Veterans Health Administration

Washington DC 20420

In Reply Refer To:

September 17, 2001


Isaf AI-Nabulsi, Ph.D.

Study Director

National Academies

2101 Constitution Avenue, N.W. Washington, DC 20418

Dear Dr. AI-Nabulsi:

This is in reply to your letter dated September 7, 2001. As we discussed, I am responding to question numbers 8, 10, and 14 as they pertain to responsibilities of our office.

Question 8. Explain the use of the “dose screen”. At what point in the process is the CIRRPC screen applied? Which of the confidence limits are used, 90%, 95%, or 99%? Are different screens applied at different stages in the process?

Reply: Screening doses are used when a compensation claim requires a medical opinion on the likelihood that radiation exposure in service was responsible and when the CIRRPC report provides screening doses relevant to the veteran’s disease. The CIRRPC screening doses are applied after the case has been sent to the Office of Public Health and Environmental Hazards for a medical opinion. The screening doses based on the 99% confidence limits are used. The same screening doses based on 99% confidence limits are used for medical opinions provided at all stages of the adjudication process.

Question 10. Who has the authority to communicate with the veteran and/or the veteran’s family?

Reply: I am not aware of any restriction on any VA employees communicating with veterans or family members.

Question 14. Are the CIRRPC screening doses used in actual compensation decisions? If not, what PC labels are used?

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