn. Once the written request has been submitted, there is approximately a 90 day waiting period for your reopening request to be evaluated. If a claim examiner finds sufficient evidence for the claim to be reopened, the denial will be discarded and a new written request will be sent back to the district office for reapproval.

What does it cost to work with an AR?

If you file with an Authorized Representative, they will receive 2% of the total compensation, payable after the claim is approved. If compensation was not received, then there is no charge. For complex cases involving reopening of a denied claim, an AR may charge up to 10% of the monies awarded in the settlement.

Filing for the First Time?
Nuclear Care Partners recommends working with our local EEOICPA Benefits Experts to be connected with reputable and knowledgeable resources for first-time filings so you can avoid a denial.

Commonly Denied Conditions Include:
Bone, Renal, Leukemia, Lung, Multiple Myeloma, Lymphomas, Bile ducts, Brain, Breast, Colon, Esophagus, Gallbladder, Liver, Ovary, Pancreas, Pharynx, Prostate, Salivary gland, Skin, Small intestine, Stomach, Thyroid, Urinary bladder

Lung Disease:
Chronic Obstructive Pulmonary Disease (COPD), Chronic Beryllium Disease, Asbestosis, Pulmonary Fibrosis, Interstitial Lung Disease, Silicosis, Pneumoconiosis

Other Systems:
Chronic Kidney Disease, Neuropathy, Parkinson’s Disease

To read the full article, check out our Fall 2022 Atomic Health News edition.