42 CFR 81.21 : Public Health (Part 1 To Parts 1009-1099) — (Part 1 To Chapters Ii-Iii) — Public Health Service, Department Of Health And Human Services (Part 1 To Parts 138-199) — Occupational Safety And Health Research And Related Activities (Part 80 To § 88.17) — Guidelines For Determining Probability Of Causation Under The Energy Employees Occupational Illness Compensation Program Act Of 2000 (§ 81.0 To Appendix A To Part 81) — Guidelines To Estimate Probability Of Causation (§ 81.20 To Appendix A To Part 81) — Cancers requiring the use of NIOSH-IREP.

(a) DOL will calculate probability of causation for all cancers, except chronic lymphocytic leukemia as provided under § 81.30, using NIOSH-IREP.

(b) Carcinoma in situ (ICD-9 codes 230-234), neoplasms of uncertain behavior (ICD-9 codes 235-238), and neoplasms of unspecified nature (ICD-9 code 239) are assumed to be malignant, for purposes of estimating probability of causation.

(c) All secondary and unspecified cancers of the lymph node (ICD-9 code 196) shall be considered secondary cancers (cancers resulting from metastasis of cancer from a primary site). For claims identifying cancers of the lymph node, Table 1 in § 81.23 provides guidance for assigning a primary site and calculating probability of causation using NIOSH-IREP.