M21-1MR, Part IV, Subpart II, Chapter 1, Section C



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M21-1MR, Part IV, Subpart ii, Chapter 1, Section C

Section C. Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311

Overview




In this Section

This section contains the following topics:




Topic

Topic Name

See Page

7

General Information on Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311

1-C-2

8

Requesting Information and Evidence From the Claimant

1-C-6

9

Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311

1-C-9

10

Obtaining Dosimetry Information

1-C-18

11

Referring Claims to Compensation Service, Policy Staff (211)

1-C-23

12

Exhibit 1: Exposure to Nuclear Radiation and Department of Defense (DoD) Secrecy Agreement

1-C-26



7. General Information on Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311




Introduction

This topic contains general information on claims for disabilities resulting from ionizing radiation exposure under 38 CFR 3.311, including


  • the centralized processing of claims based on radiation exposure

  • the provisions of 38 CFR 3.311

  • presumptive versus direct service connection

  • handling

  • claims that require a subsequent review under PL 98-542,

  • claims that require a subsequent review based on dose estimates made before May 8, 2003, and

  • the classified information needed to validate exposure to nuclear radiation, and

  • Department of Veterans Affairs (VA) responsibility for expunging classified military data.



Change Date

September 15, 2011



a. Centralized Processing of Claims Based on Radiation Exposure

In October 2006, the Department of Veterans Affairs (VA) centralized the processing of all claims for service connection based on radiation exposure at the Jackson Regional Office (RO).
The Jackson RO is responsible for developing and resolving


  • all claims for service connection for disabilities resulting from exposure to ionizing radiation under 38 CFR 3.311, and

  • all non radiation-related claims received while the radiation issue is pending.


Notes:

  • Regional offices of jurisdiction (ROJs) must verify the existence of a radiogenic disease before transferring the claims folder to the Jackson RO.

  • Following resolution of all pending issues, the Jackson RO will transfer the claims folder back to the ROJ.

Continued on next page

7. General Information on Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311, Continued


b. Provisions of 38 CFR 3.311

The specific requirements for the adjudication of claims for service connection for disabilities resulting from exposure to ionizing radiation claims are found in 38 CFR 3.311.
The provisions of 38 CFR 3.311(b)(1) require that the


  • Veteran must have been exposed to ionizing radiation as a result of participation in

  • atmospheric testing of nuclear weapons

  • the occupation of Hiroshima or Nagasaki, Japan from September 1945 until July 1946, or

  • other radiation-risk activities as claimed

  • Veteran must have subsequently developed a radiogenic disease listed in 38 CFR 3.311(b)(2), and

  • disease first manifested itself within the period specified in 38 CFR 3.311(b)(5).



c. Presumptive Versus Direct Service Connection

A claim for service connection under the provisions of 38 CFR 3.311 is also a claim for service connection under the provisions of 38 CFR 3.303.



d. Handling Claims That Require a Subsequent Review Under PL 98-542

A claim for service connection for a disability resulting from exposure to radiation as an atmospheric test participant or a member of the Hiroshima/Nagasaki occupation forces that was denied prior to enactment of Public Law (PL) 98-542, “The Veterans’ Dioxin and Radiation Exposure Compensation Standards Act,” on October 24, 1984, must receive a complete, new and complete review of the evidence (de novo review) if the claim is subsequently reopened.
Note: It is not necessary for the claimant to submit new and material evidence to reopen these claims.
Reference: For more information on the initial review of reopened claims for compensation based on radiation exposure, see

  • M21-1MR, Part IV, Subpart ii, 1.B.5, and

  • M21-1MR, Part IV, Subpart ii, 1.C.8.

Continued on next page

7. General Information on Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311, Continued


e. Handling Claims That Require a Subsequent Review Based on Dose Estimates Made Before May 8, 2003

On May 8, 2003, the National Research Council, an independent agency contracted to review the Defense Threat Reduction Agency’s (DTRA) radiation dose estimates, reported that DTRA had underestimated upper bound radiation doses for atmospheric test participants and Hiroshima/Nagasaki occupation forces.
When a case is encountered in which a denial was based on a dose estimate provided by DTRA before May 8, 2003, obtain a new dose estimate from DTRA and readjudicate the claim.
Note: It is not necessary for the claimant to submit new and material evidence to reopen these claims.
Reference: For more information on developing dose estimates, see M21-1MR, Part IV, Subpart ii, 1.C.10.


f. Handling Classified Information Needed to Validate Exposure to Nuclear Radiation

Veterans seeking benefits in connection with exposure to nuclear radiation are authorized by the Exposure to Nuclear Radiation and DoD Secrecy Agreement to divulge to VA the name, location of their command, duties performed, dates of service, and related information necessary to validate exposure to nuclear radiation.
This authorization does not relieve Veterans of responsibility for continuing to protect specific technical information that could contribute to the development of a weapon of mass destruction or the application of nuclear technology.
Important: Information relative to military bases where nuclear weapons

  • may be located within the continental U.S. is classified as “Confidential,” and

  • were or are located outside the continental U.S. is classified as “Secret” or “Top Secret.”


References: For more information on

  • the Exposure to Nuclear Radiation and DoD Secrecy Agreement, see M21-1MR, Part IV, Subpart ii, 1.C.12, and

  • claims for radiogenic diseases under 38 CFR 3.309(d), see M21-1MR, Part IV, Subpart ii, 1.B.

Continued on next page

7. General Information on Claims for Service Connection for Disabilities Resulting From Ionizing Radiation Exposure Under 38 CFR 3.311, Continued


g. VA Responsibility for Expunging Classified Military Data

The fact that a Veteran inadvertently reveals classified military information during the course of applying for benefits should not be compounded further by releasing this information within or outside VA in any manner. Cut out (rather than obliterate) any classified information from related documents or statements.
When expungement is necessary, prepare a VA Form 27-0820, Report of General Information, for the claims folder and have the form signed by the Veterans Service Center Manager (VSCM) or supervisory designee, not lower than the Assistant VSCM. On the VA 27-0820


  • cite the

  • kind of evidence removed, and

  • reason for the record expungement, and

  • summarize or restate any other expunged facts or statements not referring to specific military bases where radiation exposure allegedly occurred.



8. Requesting Information and Evidence From the Claimant




Introduction

This topic contains information on requesting information and evidence from the claimant, including


  • the minimum evidence required from the claimant for development of exposure to ionizing radiation

  • the initial review of claims

  • when to obtain information

  • requesting a diagnosis of the Veteran’s disease

  • requesting a history of the Veteran’s exposure to known carcinogens, and

  • requesting a history of cancer in the Veteran’s family, and

  • other information to obtain.



Change Date

September 5, 2008



a. Evidence Required for Initial Development

Do not initiate development of a claim for service connection for a disability resulting from exposure to ionizing radiation unless


  • the dates, places, and circumstances of exposure to ionizing radiation are

  • contained in the claims folder, or

  • provided by the claimant, and

  • diagnosis of a radiogenic disease is claimed.


Note: Ask the claimant to provide this information, if it is not of record.

Continued on next page

8. Requesting Information and Evidence From the Claimant, Continued


b. Initial Review of Claims

If a claim is received for service connection for a disability caused by exposure to ionizing radiation and the claim is substantially complete, the pre-determination activity reviews the claim to


  • direct development to determine whether service connection may be established under 38 CFR 3.303, and

  • determine whether the requirements for consideration of service connection under 38 CFR 3.311 are satisfied.

Under 38 CFR 3.311(b), the submitted or acquired evidence must show that the Veteran




  • has either

  • one of the radiogenic diseases listed in 38 CFR 3.311(b)(2), or

  • an unlisted disease for which a medical opinion or medical treatise has been submitted showing a causal relationship between the disease and exposure to radiation, and

  • was exposed to ionizing radiation

  • while a participant in atmospheric nuclear weapons testing

  • during the post-war occupation of Hiroshima or Nagasaki from September 1945 until July 1, 1946

  • as a prisoner of war (POW) in Japan, or

  • while performing other service activities, such as work as an x-ray technician, in a reactor plant, or in nuclear medicine or radiography.


Note: A Veteran will be considered involved in a radiation-risk activity if he/she performed tasks similar to work engaged in by a Department of Energy employee that qualifies the Department of Energy employee as a member of the Special Exposure Cohort under 42 U.S.C. 7384L(14).



c. When to Obtain Information

In all cases, if a substantially complete claim under 38 CFR 3.311 exists, obtain the information listed in M21-1MR, Part IV, Subpart ii, 1.C.8.d -g.

Continued on next page

8. Requesting Information and Evidence From the Claimant, Continued


d. Requesting a Diagnosis of the Disease

Obtain information on the diagnosis of the Veteran’s disease and, if known, the specific cell type and stage.
Example: If the disease is skin cancer, ask the claimant to provide the

  • type of cancer diagnosed

  • specific site of each lesion

  • date that the disease was first diagnosed or treated, and

  • name and address of the physician or facility who

  • made the diagnosis, or

  • first treated the claimed disease.



e. Requesting a History of the Veteran’s Exposure to Known Carcinogens

Obtain information on the Veteran’s history of exposure to known carcinogens, including a post-service occupational history. Ask whether, either before or after service, the Veteran was exposed to a cancer-causing substance.
Examples:

  • If the claim is for skin cancer, ask the claimant to provide the

  • extent of exposure to the sun (such as sun bathing or occupations requiring the Veteran to work outdoors, and so forth) and

  • specific site of each lesion.

  • Request the Veteran’s smoking history.



f. Requesting a History of Cancer in the Veteran’s Family

Obtain information on the history of members of the Veteran’s family who have been diagnosed as having cancer.
Example: Ask whether members of the Veteran’s immediate family, such as parents or siblings, have been diagnosed with diseases such as cancer or leukemia, birth defects, or genetic disorders.



g. Other Information to Obtain

Obtain


  • the names and addresses of any physicians and facilities who have made subsequent diagnoses or have provided treatment for the claimed disease

  • the complete clinical records (not summaries) for all medical care relating to the claimed disease, and

  • all tissue blocks, slides or other pathology samples, if available.



9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311




Introduction

This topic contains information on the process of verifying exposure to ionizing radiation under 38 CFR 3.311, including


  • requesting verification from DTRA for the Veteran’s participation in

  • atmospheric nuclear weapons tests, and

  • American occupation of Hiroshima or Nagasaki, Japan, prior to July 1, 1946

  • requesting verification of

  • involvement in non-U.S. nuclear bomb tests, and

  • exposure to ionizing radiation by reason of military duties

  • obtaining records of occupational exposure to radiation from

  • the Veteran’s service department, and

  • the Atomic Energy Commission (AEC), and

  • developing claims for service connection based on nasopharyngeal radium irradiation therapy (NRI).



Change Date

July 10, 2014

Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


a. Requesting Verification of Participation in Atmospheric Nuclear Weapons Tests

When requesting verification from DTRA of exposure to ionizing radiation due to the Veteran’s participation in an atmospheric nuclear weapons test, use the Modern Award Processing-Development (MAP-D) system or Personal Computer-Generated Letters (PCGL) to send a letter to DTRA that


  • specifies the

  • disease being claimed (Note: If skin cancer is claimed, specify the site of each lesion, type of cancer, and date of diagnosis.)

  • Veteran’s organization or unit of assignment at the time of exposure, and

  • dates of assignment to the nuclear test site, and

  • provides a full description of the Veteran’s duties and activities while participating in a radiation-risk activity.

The letter to DTRA should also include a copy of




  • all available pathology reports that identify the type of cancer and the organ involved, if the disease claimed is a listed radiogenic disease, and/or

  • the medical or scientific evidence showing a causal relationship between the claimed disease and exposure to radiation, if the disease claimed is not among those listed in 38 CFR 3.311(b)(2).

Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


b. Requesting Verification of Participation in the American Occupation of Hiroshima or Nagasaki Prior to July 1, 1946

When requesting verification from DTRA of exposure to ionizing radiation as a result of participation in the American occupation of Hiroshima or Nagasaki, Japan, prior to July 1, 1946, send a letter to DTRA that provides the following information:


  • the organization or unit (ship, task group, company or squadron) and rank at the time of exposure

  • the duty place and organizational unit from which the Veteran may have been detailed, and

  • the activities and length of time at ground zero (hypocenter).

The letter to DTRA should include a description from the claimant and from the service records of activities performed during the entire period of exposure including




  • whether or not the Veteran went ashore

  • the length of time spent ashore, and

  • the activities performed while ashore.

For former POWs, also provide DTRA with the following information:




  • the dates of confinement

  • the places of confinement

  • the date and place of liberation

  • the date and method of departure from Japan, and

  • the method of travel within Japan, since the method of travel, such as a specific train over a specific route, can provide critical information in confirming participation.

The letter to DTRA should also




  • specify the disease being claimed (Note: If skin cancer is claimed, specify the site of each lesion, type of cancer, and date of diagnosis.), and

  • include

  • available pathology reports that identify the type of cancer and the organ involved, if the disease claimed is a listed radiogenic disease, and/or

  • the medical or scientific evidence showing a causal relationship between the claimed disease and exposure to radiation, if the disease is not among those listed under 38 CFR 3.311(b)(2).




Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


b. Requesting Verification of Participation in the American Occupation of Hiroshima or Nagasaki Prior to July 1, 1946 (continued)

Important: Information on the activities performed and the amount of time spent at ground zero is critical in obtaining an accurate dose estimate. Recognition of an area can be critical in determining and verifying participation.



c. Requesting Verification of Involvement in Non-U.S. Nuclear Bomb Tests

PL 103-446 allows for a presumption of service connection for the same radiogenic diseases, regardless of whether the Veteran participated in U.S or non-U.S. nuclear tests.
Use the table below to obtain verification of a Veteran’s involvement in non-U.S. nuclear bomb tests.




If requesting radiation dose information for …

Then contact …

non-U.S. test participants involved in flight missions

Address:

HQAFTAC


ATTN: IGO

1030 South Highway A1A



Patrick AFB, FL 32925-3002
Telephone: (321) 494-6867

Fax: (407) 494-2319

all other non-U.S. test participants

the appropriate Service points of contact identified in M21-1MR, Part IV, Subpart ii, 1.C.9.e.




Important: DTRA is not responsible responding to requests involving non-U.S. test participants and will return these requests to the RO.

Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


d. Requesting Verification of Exposure to Ionizing Radiation by Reason of Military Duties

For a claim based on exposure to ionizing radiation by reason of the nature of military duties, such as a radiologist or an x-ray technician, prepare a separate Personnel Information Exchange System (PIES) request to obtain a copy of the record of occupational exposure to ionizing radiation from the


  • Military Personnel Record Jacket (MPRJ)

  • service treatment records (STRs), or

  • any other record that contains radiation exposure information.


Notes:

  • The record of occupational exposure to ionizing radiation used by the service departments include

  • DD Form 1141, Record of Occupational Exposure to Ionizing Radiation

  • NAVMED 6470/10 and NAVMED 6470/11 for the Navy, and

  • the equivalent NRC Form 5.

  • Refer a request for information on human radiation experiments to the appropriate Service point of contact identified in M21-1MR, Part IV, Subpart ii, 1.C.9.e.

Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


e. Obtaining Records of Occupational Exposure to Radiation From the Veteran’s Service Department

Each branch of service maintains a record of its service members’ occupational exposure to radiation. If evidence of occupational radiation exposure, such as a DD Form 1141, NAVMED 6470/10, NAVMED 6470/11, or NRC Form 5, cannot be found in the Veteran’s records or obtained through PIES, prepare a written request for the record. Include the identifying data as required by M21-1MR, Part IV, Subpart ii, 1.C.10.b in the request and send it to the appropriate service department.
The table below lists the addresses and telephone numbers to use to obtain records of occupational exposure to radiation from each branch of service.



Branch of Service

Address and Telephone Number

Air Force

Address:

Surgeon General of the Air Force

Air Force Medical Support Agency (AFMSA)

ATTN: SG3PB (Radiation Health)

7700 Arlington Blvd Suite 5151

Falls Church, VA 22042-5151


Telephone: (703) 681-6988

Army

Address:

US ARMY Dosimetry Center

ATTN: AMSAM-TMD-SD

Building 5417

Redstone Arsenal, AL 35898
Telephone:


  • (210) 221-6612, and

  • (210) 221-6613.

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9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued



e. Obtaining Records of Occupational Exposure to Radiation From the Veteran’s Service Department (continued)




Branch of Service

Address and Telephone Number

Navy and Marine Corps

Address:

Officer in Charge

Navy Environmental Health Center Detachment

Naval Dosimetry Center

Bethesda, MD 20889-5614
Telephone: (301) 295-5426


Coast Guard

Address:

Chief of Occupational Medicine USCG

2100 Second Street SW

Stop 7902

Washington, DC 20593-7902
Telephone: (202) 475-5212


Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


f. Obtaining Records of Occupational Exposure to Radiation From the AEC

There are instances where military personnel were assigned to the Atomic Energy Commission (AEC) laboratories during the testing period and badged by the AEC facility.
Include a search of the Department of Energy central records repository as a part of a comprehensive search for records of occupational exposure to radiation. Send requests for such a search to the following address:
Address for records from 1945 through present only:

U.S. Department of Energy

National Nuclear Security Administration – Nevada Site Office

P.O. Box 98518

Las Vegas, NV 89193-8518
Telephone: (702) 295-1000
Address for records from 1987 to present:

U.S. Department of Energy

Office of Health Studies (EH-32)

19901 Germantown Road



Germantown, MD 20874
Telephone: (301) 903-5728

Continued on next page

9. Verification of Exposure to Ionizing Radiation Under 38 CFR 3.311, Continued


g. Developing Claims for Service Connection Based on NRI

Adjudicate claims for service connection based on in-service treatment involving nasopharyngeal radium irradiation therapy (NRI) under the provisions of 38 CFR 3.311 with dose estimates prepared by the Under Secretary for Health.
Review STRs, clinical records, and dental records for any annotation of radium therapy.
Request STRs that are not already on file. In addition, request information concerning radiation exposure from standard sources, and the following data from the Veteran:


  • the date the NRI treatment was administered, and

  • the place where the NRI treatment was administered, including the specific base and medical facility.


Note: Even when STRs do verify NRI treatments, they may not contain detailed records of radiation doses during treatment. Forward the claim to Compensation Service, Policy Staff (211) if NRI treatment is verified but dose information is not present. Compensation Service will determine whether a dose estimate may be provided by the Veterans Health Administration (VHA).
Reference: For more information on NRI therapy, see the VA Fact Sheet, Nasopharyngeal Radium Therapy, dated September 1997.



10. Obtaining Dosimetry Information




Introduction

This topic contains information on obtaining dosimetry information, including


  • the initial notification of Compensation service

  • the information to include in the initial request to Compensation Service

  • obtaining dosimetry information from DTRA

  • obtaining dosimetry information for individuals outside the scope of DTRA’s Nuclear Test Personnel Review (NTPR) program

  • the information to include in the letter to the Service Department requesting dosimetry information

  • handling claims based on radiation exposure in or around Camp Hanford, Washington

  • the definitions of not exposed and zero dose, and

  • handling dose estimates



Change Date

March 20, 2011



a. Initial Notification of Compensation Service

Call Compensation Service, Policy Staff (211), at (202) 461-9734 if


  • the requirements under 38 CFR 3.311(b) have been met, and

  • either

  • the development specified in M21-1MR, Part IV, Subpart ii, 1.C.8 has been completed, or

  • there is evidence sufficient to establish the Veteran was exposed to radiation during service.


Note: After receiving Compensation Service approval, request a reconstructed radiation dose from DTRA.
Reference: For information on obtaining dosimetry estimates from DTRA, see M21-1MR, Part IV, Subpart ii, 1.C.10.c.


b. Information to Include in the Initial Request to Compensation Service

Include the following information in the initial request to Compensation Service:


  • the Veteran’s name and VA claim number

  • the nature of the disability, and

  • the location of radiation exposure, such as atmospheric nuclear weapons test, Hiroshima/Nagasaki, and so forth.

Continued on next page

10. Obtaining Dosimetry Information, Continued

c. Obtaining Dosimetry Information From DTRA for Atmospheric Tests, Hiroshima or Nagasaki Occupation, or POW Interment in Japan

For claims involving U.S. atmospheric nuclear weapons tests, occupation of Hiroshima or Nagasaki, or POW interment in Japan, send a request for dosimetry information to the
Defense Threat Reduction Agency (DTRA)

Attn: RD-NTSD

Mail Stop 6201

8725 John J. Kingman Rd.,

Ft. Belvoir, VA 22060-6201
The letter to DTRA must contain the following information:


  • the applicable regulation (38 CFR 3.309(d) or 38 CFR 3.311)

  • VA claim number

  • Veteran’s and claimant’s names, addresses, and telephone numbers

  • Veteran’s branch of service, service number, and Social Security number

  • specific organization or unit of assignment at the time of exposure

  • dates of assignment to nuclear test site or Hiroshima/Nagasaki

  • full description of duties and activities while a participant in a radiation-risk activity, and

  • specific disease being claimed (Note: Specify the type of cancer and the organ involved. If skin cancer is claimed, also specify the site of each lesion and date of diagnosis.)

The letter must include a copy of




  • the claimant’s response to the request for information about the Veteran’s exposure to ionizing radiation

  • the Veteran’s statement(s) about the nature of his/her exposure to radiation

  • any military documents supporting participation in a radiation-risk activity, such as a DD Form 214 or military orders

  • the medical or scientific evidence showing a causal relationship between the claimed disease and exposure to radiation, if the disease is not among those listed under 38 CFR 3.311(b)(2), and

  • the Board of Veterans’ Appeals (BVA) remand, if applicable.


Note: DTRA only provides confirmation of participation and radiation doses for individuals involved in U.S. atmospheric nuclear testing (1945 to 1960) and the occupation forces of Hiroshima/Nagasaki.
Reference: For information on obtaining dosimetry information in cases not handled by DTRA, see M21-1MR, Part IV, Subpart ii, 1.C.10.d.

Continued on next page

10. Obtaining Dosimetry Information, Continued


d. Obtaining Dosimetry Information for Individuals Outside the Scope of DTRA’s NTPR Program

For individuals outside the scope of DTRA’s NTPR program, such as x-ray technicians, reactor plant workers, and workers in nuclear medicine, radar, and radiography


  • send a letter requesting dosimetry information to the appropriate Service Department point of contact listed in M21-1MR, Part IV, Subpart ii, 1.C.9.e, and

  • forward all dosimetry records to Compensation Service, Policy Staff (211), for referral to the Under Secretary for Health, who is responsible for preparation of a dose estimate, to the extent feasible, based on available methodologies.


Note: The claims folder should be forwarded to Compensation Service, Policy Staff (211), for review if

  • the claim alleges exposure to radiation from medical diagnostic procedures or during medical treatment, and

  • the Veteran’s STRs support this exposure.


Reference: For information on what to include in the letter to the Service point of contact, see M21-1MR, Part IV, Subpart ii, 1.C.10.e.


e. Information to Include in the Letter to the Service Department Requesting Dosimetry Information

The letter to the Service Department point of contact requesting dosimetry information should include the following:


  • the location and dates of the Veteran’s service

  • the Veteran’s military unit

  • the Veteran’s Military Occupational Specialty (MOS)

  • the place(s) where the Veteran worked

  • a list of radioactive materials the Veteran worked with (source, strength, and type)

  • the number of hours per day the Veteran spent working with radioactive materials and the number of days, weeks, or months of the assignment the Veteran worked with radioactive sources, and

  • the number of hours per day the Veteran spent working with radiation-producing devices and the number days, weeks, or months of the assignment the Veteran worked with radiation-producing devices.

The letter should also enclose a copy of any available




  • training records associated with radiation training

  • radiation dose records provided by the Veteran, and

  • medical records showing treatment for any occupational radiation injuries or other records documenting radiation exposure.

Continued on next page

10. Obtaining Dosimetry Information, Continued


f. Handling Claims Based on Radiation Exposure in or Around Camp Hanford, Washington

Use the table below to determine how to handle claims based on radiation exposure in or around Camp Hanford, Washington.




Step

Action

1

Obtain the Veteran’s STRs and service personnel records.

2

Review the service records to


  • confirm the Veteran’s presence in or around Camp Hanford

  • determine the duration of this duty assignment, and

  • ascertain whether a DD Form 1141 or other official record of radiation exposure is available.

3

Forward the claims folder to Compensation Service, Policy Staff (211), for review when


  • the Veteran’s presence in or around Camp Hanford is confirmed, and

  • attempts to obtain information about the Veteran’s exposure to radiation, whether successful or unsuccessful, have been made and documented in the claims folder.

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10. Obtaining Dosimetry Information, Continued


g. Definition: Not Exposed

Not exposed means


  • there was no potential for exposure to radiation, and

  • the Veteran did not enter a radiological environment.



h. Definition: Zero Dose

Zero dose means there was potential for exposure to radiation, but the dose received was zero.



i. Handling Dose Estimates of Not Exposed or Zero

If the dose estimate received from DTRA is “not exposed” or “zero,” then do not submit the case to Compensation Service.
Refer these claims to the RO rating activity for a decision on the issue of service connection for residuals of radiation exposure.


j. Handling Dose Estimates Submitted on Behalf of the Claimant

Under 38 CFR 3.311(a)(3), if a dose estimate is submitted on behalf of the claimant, the rating activity must review the estimate to determine whether it is


  • from a credible source, and

  • at least double the dose provided by official military records.

If both these criteria are met, the claims folder should be submitted to Compensation Service, Policy Staff (211), for review.





11. Referring Claims to Compensation Service, Policy Staff (211)




Introduction

This topic contains information on referring claims to Compensation Service, Policy Staff (211), including


  • consideration of the claim by the rating activity

  • the process for referring claims to the Compensation Service, and

  • the information to include in the cover letter of a referral to Compensation Service.



Change Date

September 5, 2008



a. Consideration of the Claim by the Rating Activity

If the rating activity determines that at least one of the requirements of 38 CFR 3.311(b)(1) is not met, deny the claim by a formal rating decision on the grounds that the disease did not result from exposure to ionizing radiation. Do not refer such cases to Compensation Service unless all of the requirements are met.
The rating activity sends claims to Compensation Service, Policy Staff (211), for additional development if the


  • three requirements under 38 CFR 3.311(b)(1) are met, and

  • development under this section, M21-1MR, Part IV, Subpart ii, 1.C, is complete.

Continued on next page

11. Referring Claims to Compensation Service, Policy Staff (211), Continued


b. Process for Referring Claims to Compensation Service

The table below describes the process for referring a claim based on exposure to ionizing radiation to Compensation Service, Policy Staff (211).




Stage

Who Is Responsible

Description

References

1

RO

  • Refers the claim to Compensation Service, Policy Staff (211), for review once

  • the three requirements of the initial review have been satisfied, and

  • development has been completed, including receipt of a response from the Department of Defense (DoD) regarding exposure to radiation, and

  • notifies the claimant of the referral to Central Office (CO).

For information on what to include in the cover letter for a referral, see M21-1MR, Part IV, Subpart ii, 1.C.11.c.

2

Compensation Service

  • Reviews the claim

  • requests a medical opinion from the Under Secretary for Health, and/or refers the claim to an outside consultant if necessary, and

  • notifies the RO and the claimant if a referral is made to the Under Secretary for Health.

For more information on referrals by Compensation Service, Policy Staff (211), to


  • the Under Secretary for Health, see 38 CFR 3.311(c), and

  • an outside consultant, see 38 CFR 3.311(d).

3

Compensation Service

Provides the RO with


  • an opinion recommending either a grant or denial of the claim, and

  • the written response of both the VHA and/or outside consultant (if solicited).

---

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11. Referring Claims to Compensation Service, Policy Staff (211), Continued


c. Information to Include in the Cover Letter of a Referral to Compensation Service

Include a cover letter briefly summarizing the following information when referring a claim based on exposure to ionizing radiation to Compensation Service, Policy Staff (211):


  • pertinent service information

  • circumstances surrounding the exposure, including dates of the exposure

  • a description of the claimed disease, including the specific cell type and stage, if known

  • the date the claimed disease first manifested and the time lapse between exposure and the onset of the disease

  • the Veteran’s

  • age at the time of exposure

  • gender

  • relevant family medical history, and

  • employment history

  • the dose assessment, as specified in 38 CFR 3.311(a)(2)(iii), given by

  • DTRA, or

  • the applicable service department

  • the Veteran’s history of exposure to known carcinogens or radiation before and after service, including smoking history and, if claiming skin cancer, exposure to the sun, and

  • any other information relevant to determining the cause of the disease.


Note: The letter should include a copy of all available pathology reports that identify the type of cancer and the organ involved.



12. Exhibit 1: Exposure to Nuclear Radiation and Department of Defense (DoD) Secrecy Agreement




Change Date

September 5, 2008


a. Exposure to Nuclear Radiation and DoD Secrecy Agreement

The Exposure to Nuclear Radiation and DoD Secrecy Agreement is below.









1-C-


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