ated occupational diseases found in SEM. These links are imported solely from the “Diseases” field in the Haz-Map database (see Chapter 2).
For context on how SEM is used, DOL provided the committee with an overview of the EEOICP claims process (see Figure 3-1). Each pathway shows that information in the database is not the final determinant of either an exposure pathway (Figure 3-1a) or a toxic substance—disease link (Figure 3-1b). For example, a claims examiner uses the claimant’s employment history to verify that the claimant was potentially exposed to a toxic substance based on location, job category, or process (Figure 3-1a). Based on a claimant’s employment history and medical information, a claims examiner can also check to see whether a causal link between the claimant’s disease and any toxic substance exists in SEM (Figure 3-1b). DOL appears to use “Exposure Pathway” to indicate the presence or absence of a substance at a DOE site. If a causal link is found in the database, the claims examiner can recommend that the claim be accepted if a well-rationalized link between the claimant’s diagnosis and occupational exposure to a toxic substance is supplied by the treating physician and an exposure pathway is evident (Figure 3-1). If a link between a claimant’s disease and exposure to a toxic substance is not given in the database, the claimant may provide additional supporting information and statements from the treating physician regarding the etiology of his or her disease. The claims examiner may further refer the claim to a toxicologist, a district medical consultant, or an industrial hygienist for further evaluation before a decision is made to accept or deny the claim (DOL, 2012e).
SEM is periodically updated. As the introductory website states:
The exposure and diagnosed illness information provided on this website is not complete. Toxic substance use at each facility is continuously evaluated and new substances are added as their presence is discovered. DOL places SEM data on the Internet in an ongoing effort to obtain and organize exposure and disease information for all covered Part E facilities. The website was developed to support DOL Part E claims adjudication. The information presented is not an attempt to provide a complete history of any DOE or RECA facility. (http://www.sem.dol.gov; accessed January 24, 2013)
DOL states that “SEM represents the most current, accurate, and comprehensive information regarding toxic substances and their known health effects, and is updated regularly” (DOL, 2008). The current version of the database used by claims examiners and the version available to the public on the Internet contain the same information, although initially there were differences in the available information due to DOE security concerns. DOL asserts that the security concerns have been resolved and that there are no longer differences between the content of the public and the internal SEM databases (Anders, 2012a).