Compensation Funds Curb Financial Burden for Certain Exposure-Related Cancers

July 11, 2023 by Elisa Becze BA, ELS, Editor

People who live near nuclear weapons testing sites or work with uranium, U.S. Department of Energy (DOE) employees, and firefighters, victims, and rescue and recovery workers from the September 11, 2001, attacks may be eligible for various government- or employer-funded compensation if they develop cancers because of their exposure to known related carcinogens. The funds can alleviate some of patients’ financial burden (https://www.ons.org/huddle-cards/financial-toxicity-huddle-card) of cancer treatment and care and support families’ emotional well-being with a tangible reminder that the cancer is unrelated to any underlying inherited genetic disorder (https://voice.ons.org/topic/genetics-genomics).

Oncology nurses are primely positioned to identify eligible patients, but many lack awareness or standardized screening and assessment tools. In their article in the June 2023 issue of the Clinical Journal of Oncology Nursing, ONS members Nora Flucke, PhD, RN, CCCTM, CNE, and Colleen P. Sullivan-Moore, RN, MS, CNN, gave oncology nurses a go-to guide to the current government compensation funds (https://doi.org/10.1188/23.CJON.317-321), eligibility criteria, and strategies to incorporate screening into oncology nursing practice.

PACT Act for Veterans

Military-related exposure to open burn pits and other airborne hazards, contaminated water at Camp Lejeune, Agent Orange, Gulf War substances, and other toxic substances is linked to more than 20 presumptive conditions, Flucke and Sullivan-Moore said (https://doi.org/10.1188/23.CJON.317-321). Newly passed in 2022, the Promise to Address Comprehensive Toxics (PACT) Act expands Veterans Affairs (VA) healthcare and disability benefits for eligible veterans. Learn more about the PACT Act (https://www.va.gov/resources/the-pact-act-and-your-va-benefits/#what-does-it-mean-to-have-a-pr) and its eligibility requirements.

September 11th VCF for First Responders, Victims, and Other Affected Individuals

Environmental hazards exposed individuals to carcinogens at all three locations of the U.S. September 11, 2001, attacks that are associated with more than 15 types of cancers. The current September 11th Victim Compensation Fund (VCF) was established in 2010 and renewed in 2019, and it offers compensation “for any individual (https://www.justice.gov/civil/vcf) (or a personal representative of a deceased individual) who suffered physical harm or was killed as a result of the terrorist-related aircraft crashes of September 11, 2001, or the debris removal efforts that took place in the immediate aftermath of those crashes” through 2090, Flucke and Sullivan-Moore said (https://doi.org/10.1188/23.CJON.317-321). Learn more about the VCF (https://www.cdc.gov/wtc/) and its eligibility requirements.

EEOICPA for DOE Workers

The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) recognizes a special exposure cohort of 22 types of cancers associated with workplace exposure at certain nuclear weapons production and testing program sites and provides affected individuals with a lump sum plus payments for medical expenses, Flucke and Sullivan-Moore said (https://doi.org/10.1188/23.CJON.317-321). Funding is also available for workers who don’t fall under the special exposure cohort, depending on their dose reconstruction. EEOICPA has free resources (https://www.dol.gov/agencies/owcp/energy/regs/compliance/ResourceMeetings/ResourceCenters) to assist with dose reconstruction.

RECA for Uranium Workers and Downwind Residents

Patients with lung or renal cancers who worked in the uranium mining industry from 1942–1971 may be eligible for compensation from the Radiation Exposure Compensation Act (RECA), Flucke and Sullivan-Moore said (https://doi.org/10.1188/23.CJON.317-321). The act also provides for patients with primary organ cancers or hematopoietic neoplasms who lived downwind of the nuclear fallout from the Nevada Test Site in 1962 or worked directly on nuclear test sites from 1945–1962. Patients can use the National Radiation Exposure Screening and Education Program for free assistance with eligibility documentation requirements.

Flucke and Sullivan-Moore recommended that oncology nurses (https://doi.org/10.1188/23.CJON.317-321) ask every patient about potential environmental and occupational exposures as part of their standard intake assessment. Connecting eligible patients to appropriate compensation funds not only supports the cost of care, it also gives them access to care management specific to the unique needs of their exposure cohort as well as surveillance programs for early detection of new exposure-related cancers or other diseases.

Learn more about screening veterans, first responders, and all patients with cancer for environmental exposures in Flucke and Sullivan-Moore’s full Clinical Journal of Oncology Nursing article (https://doi.org/10.1188/23.CJON.317-321).


Copyright © 2023 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact pubpermissions@ons.org for quantity reprints or permission to adapt, excerpt, post online, or reuse ONS Voice content for any other purpose.