{"data":{"id":"us/42-cfr-81.21","jurisdiction":"us","citation":"42 CFR 81.21","heading":"Cancers requiring the use of NIOSH-IREP.","body":"(a) DOL will calculate probability of causation for all cancers using NIOSH-IREP.\n(b) Carcinoma in situ (ICD-10-CM codes D00-D09), neoplasms of uncertain behavior (ICD-10-CM codes D37-D44 and D48), and neoplasms of unspecified nature (ICD-10-CM code D49) are assumed to be malignant, for purposes of estimating probability of causation.\n(c) All secondary and unspecified cancers of the lymph node (ICD-10-CM codes C77 and C7B.01) 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(a) provides guidance for assigning a primary site and calculating probability of causation using NIOSH-IREP.","path":["Title 42—Public Health","CHAPTER I—PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER G—OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES","PART 81—GUIDELINES FOR DETERMINING PROBABILITY OF CAUSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000","Subpart E—Guidelines To Estimate Probability of Causation"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"8616d0dd1fcac592e00ddc00f019003c9fba81832505ac8d60bc4c6ae88f3eed","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-81.20","next":"us/42-cfr-81.22"},"notice":"GroundRules: Original legal text. Not legal advice."}