Radiation Exposure Screening & Education Program Clinical Guidelines: Uranium Ore Transporters

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1 Radiatin Expsure Screening & Educatin Prgram Clinical Guidelines: Uranium Ore Transprters Uranium Ore Transprters Eligibility A persn wh was emplyed fr at least ne year as a transprter f uranium re r vanadium-uranium re frm a uranium mine r uranium mill lcated in a specified states (AZ, CO, ID, OR, ND, NM, SD, TX, UT, WA, WY) during the perid beginning January 1, 1942 and ending December 31, Radiatin Expsure Cmpensatin Act Eligibility The fllwing specific diseases r cnditins are cmpensable under the Radiatin Expsure Screening and Educatin Prgram: Primary lung cancer (including any physilgical cnditin f the lung, trachea r brnchus that is recgnized as lung cancer ) Pulmnary fibrsis, fibrsis f the lung Silicsis Cr pulmnale related t fibrsis f the lung Pneumcnisis Renal cancer Chrnic renal disease (including nephritis and kidney tubal tissue injury) Dcumentatin r Prf f Disease In additin t prviding dcumentatin that establishes a claimant's inclusin in ne f the eligibility categries described abve, the claimant must als prvide prf that they have been diagnsed with at least ne f the cmpensable diseases. The recrds r dcumentatin required vary accrding t the cnditin and the vital status f the persn n whse behalf cmpensatin is being sught. General infrmatin All medical dcumentatin, cntempraneus recrds, and ther recrds r dcuments submitted by a claimant r eligible surviving beneficiary as prf f disease must be riginals, r certified cpies f the riginals, unless it is impssible t btain an riginal r certified cpy f the riginal. If it is impssible fr a claimant t prvide an riginal r certified cpy f an riginal, the claimant r eligible surviving beneficiary must prvide a written statement with the uncertified cpy setting frth the reasn why it is impssible t prvide an riginal r a certified cpy f an riginal. All dcuments submitted by a claimant r eligible surviving beneficiary must have a stamp r ther indicatin f their authenticity. If a claimant was diagnsed as having ne f the cmpensable cancers in Arizna, Clrad, Nevada, New Mexic, Utah r Wyming, the claimant r eligible surviving beneficiary des nt need t submit medical dcumentatin f disease at the time the claim is filed (althugh medical dcumentatin

2 subsequently may be required). Instead, the claimant r eligible surviving beneficiary may submit (with the claim), an Authrizatin t Release Medical and Other Infrmatin, valid in the state f diagnsis, that authrizes the RECA Prgram t cntact the apprpriate state cancer r tumr registry. The RECA Prgram will accept, as prf f medical cnditin, verificatin frm the state cancer r tumr registry that it pssesses medical recrds r abstracts f medical recrds that cntain a verified diagnsis f ne f the specified cmpensable diseases. If the designated state des nt pssess medical recrds r abstracts f medical recrds that cntain a verified diagnsis f ne f the specified cmpensable diseases, the RECA Prgram will ntify the claimant r eligible surviving beneficiary and allw that individual the pprtunity t submit the required written medical dcumentatin. Fr the purpses f this Prgram, the definitin f a physician is as fllws: A physician wh is emplyed by (a) the Indian Health Service r (b) the Department f Veterans Affairs; r (c) has a dcumented, nging physician/patient relatinship with the claimant. Prf f cancer If the persn with cancer is deceased r living, any f the fllwing recrds may be submitted as prf f the disease: Primary cancer f the lung Pathlgy reprt f tissue bipsy r resectin, including, but nt limited t specimens btained by any f the fllwing methds: Surgical resectin endscpic endbrnchial r transbrnchial bipsy brnchial brushings and washings pleural fluid cytlgy fine needle aspirate pleural bipsy sputum cytlgy autpsy reprt brnchscpy reprt, with r withut bipsy One f the fllwing summary medical reprts physician summary reprt hspital discharge summary reprt raditherapy summary reprt perative reprt medical nclgy summary r cnsultatin reprt Reprt f ne f the fllwing radilgic studies: cmputerized tmgraphy (CT) scan magnetic resnance imaging (MRI) X-rays f the chest Chest tmgrams Death certificate, prvided that it is signed by a physician at the time f death Primary cancer f the kidney pathlgy reprt f tissue bipsy r surgical resectin autpsy reprt ne f the fllwing summary medical reprts physician summary reprt

3 hspital discharge summary reprt raditherapy summary reprt perative reprt medical nclgy summary r cnsultatin reprt death certificate, prvided that it is signed by a physician at the time f death Prf f Nn-malignant Lung Disease (Pulmnary Fibrsis, Fibrsis f the Lung, Silicsis, r Pneumcnisis) If the persn with nn-malignant lung disease is deceased, any f the fllwing frms f medical dcumentatin may be submitted as prf f the cnditin: pathlgy reprt f tissue bipsy autpsy reprt if an x-ray exists, the x-ray and interpretive reprts f the x-ray by a maximum f tw NIOSH certified B readers, classifying the existence f disease f categry 1/0 r higher accrding t a 1989 reprt f the Internatinal Labr Office (knwn as the ILO ), r subsequent revisins if n x-rays exist, an x-ray reprt physician summary reprt hspital discharge summary reprt hspital admitting reprt death certificate, prvided that it is signed by a physician at the time f death dcumentatin specified belw fr a living claimant If the persn with nn-malignant lung disease is living, at a minimum the fllwing medical recrds must be submitted: Either: an arterial bld gas study administered at rest in a sitting psitin, r an exercise arterial bld gas test RECA Bld Gas Study Tables (CFR 28 Part 79 Appendix B) can be fund at 5&view=text&nde=28: &idn=28#28: r written diagnsis by a physician (see abve fr the definitin f physician ) And ONE f the fllwing: a chest x-ray (PA and lateral views) administered in accrdance with standard techniques accmpanied by interpretive reprts f the x-ray by a maximum f tw NIOSH certified B readers, classifying the existence f disease f categry 1/0 r higher accrding t a 1989 reprt f the Internatinal Labr Office (knwn as the ILO ), r subsequent revisins high-reslutin cmputed tmgraphy (HRCT) scans including cmputer assisted tmgraphy (CAT) scans, magnetic resnance imaging (MRI) scans, and psitrn emissin tmgraphy (PET) scans and interpretive reprts f such scans pathlgy reprts f tissue bipsies

4 pulmnary functin tests indicating restrictive lung functin and cnsisting f three reprducible time/vlume tracings recrding the results f the frced expiratry vlume in ne secnd (FEV1) and the frced vital capacity (FVC) administered and reprted in accrdance with the Standardizatin f Spirmetry 1994 Update by the American Thracic Sciety, and reflecting values fr FEV1 r FVC that are less than r equal t the lwer limit f nrmal fr an individual f the claimant's age, sex, height, and ethnicity. RECA FVC and FEV-1 Lwer Limits f Nrmal Values (CFR 28 Part 79 Appendix A) can be fund at 5&view=text&nde=28: &idn=28#28: Prf f Cr Pulmnale related t Fibrsis f the Lung If the persn with cr pulmnale related t fibrsis f the lung is deceased, the same dcumentatin as is required fr prf f nn-malignant lung disease must be submitted as prf f the existence f fibrsis f the lung. If the persn with cr pulmnale related t fibrsis f the lung is living, the same dcumentatin as is required fr prf f nnmalignant lung disease must be submitted as prf f the existence f fibrsis f the lung. In additin, regardless f whether the persn with cr pulmnale related t fibrsis f the lung is deceased r living, ne r mre f the fllwing medical recrds must be submitted: right heart catheterizatin cardilgy summary r cnsultatin reprt electrcardigram echcardigram physician summary reprt hspital discharge reprt autpsy reprt death certificate, prvided that it is signed by a physician at the time f death Prf f Chrnic Renal Disease (including nephritis and kidney tubal tissue injury) If the persn with chrnic renal disease is deceased r living, any f the fllwing frms f medical dcumentatin may be submitted as prf f disease: pathlgy reprt f tissue bipsy if labratry r radigraphic tests exist: abnrmal plasma creatinine values: and abnrmal glmerular filtratin rate (by either measured creatinine r ithalamate clearance r calculated by MDRD equatin); and renal tubular dysfunctin as evidenced by glycsuria in the absence f diabetes mellitus prteinuria less than 1 gram daily withut ther knwn etilgy; r hyperphsphaturia, aminaciduria, Β-2 micrglbinuria r alkaline phsphaturia r ther marker f prximal tubular injury; r radigraphic evidence f chrnic renal disease radigraphic evidence f chrnic renal disease

5 autpsy reprt physician summary reprt hspital discharge reprt hspital admitting reprt death certificate, prvided that it is signed by a physician at the time f death.

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