ALBUQUERQUE, N.M. — James Jaramillo and Harold Archuleta are used to having to navigate through government bureaucracy to receive compensation for illnesses they said were caused by radiation exposure during their days as employees at Sandia National Laboratories and Los Alamos National Laboratory.
Both men had to wait years after filing claims for compensation through the Energy Employees Occupational Illness Compensation Program.
Jaramillo, 65, worked at Sandia for 24 years. He found out he had cancer of the small intestine in 1998. He filed for compensation in 2003 but was originally denied. Through changes in the program, he was finally awarded compensation in 2012 for medical care and lost wages since he was forced to retire.
Archuleta, 80, worked 38 years, 35 full time, at Los Alamos, where, he said, he ended up with skin cancer after years of exposure to plutonium. He’s also received compensation, but his wife, Angie, said it wasn’t an easy process.
“Congress put forth this act to help them, but then when it comes to actually paying, they put up all of these barriers,” Angie Archuleta said. “It’s just been very frustrating.”
According to a release by the Department of Labor’s Office of Workers’ Compensation Programs, changes are being made next week to update some of the regulations, with the goal of increasing efficiency and transparency and reducing administrative costs. The rules would align the regulations regarding processing and paying medical bills with the current system Office of Workers’ Compensation Programs uses to pay medical bills, and set out a new process that the office will use for authorizing in-home health care that will enable the office to better provide its beneficiaries with appropriate care, according to the release.
However, a company that provides health care to workers such as Jaramillo and Archuleta says rule changes involving the program could make it harder for nuclear workers to receive compensation and could delay the medical treatment they need.
The company, Professional Case Management, has filed suit in the District Court of Colorado against the Labor Department to keep the changes to the Energy Employees Occupational Illness Compensation Program from taking effect. Professional Case Management Vice President Tim Lerew said the new changes could cause delays of 60 days or more in treatment.
“It’s hard to know how long those delays will be,” Lerew said at a town hall meeting in Albuquerque last week. “We estimate it will be about an additional 60 days. For some people, coming out of the hospital with particular illnesses where doctors want them to have additional care … they don’t have that time to wait.”
Lerew said the new rule changes will also add 36 steps to the process between the patient, the doctor and the Labor Department to get pre-authorization for treatment and services, such as home health care.
“If they have you jump through 36 more hoops, how is a guy supposed to do that?” Jaramillo asked.
The rule changes would require patients to fill out most of the paperwork. In the past, health care providers would fill out the majority of it, Lerew and Jaramillo said.
“If you don’t dot every ‘i’ and cross every ‘t,’ they deny you,” said Jaramillo’s wife, Terry.
“Nurses take all your vitals and with the doctor come up with your plan, and send to the Department of Labor for approval,” James Jaramillo said. “Now, they want the patients to fill out a lot of the paperwork and submit it themselves, and not let medical people get involved with that.”
Lerew said he wondered how a cancer-stricken person in his or her 80s “is successfully going to navigate that process.”