Editor’s note: This story is part of a yearlong McClatchy investigation into the deaths of nuclear workers who helped the U.S. win World War II and persevere in the Cold War. Read the entire report — stories, videos, photos, graphics and an interactive database — at bit.ly/nuclearworkers
A few years after Barbara Sall’s husband built their Pasco, Wash., house, the professional carpenter started having trouble with basic skills.
He would measure a board three or four times and still cut it wrong.
Before long, he could not follow conversations, and his family took away his car keys after watching him drive in the wrong lane and run red lights.
Never miss a local story.
What looked like Alzheimer’s was diagnosed as toxic encephalopathy, a neurological disease leading to dementia, when he was in his early 50s. His doctors believe it was caused by his exposure to toxic chemicals while working as a carpenter at the Hanford nuclear reservation.
He was eligible for benefits under the Department of Labor’s Energy Employees Occupational Illness Compensation Program. He received about $250,000 in state and federal payments after being forced to retire early.
But the federal government would pay far more than that in medical care.
That’s the real benefit of the federal compensation program for workers made ill by toxic exposures doing federal nuclear weapons work, said Faye Vlieger of Cold War Patriots at a meeting for Hanford workers organized by the nonprofit.
For seven months near the end of his life, Gary Sall had round-the-clock nursing care in his home, plus other expenses, ranging from his medications to his wheelchair. That was followed by 30 days in the hospital as his condition deteriorated and he eventually died in 2011 at age 57.
‘Lifetime of coverage’
Medical expenses account for about 40 percent of the compensation paid out by the Energy Employees Occupational Illness Compensation Program Act in the last year.
“It is lifetime medical coverage. No copays. No caps,” said Kevin Fitzgerald, vice president of community outreach for Professional Case Management, a Colorado-based company specializing in home care under the federal program.
It is lifetime medical coverage. No copays. No caps.
Kevin Fitzgerald, Professional Case Management
That’s the way it should be, he said.
He compares working at Hanford, where weapons plutonium was made during World War II and the Cold War, to being a veteran. Workers were put in harms way, sometimes without their knowledge, for the protection of the nation.
“They should be compensated like veterans,” he said.
Of more than $2 billion paid for medical care by the program, nearly 28 percent has been paid to home health care providers like Professional Case Management.
$2 billion paid for medical care by Energy Employees Occupational Illness Compensation Program
$340 million paid to Professional Case Management
It has received payments of almost $340 million for caring for about 1,600 patients in the program. That’s more than $100 million more than any other medical provider in the program.
The amount includes money for medical supplies, oxygen and therapeutic procedures, with the total paid to Professional Case Management for home health care coming to $226 million since it served its first patient in the program in 2002.
The company has taken cases to federal court several times, both to protect its business interests and as an interested party in a case to compel the Department of Labor to provide service to those they believed were owed medical care under the EEOIC program.
A class-action lawsuit filed by ill workers or their survivors in 2007 claimed the Department of Labor had engaged in an orchestrated, internal campaign to override doctors’ orders for home health services and delay compensation to care providers.
A settlement was reached in 2009.
Among the plaintiffs was cancer patient Addison Keaton, 61, whose doctor had ordered skilled nursing services around the clock in his home, in part to manage a risk of hemorrhaging. The Department of Labor took 197 days to consider the request and then agreed to eight hours of nursing care three times per week.
In other federal cases, Professional Case Management has sued competitors for allegedly poaching patients and offering free lawn care or other services that could be seen as kickbacks to attract patients.
According to court documents, the company finds people across the country to help them enroll and obtain benefits through the EEOIC program. Once they are enrolled, the company provides the patients with help to complete the paperwork needed to get health care services.
Cold War Patriots
In 2008, the company formed a business-related nonprofit group, Cold War Patriots, to support and advocate for Cold War workers, according to the company.
Professional Case Management formed a business-related nonprofit group, Cold War Patriots, to support and advocate for Cold War workers.
Cold War Patriots holds events, like the town hall meeting near Hanford this fall. Mostly retired Hanford workers were given information about how to obtain EEOIC program benefits and make the most of benefits. They were handed information packets that included a flier for Professional Case Management.
“You may be eligible for in-home nursing care provided at no cost to you,” it said. Unlike other home care programs, patients do not have to be homebound to receive care, said the flier.
Former Hanford worker William Phillips, a hot cell operator and engineering technician from 1969 to his retirement in 2004, has a Professional Case Management caseworker regularly come to his home to take his vitals, review his medical information and talk over issues that don’t get covered during doctor’s appointments, he said.
But what he’s most interested in is having home care set up now for when he needs it later.
His diagnoses covered by the EEOIC program include asbestosis, chronic obstructive pulmonary disease and chronic beryllium disease, a lung disease caused by exposure to fine particles of the metal beryllium. He also has peripheral neuropathy and hearing loss caused by chemical exposure.
“For my wife — if things really go south — it allows in-home care,” he said. “It takes the burden off her, and I don’t have to worry.”
For my wife — if things really go south — it allows in home care. It takes the burden off her and I don’t have to worry.
William Phillips, former Hanford worker
Tom Peterson, another former Hanford worker with chronic beryllium disease, estimates that his care paid for by the EEOIC program has come to more than $1 million.
That’s despite having some of his care paid for by Medicare and the Washington State Department of Labor and Industries compensation program. Sometimes he pays medical expenses himself when he’s at risk of having bills denied by the EEOIC program turned over to a collections agency.
Fitzgerald estimates that, depending on the state, EEOIC pays providers 10 percent to 25 percent better than Medicare does.
But some health care providers would rather bill Medicare than try to learn the EEOICP program, Peterson said.
‘It can be frustrating’
Lifetime medical may be guaranteed, but collecting on it can be difficult, said Craig Hall, another former Hanford worker with chronic beryllium disease.
He received the maximum compensation paid by the program, $400,000. But he would have made more than that and would have accrued more retirement benefits if his lung disease had not forced his retirement form Hanford in 2007 when he was just 55.
He’s had debt collectors come after him for two years for medical bills the EEOIC program eventually paid, he said. Imagine what that’s like when you “are sicker than a dog,” he said.
He has struggled to prove that secondary conditions, like diabetes and congestive heart failure, are conditions caused by his chronic beryllium disease, he said.
“It can be frustrating,” Fitzgerald said. “They are sick and they just don’t have the energy to go for it.”
Don’t give up, is his advice. For help, ill workers can contact EEOICP resource centers, including the Hanford Resource Center at 888-654-0014.
Today: Jesus and morphine: A Cold Warrior’s slow death Page 1B
Dec. 15: Feds’ zeal to pare costs targets nuclear workers’ health benefits
Dec. 16: Former nuclear workers contaminated, sickened, betrayed
Online: Read the entire package now — stories, videos, photos, graphics and an interactive database — at bit.ly/nuclearworkers