Catch Your Breath: Workers’ Respiratory Health Stories

By Tim Lerew, Cold War Patriots Strategic Advocacy, Emeritus

Breathing. It’s fundamental for life, moment to moment. All of us can skip a meal, take a break from mowing the lawn or exercise, even watch a bit more TV than we should, with little or no harm. But every single one of us relies on our respiratory system moment to moment, breath to breath, to sustain our life.

Still, it surprises many nuclear weapons complex and uranium workers to learn that radiation-related cancers are not the most prevalent illnesses compensated under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Asthma, chronic obstructive pulmonary disease (COPD), silicosis and chronic beryllium disease (CBD) are among the many common respiratory illnesses that taken together are the number one family of work-related illnesses. And they have so many consequences for nuclear weapons and uranium workers. Stairs sometimes become an insurmountable obstacle. Grocery shopping with a spouse just seems like too much work, so you wait in the car. Someone else shakes off a common cold, but you are careful that you don’t come down again with pneumonia and end up back in the hospital.

Another common misperception among nuclear weapons and uranium workers is that the exposures and materials that cause, contribute to, or aggravate their breathing illnesses are often not what is expected. For example, inhaling fumes from the many workplace acids and solvents, resulting in a burning sensation or cough, makes sense to most people. Nitric acid, acetone and solvent exposures, even for just limited times, can be triggers for respiratory illnesses. But a worker does not have to be a chemical operator to have toxic material exposure that can qualify them for compensation and health benefits under EEOICPA.

Let’s examine causation further. Under Part E of EEOICPA, the standard to qualify an illness as work-related is more easily met than the causation of most work-related illnesses under Part B of the program. Part E just requires that the workplace toxic exposures “caused, contributed to or aggravated” an illness. Just any one of those standards can be sufficient. People understand that a chemical operator, working with hazardous chemicals and acids over time, could likely have enough exposure to cause COPD, even if that illness took some years to present itself. But look further. The standard under Part E also includes “contributed to.” So, a worker who mowed his grass at home, but also inhaled wood dust from his or her carpentry work on the U.S. Department of Energy (DOE) site or in the mine, may well have had their COPD condition “contributed to” by their workplace activity. A different worker, who suffered from childhood asthma, long before working at a U.S. DOE nuclear weapons site, may have later worked in the paint shop, and frequent exposure to paint and acetone fumes could have “aggravated” their old case of childhood asthma, resulting in an award of EEOICPA monetary compensation and comprehensive health benefits for treatment and control of an accepted illness, in this case asthma as an adult.

Just what are those benefits? Each case is assessed on its own merits, with some overall limits of monetary compensation but with no limits on the lifetime value of necessary medical treatment of a covered illness. So, someone’s asthma – let’s call her Judy – may just require the occasional use of “rescue inhalers” and perhaps the use of albuterol and a nebulizer for a few minutes at home from time to time. All prescriptions related to their covered asthma, including their inhalers and nebulizer, would be paid for 100%, with no co-pays or deductibles.

EEOICPA also includes a methodology for assessing to what degree covered work-related illnesses are found to affect a person’s overall health and function. A medical doctor, skilled and trained in impairment medicine, assesses the degree to which Judy’s health is impaired because of her asthma. After reviewing the details of her case, and pertinent test results related to her breathing, the doctor assesses a degree of impairment, expressed as a percentage. Under EEOICPA, for each one percent of impairment, a beneficiary receives $2,500. In Judy’s case, the doctor may have assessed an overall impairment of 5%. So, 5 percent multiplied by $2,500 for each percent equals a monetary, tax-free payment of $12,500. In addition, should Judy’s asthma become worse, she could receive a new impairment that might increase her monetary compensation. For example, if two years after Judy’s first impairment her condition worsened, and she now received a 20% overall impairment rating, she would have monetary compensation that looks like this:

• First Impairment Payment for 5% = $12,500
• New overall impairment of 20% = $50,000; less the 5%, or $12,500 already received by Judy, equals an additional $37,500 in monetary impairment benefits.
• Over Judy’s lifetime, she can receive up to a maximum of $250,000 under Part E of EEOICPA, although very few individual beneficiaries receive the maximum amount.

How about another, very common illness among nuclear complex and uranium workers: Chronic Obstructive Pulmonary Disease or COPD. Let’s call this worker Herman, who worked for 24 years at the Paducah Gaseous Diffusion Plant in Paducah, Kentucky, that operated to enrich uranium for the U.S. DOE. In Herman’s case, he was indeed a chemical operator, who often wore protective clothing and from time-to-time face masks or even respirators. Some workers like Herman don’t consider illnesses, including COPD, to be work-related, since they followed plant safety procedures and wore protective clothing and equipment. But here’s the thing: a requirement to wear protective gear sadly does not mean it will always keep a worker safe. What the presence of protective gear requirements does prove is that hazardous or toxic materials and fumes are present in the workplace.

During Herman’s eventual claim for COPD, he was asked if he used such protective gear. He answered honestly that he did so. This would later prove helpful to the U.S. Department of Labor (DOL) Claim Examiner recommending his claim for COPD be approved. Other factors also go into a successful claim. Important among those are the medical opinions and supporting medical reports and test results. The role of the Claims Examiner is to weigh the facts that supports an EEOICPA claim. They are not a doctor or an industrial hygienist, but they can, and do, make use of those experts if they can assist in determining an appropriate claims decision. Herman was fortunate in using an experienced advocate, familiar with the processes of EEOICPA, for his claim. Throughout a process which took several months, Herman was copied on the letters between the U.S. DOL Claims Examiner and his advocate, who was acting as Herman’s “Authorized Representative.” There must have been more than half a dozen individual letters, often with a request for additional information, medical opinions and medical testing results — and almost all those letters stated that a reply was required with the requested information “within 60 days.” But what if that additional information was not provided within that time frame, or not provided at all?

Unfortunately, for too many other claimants, potentially with just as strong a likelihood of a work-related illness as Herman, the outcome is a denied claim — just because they were not able to gather the requested information and respond within the deadline. Word about a denied claim often gets around a community, and sadly, other workers can be discouraged from even making what could otherwise be a successful claim.

In Herman’s case, his COPD was serious. He required the use of supplemental oxygen as needed at home, which was often the case even after only mild exertion. He had a portable oxygen concentrator he could take with him in his truck and use while out and about at church or shopping. His condition was monitored, and his medication and oxygen flow rates adjusted by a case manager from a local home care company experienced in his type of illness. All those services, equipment, oxygen and medications were paid for 100% by his U.S. DOL medical benefits white card. In addition, Herman was eligible for his own Impairment Evaluation to see to what extent his COPD limited his activities of daily living, or ADLs. Herman used the same company for his impairment rating as he had for his home health care, Professional Case Management. After a review of his records, and a live telephone interview with an Impairment doctor, Herman received a 60% impairment award. His award used the same math calculation as Judy’s, but since his overall impairment percentage was higher, so was his financial award. In his case 60 percentage points at $2,500 each point equaled $150,000. Since COPD is generally a progressive disease that worsens over time, Herman could likely receive additional compensation in the future, to a maximum allowable $250,000 total.

That’s a lot of information about EEOICPA, work-related illnesses and available benefits. It can be, and is, confusing for most people. That’s where Cold War Patriots and their Outreach Help Center are so useful. They have the knowledge and contacts with key resources and information that workers and their families need for successful claims and access to medical benefits and services.

So, take another breath. Consider if that’s harder now than it has been in the past and seek a consultation and perhaps a diagnosis from your own doctor or a specialist they may recommend. Every successful claim under EEOICPA, for a breathing condition or any other illness, begins with a medical diagnosis specifically identifying that illness.

But know you are not in this fight alone. Cold War Patriots and its partners are here to help you catch your breath — and keep it. Contact them for free at (888) 903-8989 Monday through Friday from 7 a.m. to 5 p.m. mountain time.