• Retroactive calculation of internal doses in claims that were denied before development of the FIIDOS code (Egbert et al., 1985) in cases in which internal dose was not estimated in the dose reconstruction (see case #89 and 99).

  • Retroactive recalculation of inhalation doses in claims that were denied before an assumption of large particles (AMAD, 20 μm) was used routinely in exposure scenarios in which mostly large particles presumably were inhaled and an assumption of large particles, instead of respirable particles (AMAD, 1 μm), would increase the estimated dose to the organ or tissue of concern.

  • Re-evaluation of cases in which a veteran did not file a claim for compensation but stated that he had a radiogenic disease specified in 38 CFR 3.311.13

  • Retroactive re-evaluation of decisions to deny claims for compensation that were made before so-called screening doses (CIRRPC, 1988) discussed in Section III.E were used routinely in evaluating claims, especially when the screening dose to the organ or tissue of concern is lower than the dose criterion that was used previously in evaluating claims.

The issue of retroactive recalculations of dose and re-evaluations of decisions to deny compensation also will arise if methods of dose reconstruction are revised in response to the committee’s evaluations presented in this report, because appropriate changes should result in increases in credible upper-bound estimates of dose in many cases.

It is not the committee’s intent to criticize policies of the NTPR program and VA concerned with informing veterans whose claims for compensation were denied about changes in laws, regulations, or methods of reconstructing doses or estimating probability of causation that could affect their claims. The committee recognizes the effort that would be required to take the initiative to re-evaluate every denied claim whenever there is a change in some aspect of the program that could affect claims.

Nonetheless, veterans might view the NTPR program more favorably if, for example, individual veterans were informed when changes in methods of estimating doses are made that might result in increases in their previously assigned doses or when policies affecting evaluations of claims are changed and were reminded that they can request a revised dose reconstruction. For example, after recent changes in the methods of calculating beta dose to the skin and evaluating claims for compensation for skin cancer, individual veterans with a previously denied claim for skin cancer, and the community of atomic veterans as a whole, could have been informed that doses to the skin are now being calculated in a different way and, furthermore, that more claims for skin cancer are being granted on the basis of a re-evaluation (lowering) of doses that could cause skin cancer. A

13  

The committee encountered one such case in its review of dose reconstructions for individual veterans (case #55).



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