A Review of the Dose Reconstruction Program of the Defense Threat Reduction Agency (2003) / Chapter Skim
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III. The Process of Submitting and Deciding Claims
III. The Process of Submitting and Deciding Claims
Pages 51-64
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From page 51... ...
VA regulations do not, however, require veterans or their survivors to obtain confirmation of participation or dose information from DTRA before initiating a VA claim. Veterans' requests for medical care under VA regulations also do not require the prior filing of claims.
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From page 52... ...
The claimant must furnish medical evidence of a radiogenic disease listed in 38 CFR 3.311 or of any other disease plus a medical opinion that the unlisted other disease can be caused by radiation exposure. The claimed activity must involve participation in the US atmospheric nuclear testing program, occupation of Hiroshima or Nagasaki, Japan, or POW status in the vicinity of Hiroshima or Nagasaki.
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From page 53... ...
.L ~.~_.~i~.~~.~ ~.~ —~~ ~ _ {Fiji) (-it} FIGURE III.B.1 How VA and DTRA process a radiation-related claim from a veteran for a nonpresumptive disease.
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From page 54... ...
For each disease, OPHEH considers the upper bound dose to the target organ, age or approximate age at exposure and at diagnosis, family and employment history, and exposure to other toxicants and carcinogens before and after military service. Thereafter, using DTRA-reported upper-bound doses, OPHEH applies probability of causation methods, such as those based on radioepidemiological tables issued by the National Institutes of Health (NIH)
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From page 55... ...
As shown in the figure, Veteran with presumptive radiogenic disease files claim with the VARO VARO reviews the inquiry and requests documentation of VARO participation from DTRA 3 DTRA reviews the inquiry ~~ and forwards it to the I contractors for processing DTRA contractor team conducts historical research to confirm participation and drafts response .
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From page 56... ...
The VA letter to DTRA should identify the veteran, describe his claimed participation, name the radiogenic disease, cite the specific controlling regulation, and include available claimant statements and supporting evidence if any. DTRA reviews the information provided by the VARO and conducts historical research to determine the veteran's participation status.
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From page 57... ...
Atomic veterans also receive other kinds of information in communications from the NTPR program. For example, veterans who file a claim for compensation or request a dose reconstruction usually receive general information, in the form of "Fact Sheets," on the atomic testing program, the program of dose reconstruction and compensation for atomic veterans, and the magnitude and significance of doses received by the veterans.
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From page 58... ...
To give the benefit of the doubt to the veteran, VA has chosen to use the doses associated with 99% credibility limits of PC rather than the 50% PC values. For example, the dose associated with a 50% PC for colon cancer in Table III.E.
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From page 59... ...
within 20 years of exposure 14.4 21.4 37.1 20 or more years post-exposure 37.1 42.4 56.6 Colon cancer 209.4 331.8 497.4 Esophageal cancer 183.8 331.8 458.6 Female breast cancer 92.3 157.0 287.3 Kidney and bladder cancer 258.1 368.3 483.5 Liver cancer 28.0 72.6 138.0 Lung cancer known smokersC 258.1 409.0 546.8 others 73.2 128.0 178.6 Pancreatic cancer 112.4 202.2 297.9 Stomach cancer 95.6 157.0 225.9 Thyroid cancer 28.9 56.6 63.9 aDoses at ages between 20 and 30 years or between 30 and 40 years should be obtained by linear interpolation. bDose to active bone marrow.
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From page 60... ...
a Age at Exposure, years Type of Cancer <20 30 >40 Chronic granulocytic leukemiab within 20 years of exposure 1.4 2.0 2.2 20 or more years post-exposure 4.2 5.0 9.3 Acute leukemiab within 20 years of exposure 1.8 2.9 6.5 20 or more years post-exposure 5.5 6.5 8.5 Leukemia (excluding chronic lymphatic) within 20 years of exposure 1.8 2.8 5.2 20 or more years post-exposure 5.2 6.1 8.5 Colon cancer 25.9 48.6 82.7 Esophageal cancer 9.1 22.2 35.8 Female breast cancer 26.7 50.9 104.3 Kidney and bladder cancer 21.1 35.2 51.7 Liver cancer 1.6 5.4 12.9 Lung cancer known smokersC 37.8 69.6 100.6 others 6.8 14.4 22.8 Pancreatic cancer 10.3 23.4 40.0 Stomach cancer 10.8 21.2 34.8 Thyroid cancer 4.9 10.7 12.7 aDoses at ages between 20 and 30 years or between 30 and 40 years should be obtained by linear interpolation.
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From page 61... ...
a 61 Age at Exposure, years Type of Cancer <20 30 >40 Chronic granulocytic leukemiab within 20 years of exposure 0.9 1.3 1.4 20 or more years post-exposure 2.7 3.2 5.9 Acute leukemiab within 20 years of exposure 1.1 1.8 4.1 20 or more years post-exposure 3.5 4.1 5.5 Leukemia (excluding chronic lymphatic) within 20 years of exposure 1.1 1.7 3.3 20 or more years post-exposure 3.3 3.9 5.5 Colon cancer 17.0 33.1 58.1 Esophageal cancer 3.9 9.9 16.7 Female breast cancer 18.8 37.0 78.6 Kidney and bladder cancer 13.4 23.1 34.7 Liver cancer 1.0 3.3 8.2 Lung cancer known smokersC 25.5 48.8 72.1 others 4.3 9.3 15.0 Pancreatic cancer 5.8 13.7 24.3 Stomach cancer 6.9 13.8 23.2 Thyroid cancer 3.3 7.4 8.8 aDoses at ages 20 and 30 years or between 30 and 40 years should be obtained by linear interpolation.
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From page 62... ...
Table III.E.5 shows the doses associated with a PC of 50% and the 99% credibility limit for a PC of 50% for exposure at age 20 and various ages at diagnosis of leukemia. Although leukemia has possibly the greatest cancer risk associated with radiation exposure relative to background cancer rates, the calculations show that after a number of years, the excess risk above background is essentially minimal.
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From page 63... ...
External beta radiation affects primarily the skin, and the NIOSH IREP program allows consideration of beta radiation in its calculations. The committee has reproduced in Table III.E.6 values of beta doses for skin cancers corresponding to different credibility limits of PC for both black and white men.
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From page 64... ...
It must be understood that the PC values constitute only one tool used in the medical decision process, and PC is not the only factor used in deciding whether an atomic veteran with a nonpresumptive radiogenic disease receives compensation for service-connected disability.
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