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ATOMIC ENERGY COMMISSION 7 (1)8,31;9 NEVADA OPERATIONS OFFICE Attorney at Law Since t h e receipt of your claim and, later, of supporthg infoxmatian we have, with the help of them n mental Protection Agey ' s Western Eh vim mental Research Laboratory (MEFG), formerly the ce, exatnined all of the medical mor dsc and complgtttd medical exd sac i - copc
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A s si s tant Chi efC oun se1 Nevada Operations Office, AEC LAS VEGAS, NEVADA 89114 of September 2 , 1971. I hope that this brings t h e If we can be of any further assistance, please feel free to call.
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ATTORNEYS AT LAW I51 NORTH MAIN STREET A to c ic Eneygy Commission Oak Fiidge, Tennessee 37830 %closed in duplicate find Standard Form 95,Claim for cat ing your file number as s lg ned to the claim. Cu? investigation is conti nz5ng and we will submit further doc un ent ation and exhibits in the near future. Please advise if there are any item which are os" particular interest to you, in addition to those mentioned in the instructions on t ke claim form. * A s you know, the Federal Tort Claims Act restricts an ixcreese in the a mom t clzirned, in the event a suit is filed. Ac core ingly,the amount cleimed Is substantially higher than xhzt would. be acc e2table to the cl zim ant,if a settle nen tis proposed inc cnn ect ion with t ne claim. Very truly yours, c c : Gni ted States -4tomic Energy Cori i is sion
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* I~ order that yocr d a i w for C3mag.e~may receive pro?cr consideration YOU are requested to supply the information called for on both sidcs o f t h i s form. All material facts should be stated on this form, as it will be the basis of further action upon your ' The instructions set forth below should be read carefully before the form is prepared. 00 YOU CARRY COUJSION INSURANCE7 IF YES. OIVE NAME AND ADDRESS OF INSURANCE COMPANY AND POLICY NUMBUl Claims for damage to or for loss o r destruction of prop r ty, or for personal injury, must be signed by the owner of the property damaged or lost or the injured person. If, by reason of death, other disability or for reasons deemed satisfactory by the Government, the foregoing reguircmcnt cannot be fulfilled, the claim may be filed by a duly authorized agent o r other legal represeatative, provided evidence satisfactory to the Government is submitted with said claim establishing authority to act. If claimant intends t o file claim for both personal injury and propeny damage, claim for both must be showr. in item 8 on this form. Separate claims for personal injury and property damage are not acceptable. The amount claimed should be substantiated by competent evidence as follows: (a) I n support of claim for personal injury or death, the claimant should submit a written report by the attending physician, showing the nature and extent of injury, the nature and extent of treatment, the degree of permanent disability, if any, the prognosis, and the period of hospitalization, or incapacitation, attaching HAM YOU FILE0 CUM ON YOUR I ~ UIUNC ECARRIER IN THIS LNSTANCL AND IF SO. IS IT NU COVERAGE OR DEDUCT lU ? itemized bills for medical, hospital, or burial expenses ( b ) In support of claims for damage to property which has been or can be economically repaired, the * claimant should submit at last two itemized signed statements or estimates by reliable, disinterested concerns, or, if payment has been made, the itemized signed receipts evidencing payment. (c) I n support of claims for damage to property which is not economically reparable, or if the property is lost o r destroyed, the claimant should submit statements as to the original cost of the property, the date of purchase, and the value of the property, both before and after the accident. Such statements should be by disinterested competent persons, preferably reputable dealers or officials familiar with the type of property damaged, or by t w o or more competitive bidders, and should be certified as being just and correct. Any further instructions or information necessary in the preparation of your claim will be furnished, upon request, by the office indicated at the top of the other side of this f o m IF DEDUCIIBLE. STATE AMOUNT IF YES. GIVE NAME OF INSURANCE CARRIER
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