U.S. DEPARTMENT OF LABOR

EMPLOYMENT STANDARDS ADMINISTRATION

OFFICE OF WORKERS' COMPENSATION PROGRAMS

1111 THIRD AVENUE-SUITE 650

SEATTLE WA 98101-3211

PHONE: (206) 553-5508

 

January 30, 1997

 

File Number: 140320904

Date of Injury: 02/25/1993

Employee: ROBERT FARMER

 

Dear Mr. Farmer:

 

I am writing in reference to the claim for benefits under the Federal Employees' Compensation Act, which you filed for chronic myelogenous leukemia. The materials which you have submitted to date have been reviewed. We have received your CA-2 dated October 21, 1996 (submitted to the employing agency on January 13, 1997), a supplemental statement addressing each item on the CA-2, copies of previously submitted employee statements dated March 21, 1993 and May 18, 1992, a copy of a letter to Olga Clements, Claims Examiner, dated November 5, 1992 requesting assistance in obtaining air samples, a chart describing your exposure titled "Exposures to Carcinogens," a copy of your position description and a copy of your Application for Federal Employment dated April 14, 1964. This is not sufficient for this office to determine whether you are eligible for benefits under the FECA because you will need to submit detailed information regarding how and when you became aware of the condition and when you realized your condition could be causally related to your employment. Please provide the information requested below to OWCP (above address) at your earliest convenience. Please provide as much detail as possible.

 

Describe all exposure outside your Federal employment, i.e. in other employment, at home, or with any hobbies which is relevant to the working conditions claimed to be related to your illness.

 

Describe the development of the claimed condition. When did you first notice it? What symptoms did you experience, and when?

 

Describe all previous similar conditions.

 

Provide a comprehensive medical report from your treating physician which describes your symptoms; results of examinations and tests; diagnosis; the treatment provided; the effect of treatment; and the doctor's opinion, with medical reasons, on the cause of your condition. Specifically, if your doctor feels that exposure or incidents in your Federal employment contributed to your condition, an explanation of how such exposure contributed should be provided.

 

Please provide copies of all medical records, treatment notes, diagnostic tests, etc. pertaining to your chronic myelogenous leukemia. You indicated on your CA-2 that you first received medical care for this condition on February 9, 1993, from Dr. Walcott.

 

Please provide detailed information regarding your chronic myelogenous leukemia. I note from your statement that you first became aware of the condition on February 25, 1993. How did you come to realize that you were suffering from chronic myelogenous leukemia? You have indicated that you first realized the illness was caused or aggravated by your employment at "present." Please be more specific. On what date did you realize that your condition could be caused, aggravated or precipitated by your employment?

 

OWCP may correspond directly with a physician or any other party who may be able to provide information which will help the Office make a decision on your eligibility for benefits under the FECA. Our efforts are intended to assist you in the collection of evidence. Please understand that it is ultimately your responsibility, as the claimant, to provide or ensure the provision of all evidence needed to decide your claim, including all information requested directly by the Office. Whenever a request for information is initiated by this Office, a copy will be sent to you so you may ensure that the requested information is provided as promptly as possible.

 

This Office is committed to rendering a timely decision on your claim. A reasonable period will be allowed for the submission of all requested evidence (approximately 30 days). If we have not received the requested information, an indication that it is forthcoming, or evidence that the information is not necessary to decide your claim, we will be required to render a decision on your claim based on the evidence in file.

 

If you do not understand any portion of this request, or are unable to provide all requested information for any reason, you should call or write to this Office immediately and request clarification or assistance.

 

Sincerely,

 

Kelly A. Reavell

Claims Examiner

 

cc:

DEPARTMENT OF THE NAVYPUGET SOUND NAVAL SHIPYARD

CODE 1113.1

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