For a RECA uranium workers’ claim to be accepted, the claimant must prove that he or she meets the eligibility criteria, which include employment and covered illness. Claimants do not have to prove causation to be compensated under the program, i.e., that his or her illness is related to uranium mining. The Department of Justice (DOJ) determines if claims filed under the program meet these eligibility requirements. Eligible uranium workers are awarded a one-time lump-sum payment of $100,000, and an additional $50,000 and medical coverage for the covered illness under the EEOICPA. If the individual died, eligible survivors may apply for the compensation.
Statistics for RECA Uranium Worker Compensation
As of 2024, about 57,081 claims had been filed with the Department of Justice since the program’s implementation in 1992. Out of these claims, the Department of Justice DOJ had awarded more than $2.7 billion from 42,308 approved claims by December 31, 2025. With the extension and expansion of the RECA, it is estimated that approximately 75,000 claims will be filed under the act by the 31st December 2027 deadline.
Currently, the RECA compensates injured uranium workers who worked in covered employment from January 1, 1942, through December 31, 1990. Congress defined these exact timeframes to match the periods when the U.S. Federal Government was the sole or primary buyer of uranium for the nation’s nuclear weapons program and the Cold War. The federal government is solely liable because it failed to warn or protect workers during this period adequately. By offering compensation through the RECA, the federal government acknowledges its responsibility.
What can you do to get your RECA Claim Accepted?
DOJ follows strict requirements in determining if a claimant qualifies for compensation under the program. A uranium miner filing a RECA claim must first determine his or her eligibility and gather all the required documents to establish his or her claim. Our experienced RECA claim attorney helps eligible uranium workers obtain compensation, including those whose claims were wrongfully denied.
A uranium worker filing a RECA claim must be able to prove that he or she was employed as a uranium miner, uranium miller, core driller, in the transport of uranium or vanadium-uranium ore from such a mine or mill, or was involved in remediation efforts at a uranium mine or uranium mill. These include miners who worked in uranium mines and mills in Colorado, New Mexico, Arizona, Wyoming, South Dakota, Washington, Utah, Idaho, North Dakota, Oregon, and Texas.
There must be evidence that the worker was employed during the covered period for at least 1 year or that the worker has at least 40 working-level months of radiation exposure. To establish employment, the DOJ considers all the employee’s covered employments collectively. DOJ often verifies claimed employment by obtaining the claimant’s Social Security Administration (SSA) earnings data. If evidence cannot be obtained from SSA records, the claimant can obtain signed affidavits from co-workers attesting to his or her claimed employment.
The worker must also provide written medical documentation showing that he or she was diagnosed with a specified compensable disease, which includes lung cancer, pulmonary fibrosis, fibrosis of the lung, silicosis, pneumoconiosis, cor pulmonale related to fibrosis of the lung, renal cancer, and any other chronic renal disease including nephritis and kidney tubal tissue injury. Lung cancer refers to any physiological condition of the lung, trachea, or bronchus that is recognized as lung cancer by the National Cancer Institute, including in situ lung cancers. Nonmalignant respiratory diseases include lung and pulmonary fibrosis, cor pulmonale related to lung fibrosis, silicosis, and pneumoconiosis. Renal cancer and any other chronic renal disease, including nephritis and kidney tubal tissue injury. Research has established that these illnesses are radiation-related, and they may occur many years after the initial radiation exposure.
What Medical Evidence is Required to Prove Your RECA Claim?
The medical evidence required for RECA claims varies by the type of claimed illness. The medical evidence must include a written diagnosis of a covered illness from a physician, as well as the relevant interpretive reports. All claims require the claimant to provide a written qualified physician’s opinion demonstrating that the miner contracted a covered illness during employment as a uranium miner, miller, core driller, ore transporter, or remediation worker. The physician must meet specific qualifications as provided under the Act. I.e., he or she must be employed by the Indian Health Service, the Department of Veterans Affairs, or be board-certified. He or she must also have a documented ongoing physician-patient relationship with the claimant. The DOJ subjects the medical evidence to a fair and random audit procedure.
RECA Evidence for Respiratory Illnesses
Medical evidence for respiratory diseases includes arterial blood gas study (ABG), chest x-ray, high-resolution computed tomography scans (HRCT scans), computer-assisted tomography scans (CAT scans), magnetic resonance imaging scans (MRI scans), and positron emission tomography scans (PET scans), tissue biopsy reports, and pulmonary function tests (PFTs). Imaging is performed to assess structural changes, scarring, and nodule formation characteristic of these diseases. Such reports should be accompanied by interpretive reports by a qualified physician supporting a diagnosis of the claimed condition to be considered conclusive evidence.
- Arterial blood gas study (ABG)
Blood gas analysis is a diagnostic tool used to evaluate the partial pressures of gas in blood and the acid-base content. The analysis provides a clear understanding of respiratory, circulatory, and metabolic disorders. It involves an explicit analysis of arterial blood for partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2), or pH (acid/base). PaO2 indicates the oxygenation status, and PaCO2 indicates the ventilation status in cases of chronic or acute respiratory failure. Low oxygen levels and impaired alveolar gas exchange may indicate a non-pulmonary medical condition. The ABG analysis is also an exceptional diagnostic tool for acid-base diseases (ABDs), such as severe sepsis, septic shock, hypovolemic shock, diabetic ketoacidosis, renal tubular acidosis, chronic respiratory failure, chronic heart failure, and diverse metabolic diseases.
As an alternative to an arterial blood gas study, a claimant may submit a written diagnosis by a qualified physician, accompanied by one or more of the interpretive reports below.
- Imaging Reports
Chest X-rays are the initial imaging done for patients with respiratory problems. They are less detailed than a CT scan, but they can identify advanced scarring or the hallmark nodules of silicosis. X-ray reports must be accompanied by a letter from a pulmonologist that diagnoses pneumoconiosis based on a B-Read by a National Institute of Occupational Health and Safety (NIOSH) certified pulmonologist or radiologist. The X-ray must be administered following standard techniques and the interpretive reports of a maximum of two NIOSH-certified ‘B’ readers classifying the existence of the nonmalignant respiratory disease of category 1/0 or higher according to a 1989 report of the International Labor Office or subsequent revisions.
A claimant can also provide other imaging reports for high-resolution computed tomography (HRCT), computer-assisted tomography (CAT), magnetic resonance imaging (MRI), and positron emission tomography (PET). These reports are used to diagnose pulmonary fibrosis and lung fibrosis.
High-Resolution Chest CT Scan (HRCT) is the definitive imaging tool for diagnosing lung fibrosis. For persons with general fibrosis, the scan will show a “honeycomb” appearance and net-like (reticular) lines. For pneumoconiosis and silicosis, an HRCT will show distinct, tiny, round nodules primarily in the upper zones of the lungs. In severe cases, these nodules merge into large scars known as Progressive Massive Fibrosis (PMF). The scan may also show unique “eggshell calcifications” in the lymph nodes in persons with PMF.
- Pulmonary function tests (PFTs)
DOJ may accept evidence of pulmonary function tests (PFTs) indicating restrictive lung function, as defined by the American Thoracic Society. Pulmonary function tests evaluate respiratory function in clinical situations with risk factors for lung disease, occupational exposures, and pulmonary toxicity. These tests are combined with relevant history, physical exam, and laboratory data to help reach a diagnosis.
PFTs may be administered to measure exactly how much scarring has physically restricted the lungs’ ability to hold air and transfer oxygen. Individuals with fibrosis show a restrictive lung pattern due to scar tissue that makes the lungs stiff and difficult to expand fully. In such cases, the individual will have a decrease in Total Lung Capacity (TLC) and Forced Vital Capacity (FVC).
PFTs are followed up over time and assess the response to treatment. They apply several procedures, including spirometry, lung volume measurements, diffusion capacity, respiratory muscle pressure measurements, bronchoprovocation testing, and the Six-minute-walk test (6MWT).
Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) is a test that measures how easily gas travels from the air sacs (alveoli) into the bloodstream. In pulmonary fibrosis and silicosis, the scar tissue creates a thick barrier, causing the DLCO score to drop significantly.
Pulse Oximetry and the Six-Minute Walk Test (6MWT) are used to determine whether fibrosis is causing hypoxemia, which is the primary trigger that ultimately leads to cor pulmonale.
Forced vital capacity (FVC) is the total volume of air expelled from the lungs during forced exhalation following maximal inspiration. It is used alongside FEV1 to differentiate between obstructive and restrictive lung diseases. An FVC below 80% of the predicted value is a sign of lung dysfunction and Fibrosis. FVC is rarely interpreted in isolation; clinicians analyze it alongside the FEV1 (Forced Expiratory Volume in the first second) and the FEV1/FVC ratio to categorize breathing patterns. The volume of air expired in 1 second (FEV-1) measures obstruction.
Pathology Reports of Tissue Biopsies
RECA claimants may submit pathology reports diagnosing illnesses such as lung cancer, renal cancer, kidney diseases, and non-malignant respiratory diseases. Pathology reports of tissue biopsies provide detailed microscopic findings of lung tissue samples, infections, inflammation, and tumors, for diagnosis and treatment. Different biopsy techniques are used depending on the suspected condition, including needle, bronchoscopic, and surgical biopsies. Pathology reports, specifically from an autopsy (post-mortem), may be submitted in survivor claims as evidence that a miner’s death occurred from a covered illness.
Evidence of Kidney-Related Illnesses
Medical evidence required for RECA-covered kidney illnesses (chronic renal diseases, nephritis, and kidney tubal tissue injury) includes blood tests, urine tests, ultrasound scans, CT scans, or MRI scans. Imaging such as ultrasound, CT, and MRI scans assesses the extent of damage to an individual’s kidneys or the presence of blockages.
Kidney cancer is diagnosed through a biopsy pathology report. A kidney biopsy involves removing a small sample of kidney tissue, and the cells are examined for signs of damage. A kidney biopsy is often performed when there are unexplained abnormalities in kidney function, urine, or blood tests, especially if there’s suspicion of unexplained kidney disease or damage, renal failure, nephrotic or nephritic syndrome, significant proteinuria or hematuria, or suspected glomerulonephritis, vasculitis, or interstitial nephritis.
Blood and urine tests measure levels of waste products, electrolytes, and proteins to evaluate kidney function. Blood tests, such as the Glomerular Filtration Rate (GFR), are used to diagnose kidney diseases. They measure the level of a waste product (creatinine) in the individual’s blood and calculate the amount (in milliliters) of waste that the kidneys should filter per minute based on the individual’s age, size, and gender. This calculation is known as the estimated glomerular filtration rate (eGFR). Healthy kidneys should filter more than 90ml/min. Lower values may indicate kidney disease.
Urine tests are often evaluated alongside eGFR to assess kidney function more accurately. Urine tests check the levels of albumin and creatinine in the urine (albumin: creatinine ratio or ACR). They may also check for blood or protein in urine.
Wrap up
Medical evidence is critical in determining eligibility for RECA uranium worker claims. The administration and interpretation of medical procedures and reports for purposes of RECA claims follows standard techniques. DOJ may consult with the Surgeon General to determine if the medical evidence a claimant submits shows that the uranium worker contracted a covered illness. According to the Act, “All reasonable doubt with regard to whether a claim meets the requirements shall be resolved in favor of the claimant.”