Nuclear Workers Still Face Problems with Health Coverage


By Liz Carey

Washington, DC ( - Nearly two decades ago, the federal government passed legislation to cover any medical expenses incurred by employees working in the country’s nuclear weapons facilities.

And nearly two decades later, employees, their families, advocacy groups and attorneys are still fighting to make sure employees get those benefits.

In 2000, President Bill Clinton signed an executive order requiring the federal government to compensate nuclear weapons workers, and established the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). The program’s goal is to provide medical benefits and lost wage benefits to employees who worked at nuclear weapons facilities who contracted illnesses as a result of their exposure to radiation and toxic chemicals, and their families. 

“Passage of the EEOICPA was the federal government’s admission that the (these employees) had indeed been unwittingly exposed to radioactive and chemical materials that shortened their lives and caused undue suffering,” said Patricia Cianciolo, a professor of social work with Northern Michigan University, who studied the compensation program in 2015. “Families, who either stood by to care for or lost their loved ones due to cancers caused by this exposure, became members of a unique club — an unwelcomed membership: Survivors of nuclear weapons workers. The legislation, although a victory for workers and their families, has not been a panacea, however.” 

According to research by McClatchey Group reporters in 2015, federal officials originally estimated that the program would provide benefits to 3,000 workers; at an annual cost of $120 million. As of 2015, the report said, the program has paid out more than $12 billion to more than 53,000 workers. But fewer than half of those who apply receive any benefits, leaving workers to complain that they are overwhelmed by the paperwork and bureaucratic red tape that they must navigate.

There are more than 325 nuclear weapons facilities in the United States, and at its peak, the program had more than 600,000 workers in it. More than 107,000 former nuclear facilities employees had filed claims by 2015.

Getting approval for illnesses caused by exposure to the radiation isn’t easy.

“Some facilities covered by the legislation were designated as ‘Special Exposure Cohorts’ (SEC),” Ciancolo said. “This meant that if workers developed or died from a specified cancer, proof of causation was assumed to be the workplace. Some facilities were not SEC-designated, placing the onus of proof on the worker and their families. These individuals were required to gather all employment-related information to substantiate their claim — where, when, and in what capacity the employee worked in the facility, along with causation of death. This information was then examined by the National Institute of Occupational Health and Safety (NIOSH) experts to reconstruct the level of radiation exposure, known as ‘dose reconstruction.’ For any other workers and their families, establishing causation of illness or death remained squarely on their shoulders.”

Advocacy groups, like the Cold War Patriots, work with affected employees to ensure that they get the coverage they need. The process essentially makes the employee responsible for proving that their illnesses stem from their work at the nuclear weapons facility.

“The program is divided into two parts (Part B and Part E); different requirements and benefits are associated with each part,” said Ani Vattano, director of communication for Cold War Patriots in an interview with “The process for a current or former nuclear weapons worker is to utilize the worker screening program and/or physician diagnosis of a work-related illness, then file a claim with a DOL Resource Center. If approved for EEOICPA benefits/compensation, a physician will conduct an impairment rating. When a claim is approved under the program the worker will receive a white medical benefits card from the Department of Labor (DOL) with the conditions listed.”

But obstacles for coverage abound, said Hugh Stephens, an attorney with Stephens and Stephens, that primarily handles getting employees covered under the EEOICP.

“There are a whole bunch of obstacles that claimants face,” Stephens said in an interview with “Medical records are just one of them. If your relative died many years ago, the medical records that cover their illness are most likely destroyed. Most private practices destroy their records after 10 years. …The Department of Labor (DOL) will consider secondary evidence, like a death certificate, in the absence of primary evidence, but death certificates don’t always tell the whole story. In some cases, medical records might not even be accurate, like in the case of chronic beryllium disease, which is an allergy to the special metal beryllium that people were breathing in. There wasn’t even a test for chronic beryllium disease until 1993, so in those cases, if someone died before the test was even created, the medical records wouldn’t be accurate.”

Stephens said other conditions, like letters from doctors about the patient’s illnesses, may not be acceptable to the DOL as evidence, just because of their wording. And in some cases, because the employer was a private company contracting with the federal government, employees are qualified for coverage under federal law, state law and state workers’ compensation programs. 

“Claims examiners always suggest these are easy records and letters to get, and they’re not,” Stephens said. “Claims examiners give these claimants a false sense of security. …These employees absolutely need an attorney helping them and guiding them through the process.”

But still, the program is better than others, he said.

“If you compare this program to the Black Lung program, the federal Workers’ Compensation program, the VA... I think this is a much better and more receptive program,” he said.

Regardless, he said, there are people who are qualified for the program who might not know it exists, or that they are covered.

“No one thinks of suing their employer from 40 years ago when they get sick and die of cancer, but these employees deserve to be covered,” he said. “I think of the Native Americas who worked at nuclear facilities in New Mexico… literally, there would be whole families who would have died of cancer at a young age. The husband got it from exposure at work. The wife got it from laundering her husband’s clothes that were covered with radioactive material. Those were people who were just left behind.”

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