On January 2, 2011, the President signed the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act) into law. This law amended the Public Health Service Act, establishing the WTC Health Program, to be administered by the Department of Health and Human Services. A second part of the Act reopened and modified the September 11th Victim Compensation Fund (VCF), initially operated from 2001 to 2004, under the administration of the Department of Justice. For more information on the VCF visit www.vcf.gov. To contact the WTC Health Program, please call the toll-free number at 203-966-3911 or 855-709-0100.
|•||Education and outreach to people who may be eligible;|
|•||Collection and analysis of physical and mental health data with members' permission; and|
|•||Research to better understand health conditions related to the attacks.|
|•||Use healthcare providers approved by the WTC Health Program for eligible medical evaluation, monitoring, and treatment; and|
|•||Use pharmacies that participate in the WTC Health Program to fill any prescriptions you are given for a WTC-related health condition by an approved WTC Health Program healthcare provider.|
|•||You are a New York City responder or volunteer and were enrolled in the WTC Medical Monitoring and Treatment Program (MMTP). (The MMTP was replaced by the WTC Health Program in July 2011.);|
|•||You are a member of the Fire Department of New York (active or retired) and were enrolled in the MMTP. (The MMTP was replaced by the WTC Health Program in July 2011.);|
|•||You are a community member and were enrolled in the WTC Environmental Health Center Community Program on or before December 31, 2010. (The WTC Environmental Health Center Community Program was replaced by the WTC Health Program in July 2011.) Your category in the new Program is called "Survivor."|
Yes. As long as the reason you are hospitalized is for treatment of a strongly suspected or certified WTC-related health condition, the WTC Health Program will pay for inpatient care. You should speak to your Clinical Center of Excellence or the Nationwide Provider Network about your inpatient care needs.
In July 2013, the WTC Health Program began sending out member cards, but you do not need a card to receive coverage for certified WTC-related health conditions.
and How to Receive Benefits
No. The WTC Health Program provides medical monitoring and treatment only for conditions specified on the List of WTC-Related Health Conditions. If your healthcare physician in the WTC Health Program determines you have a health condition not on the List, he or she will advise you about seeking care outside the WTC Health Program.
The list of health conditions eligible for coverage under the WTC Health Program (List of WTC-Related Health Conditions) is below. The List of WTC-Related Health Conditions may be amended by the WTC Program Administrator to include other health conditions as more information is learned about the relationship of 9/11 terrorist site exposures and those health conditions.
Yes, each participating Clinical Center of Excellence and the Nationwide Provider Network includes mental health professionals who are experienced in treating WTC-related psychological and substance abuse problems.
The WTC Health Program will cover medically necessary diagnostic evaluation and treatment costs for WTC-related health conditions as per program protocols, including inpatient and outpatient medical procedures and prescribed medications. During the diagnostic work-up, if your provider determines you do not have a covered health condition or the health condition is not related to your 9/11 terrorist site exposures, the Clinical Center of Excellence will assist you in finding medical care outside the WTC Health Program. However, the WTC Health Program will no longer pay for services related to those conditions.
Before we can certify your condition, you must schedule an initial health evaluation with a WTC Health Program provider. During the evaluation, your doctor will determine if you have a condition that is related to your 9/11 terrorist site exposures. If you have a condition on the List of WTC-Related Health Conditions that your physician determines is related to your 9/11 terrorist site exposure, your doctor will request that your condition be certified by the WTC Health Program. Certifications are done on a case by case basis. Although there is no set timeframe for a health condition to be certified, the WTC Health Program will make certification decisions as promptly as possible.
If you are denied certification, your cancer treatment will not be paid for by the WTC Health Program. You have a right to appeal a denial of certification. Information on how to appeal a denial will be included in the letter informing you of the WTC Health Program's denial decision.
As soon as your cancer has been certified by the WTC Health Program as a WTC-related health condition, you are eligible for treatment coverage for your cancer in the WTC Health Program. However, you and your doctor must make decisions about when you should begin treatment based on the type of cancer and your personal medical situation.
No. The WTC Health Program cannot, by law, reimburse members or healthcare providers for the costs of cancer treatments received before October 12, 2012 (the effective date of the final rule adding many types of cancer to the List of WTC-Related Health Conditions). Similarly, costs associated with prostate cancer treatment will not be reimbursed for treatment received before October 21, 2013.
|•||Your WTC Health Program healthcare provider must confirm that the type of cancer you have is one of the cancers on the List of WTC-Related Health Conditions and that the date of diagnosis meets minimum latency requirements. This means that the doctor will have to review your biopsy report and/or other medical records.|
|•||The healthcare provider must then determine that your exposure to airborne toxins, other hazards, or adverse conditions resulting from the September 11, 2001, terrorist attacks is substantially likely to be a significant factor in aggravating, contributing to, or causing your cancer. To do this the doctor must have the details of your exposure at the terrorist attack site in either New York City, Shanksville, or at the Pentagon, and your subsequent medical history.|
|•||If your doctor confirms that you do have one of the cancers on the List of WTC-Related Health Conditions and determines that your exposure resulting from the September 11, 2001, terrorist attacks is substantially likely to be a significant factor in aggravating, contributing to, or causing your cancer, she or he will request certification of your cancer from the WTC Health Program. The WTC Health Program will then review your doctor's request for cancer certification. Your cancer will be certified for treatment coverage unless the WTC Health Program finds that your cancer is not a cancer on the List of WTC-Related Health Conditions, or your cancer diagnosis does not meet the minimum latency requirements, or that your exposure resulting from the September 11, 2001, terrorist attacks is not substantially likely to be a significant factor in aggravating, contributing to, or causing your cancer.|
|•||The exam may detect changes in body function that you are not aware of and that can be corrected or slowed with early intervention; and|
|•||While the main focus of the WTC Health Program is to assess your health, the information that is learned about 9/11 responders will be extremely valuable in understanding how to protect workers in future emergency or disaster operations.|
Screening for some types of cancer may be available to responders as part of the annual monitoring exam benefit. Although you are not required to have a certified WTC-related health condition to receive a cancer screening, other requirements, such as age, may have to be met. Cancer screening will be offered to eligible WTC Health Program members in accordance with the U.S. Preventive Services Task Force Guidelines.
If you believe you may be eligible for the program, please visit the WTC Health Program website for information about the application process, visit the How to Apply pages for responders and survivors or contact our helpline at 203-966-3911 or 855-709-0100.
The James Zadroga 9/11 Health and Compensation Act of 2010 specified a number of health conditions covered by the WTC Health Program. The list was developed using existing knowledge of the health effects related to the toxins, contaminants, and other hazards that responders and survivors experienced at the three 9/11 terrorist attack sites. This list of health conditions, codified by regulation as the List of WTC-Related Health Conditions, may be amended by the WTC Program Administrator to include other health conditions as more information is learned about the relationship of 9/11 terrorist site exposures and those health conditions. For instance, in October 2012, the WTC Health Program amended the List to include certain types of cancer.
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