The World Trade Center Health Program was created when Congress passed the James Zadroga 9/11 Health and Compensation Act of 2010. It provides health tests and medical care for people who worked in response and recovery operations at the World Trade Center, the Pentagon, and the passenger-jet crash site near Shanksville, PA.

The program also covers New York City survivors who were in the New York City disaster area, lived, worked, or were in school in the area.

Currently, the WTC Health Program is serving New York City responders and survivors. Enrollment for responders to the Pentagon and the Shanksville, PA crash site is expected to open in early 2013, after eligibility guidelines and program benefits are defined.

The WTC Health Program provides medical testing and care for specific symptoms and illnesses related to exposure at the disaster sites. The services are provided by clinics and hospitals that have expertise in the diagnosis and treatment of 9/11-related health conditions.

Program Information

• What is the James Zadroga 9/11 Health and Compensation Act of 2010 and what did it do?

  The James Zadroga 9/11 Health and Compensation Act of 2010 is legislation passed by the United States Congress that created the World Trade Center Health Program.

  The World Trade Center Health Program is also called the WTC Health Program. Its toll-free number is 1-888-982-4748. (1-888-WTC-HP4U).

  The law also authorizes:

  • Education and outreach for people who are eligible for the WTC Health Program
  • The collection and analysis of physical and mental health data with patients' permission
  • Research to better understand health conditions linked to the attacks

• What does the WTC Health Program provide?

  The program provides medical monitoring and treatment for emergency responders, recovery and cleanup workers, and volunteers who helped after the terrorist attacks on September 11, 2001, at the World Trade Center, the Pentagon, and the passenger-jet crash site near Shanksville, PA.

  The program also provides medical tests and care for residents, students, and people who worked in the New York City disaster area on 9/11 and for a time afterward, and for visitors who were there on 9/11.

• Does the program cost me anything?

  The WTC Health Program does not cost anything for people who are enrolled as long as you:

  • Use health providers who are approved by the WTC Health Program for the medical evaluation to see if you can enroll in the program
  • Use health providers who are approved by the WTC Health Program for any treatment you receive for 9/11-related health conditions
  • Use pharmacies that are participating in the program to fill any prescriptions you are given for a condition related to 9/11

• Aren't I already enrolled in this program?

  Yes, if:

  • You are a New York City Responder and were enrolled in the WTC Medical Monitoring and Treatment Program (MMTP). That program has been replaced by the WTC Health Program.
  • You are a member of the Fire Department of New York and were already enrolled in the earlier MMTP program. That program has been replaced by the WTC Health Program.
  • You are a Community Member who was already enrolled in the WTC Environmental Health Center Community Program. That program has been replaced by the WTC Health Program. Your category in the new program is called Survivor.
  • You were identified as a Survivor on or before Dec. 31, 2010, and were enrolled in the earlier Medical Monitoring and Treatment Program (MMTP). That program has been replaced by the WTC Health Program.

  NIOSH is handling your enrollment and you do not need to do anything unless you are notified. You will continue to receive quality medical care for WTC-related health conditions, including inpatient and outpatient treatment and medications.

• I am a survivor who enrolled in the earlier MMTP program on or after January 1, 2011. What do I do?

  You are NOT already enrolled in the new WTC Health Program if you signed up for the earlier program on or after January 1, 2011.

  NIOSH has sent you information about how to apply. If you did not get an enrollment packet or have lost it, please call 1-888-982-4748 (1-888-WTC-HP4U) immediately.

  The re-enrollment requirement is included in the James Zadroga 9/11 Health and Compensation Act of 2010.

• I am a responder or survivor who isn’t enrolled yet. What will the program provide for me?

  Responders who enroll receive annual medical monitoring. If you have health conditions related to your WTC, the program providers will provide quality medical treatment.

  Survivors who enroll will receive a one-time medical screening evaluation. The screening is to find out if you have a health problem covered by the WTC Health Program. If you do, the doctor will certify you as qualifying for the WTC Health Program. The WTC Health Program will provide quality medical care for that condition.

• Does the WTC Health Program provide treatment for all health problems?

  No. The program provides medical tests and treatment only for conditions specified by law in the James Zadroga Act. If your doctor in the WTC Health Program suspects you have any other health problem, he or she will advise you about seeking care outside the program.

• What conditions are covered by this program?

  The list is below. If a program member gives permission, the WTC Health Program will collect and study your health information. This list of conditions will be updated as doctors and researchers learn more.

  These conditions apply to FDNY members, New York City Responders, and New York City Survivors

  Airways and Digestive Disorders
  New occurrence or aggravation of these pre-existing conditions due to WTC work exposure:

  Interstitial lung diseases (diseases that cause scarring of lung tissue); chronic respiratory disorder-fumes/vapors; asthma; reactive airways dysfunction syndrome (RADS); WTC-exacerbated chronic obstructive pulmonary disease (COPD); chronic cough syndrome; upper airway hyperreactivity; chronic rhinosinusitis; chronic nasopharyngitis; chronic laryngitis; gastroesophageal reflux disorder (GERD); sleep apnea exacerbated by or related to any of these conditions.

  Mental Health Conditions
  Posttraumatic stress disorder (PTSD), and certain mood, anxiety, and substance abuse disorders

  Cancer

  Other
  Secondary conditions related to disease progression or complication from treatment of the primary covered health condition

  These conditions are covered for FDNY members and other New York City Responders, but do not apply to New York City Survivors:

  Musculoskeletal Disorders
  Specific injury caused by WTC-related work and evidence of medical care within two years of the incident: Low back pain from disc injury, carpal tunnel syndrome from repetitive motion injury

  Other
  Secondary conditions related to disease progression or complication from treatment of the primary covered health condition

• Who decided what conditions are covered as World Trade Center conditions?

  The James Zadroga Act of 2010 mandated by law the specific conditions to be covered by the WTC Health Program. The list was established by medical and scientific experts based on existing knowledge of what people were exposed to and health effects that responders and survivors have experienced.

• How do I get approved to receive health care?

  The first step for receiving care is to apply to the program. Once you apply and have been determined to be eligible for and enrolled in the program, you will choose a clinic for your initial screening exam. During this exam it will be determined what WTC-health related conditions you may have.

  Your WTC health program provider will make a clinical evaluation of your specific exposure situation and the type of health condition you develop (the diagnosis). Then the Administrator of the WTCHP must approve (certify) the evaluation and diagnosis to allow you to receive treatment for the specific health condition through your WTCHP Clinical Center of Excellence (CCE). The WTCHP Administrator’s decision will be shared with you through your CCE provider or via letter.

• I believe another medical condition should be covered by the WTC Health Program. What can I do?

  You (or any interested party) may petition the WTC Program Administrator to add a recognized medical condition to the list of WTC-related health conditions in 42 CFR §88.1. Please use this form.

• Will the WTC Health Program pay for inpatient care?

  Yes, as long as the reason you are hospitalized is for treatment of a suspected or identified WTC-related condition.

• Will current members be issued new health cards from the WTC Health Program?

  We are not currently sending out WTC Health Program member cards. You do not need a card to receive care.

• Is this a research program?

  The main goal of this program is to provide health care for people with 9/11-related health problems. When you come in for an exam, you will be asked if the clinic can add your medical information to the data which researchers are using to understand 9/11 health effects.

  You are not required to do this. You will receive your exam and continue to receive health care if you do not sign the consent form. If you do consent to let researchers see your health information, your name and contact information will not be given to them. Only your health information will be a part of the research record.

Responder

• If I have work-related health issues that are not related to my WTC work and exposures, what can I do?

  The New York State Occupational Health Clinic Network can provide diagnosis and treatment of work-related health conditions.

• How would I know if my health problems are related to 9/11?

  By law, the program is limited to the coverage of specified health conditions. If you are enrolled in the program and you’ve received monitoring, or if you are enrolled and will receive your first monitoring examination, tell the doctor about your problem and ask him or her to determine whether it is related to 9/11.

• If I am found to have health issues related to my WTC work and exposures, what can I do?
  

  Your WTC Health Program provider will meet with you individually, informing you of the free treatment and services available to you.

• What if during my monitoring exam a condition is found that is not covered under the WTC Health Program?

  You will be referred to someone to talk to about health care that is available through other programs, possibly at reduced cost or for free.

• How do I find out if I qualify for this program?

  Call us at 1-888-982-4748 (1-888-WTC-HP4U). You also can download the enrollment form that fits you best at www.cdc.gov/wtc/apply.html We can also mail you a paper form. If you need one, call us toll-free at 1-888-982-4748 (1-888-WTC-HP4U).

• How do I apply to the WTC Health Program?

  To apply to the WTC Health Program please visit: www.cdc.gov/wtc. The application can be completed online, and then you can print it and submit via mail or fax. If you don’t have access to a computer, we can also mail you a copy of the application. Approval times for each application will vary. Once you have been approved for the program, you will receive an acceptance letter notifying you of your approval. You can check the status of your application by calling us back at 888-WTC-HP4U (888)-982-4748.

  Approval times for each applicant will vary. Once you have been approved for the program, you will receive an acceptance letter notifying you of your approval.

  You can check the status of your application by calling us at toll-free at (888)-982-4748 (888-WTC-HP4U).

• Should I come in for a WTC Monitoring exam even if I'm feeling fine now?

  Yes. Everyone who is eligible for medical monitoring within the WTC Health Program is strongly encouraged to participate for three main reasons:

  1. First, the exam may detect changes in body function that you are not aware of and that can be corrected or slowed with early intervention.
  2. Second, measuring your health status over time helps your provider identify and intervene with any concerning trends.
  3. Lastly, while the main focus of the 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.

Survivor

• I enrolled in the WTC Health Program after Jan. 1, 2011. Why do I need to re-enroll?

  In order to comply with the James Zadroga Act, the WTC Health Program is requiring that all survivors who enrolled in the WTC Environmental Health Center after the law was signed on January 2, 2011 must re-enroll in the World Trade Center Health Program.

• How do I re-enroll?

  We are sending you a re-enrollment notification letter that explains how to re-enroll. We are also including an enrollment application in the package. You should follow the instructions in the letter and complete the enrollment form. If you would like to download the enrollment form online, please visit http://www.cdc.gov/wtc/apply.html. We can also mail or fax it to you. Fill out the enrollment form and fax or mail it to the World Trade Center Health Program at:
  
  World Trade Center Health Program
  PO Box 7000
  Rensselaer, NY 12144-7000
  Fax: 1-877-646-5308

• I re-enrolled in the survivor program and I have been denied. Now what do I do?

  You may appeal the decision within 60 days of receiving your Denial Letter. Instructions for how to submit an appeal are explained in the letter. If you did not receive that letter, please call us toll-free at 1-888-982-4748 (1-888-WTC-HP4U).

• I was in the affected New York City Disaster Area on 9/11 but I don’t feel sick. Can I make an appointment and be monitored?

  To qualify for a medical screening, you must have symptoms that could be related to a condition that is covered by the WTC Health Program. Please see "What conditions are covered by this program?" above to see the list of conditions.

• What benefits do I have under the program?

  When you are accepted into the program, you are eligible for a medical exam. The doctor will determine if you have a health condition related to your WTC exposure. If you do, the doctor will certify your health condition and you will receive treatment, monitoring and pharmacy benefits for that condition.

• What happens if I get sick after my one-time screening?

  If you experience symptoms after your initial screening, you have the option to pay for an additional screening appointment. If the doctor finds that you do have a WTC related condition during this screening, the evidence will be submitted to the Program and your eligibility for treatment benefits will be reconsidered.

• How long do I have to wait for my condition to be certified?

  Before we can certify your condition, you must schedule a screening exam with your doctor. During the screening exam, your doctor will determine if you have a condition that is related to the effects of the 9/11 attacks. If you have a WTC related condition, your doctor will request that your condition be certified. Certifications are done on a case by case basis so there is no set timeframe for a condition to be certified.

• Does my family member need to enroll in the program to receive benefits?

  Yes. Although the two of you are related, your family member is considered a new member and must go through the enrollment process in order to be in the program.

• If I have work-related health issues that are not related to my WTC work and exposures, what can I do?

  The New York State Occupational Health Clinic Network can provide diagnosis and treatment of work-related health conditions.

• How would I know if my health problems are related to 9/11?

  By law, the program is limited to the coverage of specified health conditions. If you are enrolled in the program and you’ve received monitoring, or if you are enrolled and will receive your first monitoring examination, make your doctor aware of your problem and ask the WTC Health Program monitoring physician to make a determination whether it is related to 9/11.

• If I am found to have health issues related to my WTC work and exposures, what can I do?

  Your WTC Health Program provider will meet with you individually, informing you of the free treatment and services available to you.

• What if during my monitoring exam a condition is found that is not covered under the WTC Health Program?

  A social services referral will be made to advise you of available resources for reduced cost or other socially funded health care programs.

• How do I find out if I qualify for this program?

  Please visit our How to Apply page to determine if you are eligible to apply for the program.

• How do I apply to the WTC Health Program?

  You may download an eligibility form located at http://www.cdc.gov/wtc/apply.html. The application can be completed online, and then you can print it and submit via mail or fax. If you don’t have access to a computer, we can also mail you a copy of the application. Approval times for each application will vary. Once you have been approved for the program, you will receive an acceptance letter notifying you of your approval. You can check the status of your application by calling us back at 888-WTC-HP4U (888)-982-4748.

Nationwide Provider Network

• What is the Nationwide Provider Network?

  The WTC Health Program has a nationwide network of clinics with providers across the country for responders and survivors who live outside the New York City metropolitan area. For information about the nationwide provider network call 1-888-982-4748.

• I am a survivor and I was told that I could not join the nationwide provider network and had to go to a clinic in the NYC metropolitan area. Is this still true?

  Prior to October 1, 2012, the WTC Health Program could only provide monitoring and treatment benefits to responders through the nationwide network of providers. However, starting October 1, 2012, that nationwide network of providers has been opened up to survivors. If you are a survivor who is enrolled in the WTC Health Program and live outside the NYC metropolitan area and would like to be enrolled in the nationwide provider network call 1-888-982-4748.

  If you are not currently enrolled in the WTC Health Program but believe you may be eligible call 1-888-982-4748 or view more information on how to apply on our website.

• How is the nationwide provider network different than the NYC clinics?

  The nationwide provider network is able to find the providers you need close to where you live so that you do not have to pay the expense to travel to the NYC area. However, if you are already a patient at one of the NYC Health and Hospitals Corporation WTC Environmental Health Center clinics at Bellevue, Gouverneur, or Elmhurst you can continue to be a patient there if you choose. However, if you live outside the NYC area and choose to continue your care at one of the NYC locations you will be responsible for your travel expenses.

  The national program also conducts monitoring exams differently. The exam is conducted in a three-part process: a medical history questionnaire, testing, and clinical evaluation. The medical history questionnaire will be conducted over the phone by a member of the Case Management team. During the call you will be scheduled for an appointment at a provider for appropriate testing services. Upon completion of these two parts of the process, a clinical evaluation will be scheduled with a physician in order to complete your monitoring exam.

• Do I have to enroll in the nationwide provider network if I am a survivor who lives outside the NYC metropolitan area?

  No. If you are a survivor who lives outside the NYC metropolitan area then you can choose to either get care at one of the NYC Health and Hospitals Corporation WTC Environmental Health Center clinics at Bellevue, Gouverneur, or Elmhurst or you can enroll in the nationwide provider network. If you choose to visit a clinic in the NYC metropolitan area, you are responsible for your travel costs for your clinic visits.

• Do I have to reapply to the program if I want to receive services from the nationwide network of providers?

  If you have already enrolled in the WTC Health Program and have been determined to be eligible you do not need to reapply. If you are already receiving care at a NYC Health and Hospitals Corporation WTC Environmental Health Center clinic at Bellevue, Gouverneur, or Elmhurst and you want to receive services from the nationwide provider network, then you should call your clinic and ask them to transfer you. If you are enrolled in the WTC Health Program but you are not a patient at a clinic in the NYC metropolitan area then you should call the WTC Health Program at 1-888-982-4748 and tell us you would like to enroll in the nationwide provider network.

Clinic Information

• What are the locations of the medical providers?

  If you are a responder living in the NYC/NJ area, there are ten clinic locations (see www.cdc.gov/wtc/clinics.html) for you to choose from. For responders living outside this NYC/NJ area, the National Responder Health Program (NRHP) has a network of clinics nationwide that have been contracted to provide care. You can call the NRHP at 877-498-2911.

  Current and retired FDNY employees are seen at the Bureau of Health Services office in Brooklyn or may be referred to satellite locations.

  For newly enrolled survivors, you will go to the Bellevue Hospital Center for your initial screening appointment (Address: Bellevue Hospital Center, 462 First Ave at 27th St, New York, NY 10016). If the doctor determines that you have a WTC related condition during your initial screening appointment, you may go to Bellevue Hospital, Elmhurst Hospital, or Gouverneur Hospital.

• Can I be seen at more than one clinical center?

  No. To maintain continuity of care, you must be a patient at one clinical center, or be a patient in the NRHP.

• How do I get an appointment?

  You should not make an appointment until you have applied to the program and been notified that you are enrolled. At that time you will be asked to make a choice about which clinic you would like to visit. If you are already enrolled and need to make an appointment or contact your clinic please go to www.cdc.gov/wtc/clinics.html for clinic information.

• Can I switch clinics?

  If you move out of your current community, you may elect a more convenient participating clinical center to provide your benefits. If you move out of the NYC area, you may transfer into the national program.

  Before making any change in clinic or transfer into the National Program, you must first notify your current clinical center and have your medical records transferred to the appropriate new provider to arrange an appointment. Only one transfer per year will generally be allowed, except in special situations.

Benefits Information

• Can I continue to see my personal physician for non-related WTC conditions while I am being treated by the program?

  Yes. However, the program only covers costs of care provided by WTC Health Program providers for WTC-related health conditions. It is important that all your health care providers are aware of all health conditions for which you receive any treatment for coordination of care.

• Does the program also cover treatment for mental health problems?

  Yes, each participating clinic includes mental health professionals who are experienced in treating WTC-related psychological and substance abuse problems.

• Which diagnostic and treatment services are available?

  The program will cover medically necessary diagnostic evaluation and treatment costs for the covered conditions as per program protocols, including inpatient and outpatient medical procedures and prescribed medications. If during the diagnostic work up, the physicians determine that you do not have a covered condition, the clinic will assist you in finding medical care, but the program will no longer pay for these services.

Cancer

• What cancers are covered by the WTC Health Program?

  The Administrator added the following types of cancers:

  • Mesothelioma
  • Childhood cancers occurring after 9/11/01
  • Rare cancers Malignant neoplasms of the following: Lip, tongue, salivary gland, floor of mouth, gum and other mouth, tonsil, oropharynx, hypopharynx, and other oral cavity and pharynx.
  • Nasopharynx
  • Nose, nasal cavity, middle ear and accessory sinuses
  • Larynx
  • Esophagus
  • Stomach
  • Colon and rectum
  • Liver and intrahepatic bile duct
  • Retroperitoneum, peritoneum, omentum and mesentery
  • Trachea; bronchus and lung; heart, mediastinum and pleura; and other ill-defined sites in the respiratory system and intrathoracic organs
  • Soft tissues (sarcomas)
  • Skin (melanoma and non-melanoma), including scrotal cancer
  • Breast
  • Ovary
  • Urinary bladder
  • Kidney
  • Renal pelvis, ureter and other urinary organs
  • Eye and orbit
  • Thyroid
  • Blood and lymphoid tissues (including, but not limited to, lymphoma, leukemia, and myeloma)

  The above covered cancers will be added to the WTC Health Program “List of WTC-Related Health Conditions” as of October 12, 2012. The “List of WTC-Related Health Conditions” is the list of physical and mental illnesses that are covered by the WTC Health Program.

• What is a childhood cancer?

  For the WTC Health Program, the term “childhood cancer” means any type of cancer first diagnosed after 9/11/01 in a person less than 20 years of age at the time of diagnosis.

• What does it mean for my cancer to be “covered” by the WTC Health Program?

  “Covered” means that all approved cancer treatment, drugs, and services will be paid for by the WTC Health Program. The WTC Health Program will only cover these costs when you have been certified by the WTC Program Administrator for a specific cancer. The list of WTC-related cancers are the only types of cancers that can be considered for certification. The WTC Program Administrator is certifying that your 9/11 exposure is related to your cancer.

• How do I get my cancer certified??

  Certification is a two-step process.
  1. First, your WTC Health Program doctor must confirm that the type of cancer you have is one of the cancers on the List of WTC-Related Health Conditions. This means that the doctor will have to review your biopsy report and other medical records. The doctor must also find that 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 WTC exposure 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 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 Administrator of the WTC Health Program.
  
  2. The Administrator then reviews all doctors’ requests for cancer certification. Your cancer will be certified for treatment coverage unless the Administrator finds that your cancer is not a cancer on the List of WTC-Related Health Conditions 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.
  
  If you are not a member of the World Trade Center Health Program:
  Please visit our website for information about the application process, www.cdc.gov/wtc. You can also contact the WTC Health Program at 1-888-982-4748 for information on how to apply.

• If I have one of the cancers on the list, am I automatically eligible for treatment coverage in the WTC Health Program?

  No. The inclusion of your cancer on the List of WTC-Related Health Conditions does not mean that your cancer will automatically be covered by the Program. Your Program doctor must also find that your WTC-related exposures caused, aggravated, or contributed to your cancer and request certification of your cancer from the WTC Program Administrator. If the Administrator certifies your cancer, then you are eligible for treatment coverage in the WTC Health Program.

• When can a WTC Health Program member begin the process of certification of their cancer?

  The process of requesting certification for cancer may begin as of October 12, 2012. Members should contact their current Clinical Center of Excellence (CCE) to begin this process. If you do not know which CCE you are with, please contact our call center at 1-888-982-4748.

  If you are not yet enrolled, and believe you may be eligible for the Program, please visit the WTC Health Program website for information about the application process, www.cdc.gov/wtc or contact the WTC Health Program at 1-888-982-4748.

• How long does certification take?

  It is not possible to provide a specific estimate for how long certification should take because each case is different. However, the WTC Program Administrator knows that certification decisions must be made as quickly as possible. Certification of a cancer and beginning treatment are two separate issues. Once your cancer has been certified by the WTC Program Administrator, you are eligible for treatment coverage for your cancer in the WTC Health Program. You and your doctor, however, must make decisions about when you should begin treatment based on your cancer and medical needs.

• If my cancer is not certified, do I have a right to appeal?

  If you are denied certification, this means that your cancer treatment will not be paid for by the WTC Health Program. You have a right to appeal a denial. Information on how to appeal a denial will be included in the letter informing you of the WTC Program Administrator’s denial decision.

• How soon after my cancer is certified will I actually expect to begin treatment?

  Certification of a cancer and beginning treatment are two separate issues. Once your cancer has been certified by the WTC Program Administrator, you are eligible for treatment coverage for your cancer in the WTC Health Program. You and your doctor, however, must make decisions about when you should begin treatment based on your cancer and medical needs.

• If I have cancer and I am already seeing a doctor for my cancer care, can I still keep seeing my doctor?

  In order for a WTC Health Program member to obtain coverage for treatment of any health condition on the List of WTC-Related Health Conditions, including any type of cancer added to the List, the condition must first be certified by the WTC Program Administrator.
  
  All care for the WTC Health Program must be rendered by a provider affiliated with the WTC Health Program. If your current provider is affiliated with the WTC Health Program, then you will be able to continue seeing your doctor. If your current provider is not affiliated, ask the provider to contact your CCE to discuss becoming a WTC Health Program provider.

• Will the WTC Health Program provide reimbursements to individuals for cancer treatment costs incurred before October 12, 2012?

  No. The WTC Health Program will not reimburse members or healthcare providers for the costs of cancer treatments received before October 12, 2012.
  
  However, you might be able to receive compensation through the September 11th Victim Compensation Fund (VCF) for past cancer treatment costs. The VCF is administered by the Department of Justice, and enrollment in that program is separate from the WTC Health Program. For information regarding the VCF, please visit www.vcf.gov or call the VCF toll-free at 1-855-885-1555.

• Does this mean that the Victim’s Compensation Fund (VCF) will be adding cancer to their list?

  Yes. For information regarding the VCF, please visit www.vcf.gov or call the VCF toll-free at 1-855-885-1555.1

• When can the WTC Health Program begin to provide reimbursements to individuals for cancer treatment costs incurred after October 12, 2012?

  Treatment costs can only be reimbursed for certified conditions, and for authorized services rendered by providers affiliated with the WTC Health Program. Once certified, costs can be reimbursed as of the date the condition is certified by the WTC Program Administrator. As of this time, a final decision has not been made whether to allow for any special authorizations to pay for treatment rendered before certification is finalized. As with any expansion of services, program specifics are still being decided and we will keep you informed of important changes as information becomes available.

• If my cancer is certified by the WTC Health Program, are there any types of monetary caps or financial limits placed on the dollar amount of the care I’m entitled to?

  No. There is no financial limit for the required treatment of your cancer if it has been certified by the WTC Program Administrator. However, the James Zadroga 9/11 Health and Compensation Act only provides funding for the WTC Health Program through 2016. At this time, we don’t know if additional funding will be made available for medical monitoring and treatment of cancer or any other illness on the List of WTC-Related Health Conditions after 2016.

• Does this mean that the Victim’s Compensation Fund (VCF) will be adding cancer to their list?

  Yes. For information regarding the VCF, please visit www.vcf.gov or call the VCF toll-free at 1-855-885-1555.1

• What if my cancer is not on the List of WTC-Related Health Conditions?

  Starting October 12, 2012, only those cancers on the List of WTC-Related Health Conditions will be covered by the program. Even if you think your cancer is not on the list, you should contact your CCE to inform your doctor about your cancer and find out if it is covered by the WTC Health Program.
  
  If you find out that your cancer is not covered, this means that the WTC Health Program will not cover the costs of your cancer treatment, drugs, and services. However, if needed, your doctor will work with you to help you identify a place to get your care.
  
  In addition, there is a process for adding additional types of cancer to the List of WTC-Related Health Conditions in the future. The Administrator may propose the addition of other types of cancer if he determines that there is evidence of a relationship between WTC exposures and a specific type of cancer. If your cancer is added to the List of WTC-Related Health Conditions in the future, the WTC Health Program will make every effort to inform you of this change.

• What was the process for adding these types of cancers to the List of WTC-Related Health Conditions?

  In September 2011, the Administrator received a petition that requested he consider adding coverage for cancer(s) to the WTC Health Program. As permitted by the Act, the Administrator consulted with the WTC Health Program Scientific/Technical Advisory Committee (STAC). After receiving the STAC’s recommendation, the Administrator issued a notice of proposed rulemaking on June 13, 2012, proposing to add certain types of cancer to the List of WTC-Related Health Conditions. The Administrator received comments from the public offering both support and criticism of the proposal. The public comments were addressed in the final rule, which was published in the Federal Register on September 12, 2012.
  
  In the September 12, 2012 final rule, the WTC Program Administrator announced the addition of all of the types of cancer that were included in the June 2012 Notice of Proposed Rulemaking. The final rule will become effective on October 12, 2012. At that time, WTC Health Program members who have one of the covered cancers are encouraged to contact their CCE to begin the process of determining if their cancers qualify to be certified by the Administrator as WTC-related health conditions.

• When will the WTC Program Administrator be considering whether or not to add other types of cancer?

  The Administrator may propose the addition of a type of cancer if he determines that there is evidence of a relationship between WTC exposures and a specific type of cancer.

• I have cancer now. What should I do?

  If you are a member of the World Trade Center Health Program:
  Contact your Clinical Center of Excellence (CCE) to schedule an appointment so that you can begin the cancer certification process as soon as possible. If you do not know which CCE you are with, please contact our call center at 1-888-982-4748.
  
  In addition, you may be able to receive compensation through the September 11th Victim Compensation Fund (VCF) for cancer treatment costs and economic loss you have experienced due to cancer. The VCF is administered by the Department of Justice, and enrollment in that program is conducted separately from the WTC Health Program. For information regarding the VCF, please visit www.vcf.gov or call toll-free: 1-855-885-1555.
  
  If you are not a member of the World Trade Center Health Program:
  Please visit our website for information about the application process, www.cdc.gov/wtc. You can also contact the WTC Health Program at 1-888-982-4748 for information on how to apply.

• I don’t have cancer now, but I have had cancer since September 11, 2001. What should I do?

  If you are a member of the World Trade Center Health Program:
  Contact your Clinical Center of Excellence (CCE) to schedule an appointment to review your medical history. Your doctor will determine if the cancer certification process should be started in case you need treatment again in the future. If you do not know which CCE you are with, please contact our call center at 1-888-982-4748.
  
  If you are not a member of the World Trade Center Health Program:
  Please visit our website for information about the application process, www.cdc.gov/wtc. You can also contact the WTC Health Program at 1-888-982-4748 for information on how to apply.
  
  In addition, you may be able to receive compensation through the September 11th Victim Compensation Fund (VCF) for prior cancer treatment costs and economic loss you’ve experienced due to cancer. The VCF is administered by the Department of Justice, and enrollment in that program is conducted separately from the WTC Health Program. For information regarding the VCF, please visit www.vcf.gov or call toll-free: 1-855-885-1555.

• I don’t have cancer now, but what if I get it in the future? What should I do then?

  If you are a member of the WTC Health Program, it is important that you continue to go to your annual monitoring exams so that your health can be checked. If a doctor finds that you have cancer or any other WTC-related health condition during your annual monitoring exam, the doctor would complete a determination and request certification of those conditions as soon as possible so that you could get the treatment you need.
  
  At any point in time, if you find out you have cancer, contact your CCE as soon as possible so that your doctor can determine if the certification process should be started. If you do not know which CCE you are with, please contact our call center at 1-888-982-4748.

• What if I want to be screened for cancer?

  Screening for breast or colon cancer may be available in the future as part of the annual monitoring exam benefit using the U.S. Preventive Services Task Force guidelines. Although screening does not require a member to have a certified condition, other requirements, such as age, may have to be met. Screening mammograms and colonoscopies will not begin until the WTC Program Administrator further defines these screening eligibility requirements.

• What should I do if I am not a member of the WTC Health Program?

  If you believe you may be eligible for the Program, please visit the WTC Health Program website for information about the application process, www.cdc.gov/wtc or contact the WTC Health Program at 1-888-982-4748.

Appeal Information

• What types of decisions can be appealed?

  You may appeal the denial of: health condition certifications (either WTC-related or medically association conditions); treatment; and certified-eligible status (survivors only).

• How do I make an appeal?

  The appeal must be in writing and describe the reason(s) why you believe the denial was incorrect.

• How long do I have to make an appeal?

  Your appeal must be postmarked within 60 calendar days from the date marked on your denial letter.

• Can I submit new supporting information in my appeal?

  No. The WTC Health Program cannot consider documentation during the appeal process that was not available during the initial determination.

• What if I have new information that I believe is relevant to my case?

  If you believe that new information would better support your application, you may resubmit your request for certification/request for treatment with this supporting documentation.

• How does the WTC Health Program consider my appeal?

  First, the Appeals Coordinator will review the appeal and determine if it is valid (e.g. within the 60 day postmark). The Appeals Coordinator will then send acknowledgment that the Program has received your appeal and what action has been taken.

  If the appeal is valid, the Administrator of the WTC Health Program will appoint a Federal Official to conduct the appeal. The Official will have all of the information about the appeal and may review the decision himself or herself. The Official may also convene one or more qualified experts independent of the WTC Health Program to review the case.

• How will I find out about the appeal decision?

  You will be notified in writing whether your appeal was granted or denied.

• Can I appeal my appeal decision?

  No. All appeal decisions are final.

  Pentagon/Shanksville

• Who from the Pentagon and Shanksville disaster site may apply for coverage?

  You may apply for coverage under the WTC Health Program if you performed rescue, recovery, demolition, debris cleanup, or other related services at either the Pentagon or Shanksville, Pennsylvania sites. Responders include:

  • Members of a fire or police department (active or retired)
  • Emergency health workers
  • Workers from recovery or cleanup contractors
  • Volunteers who assisted in rescue, recovery, or clean up efforts

• How do I enroll?

  Complete and submit an application to the WTC Health Program. Your application will help determine your eligibility for the Program. Applications may be found at www.cdc.gov/wtc or by calling 1-888-982-4748.

• What type of information is in the application?

  The application will ask for basic information like your name and address. It also will ask you to provide details about your work experience during the 9/11 attacks and their aftermath, such as where you worked, for how long, and what type of duties you preformed. Supporting documentation and a signature will be needed to verify your application.

• What will I need for supporting documentation?

  Supporting documentation is anything that attests to your work with the rescue, recovery, and/or clean-up operations. A pay stub, official personnel roster, site credentials, or a written statement by an employer under penalty of perjury are examples of supporting documentation. If you cannot find these or similar materials, you must explain how you tried to find it and why the attempt was unsuccessful and provide a signed, written statement attesting under penalty of perjury that you meet the eligibility criteria.

• What type of services may I receive under the WTC Health Program?

  Once enrolled, the WTC Health Program provides free, in-depth yearly medical screenings. If a screening reveals that you have a health condition related to your 9/11 work experience, you will be eligible to receive high quality health care, including prescription drugs, at no cost to you.

• Does the WTC Health Program cover all health issues?

  The Program only provides treatment for specific physical and mental health conditions that have been certified by the WTC Health Program. These include specific types of cancer; respiratory diseases like asthma and chronic cough; digestive disorders, such as GERD; and mental health conditions like anxiety or post-traumatic stress disorder. The Program will provide no cost medical treatment if the covered condition is determined to be caused by exposure to airborne toxins, other hazards, or other adverse conditions resulting from the September 11th terrorist attacks. For a detailed list of covered conditions please visit www.cdc.gov/wtc or call 1-888-982-4748.

• What if I was diagnosed before joining the WTC Health Program?

  If you have already been diagnosed with a condition that the Program provides coverage for, you may still be eligible for medical benefits. A WTC Health Program provider would need to certify your condition as being related to the 9/11 terrorist attacks. Once certified, you may begin receiving benefits under the Program.

• It's been over 11 years, why should I see a doctor now?

  Though the September 11th attacks were over a decade ago, many first responders continue to experience physical and mental health symptoms as a result of their experience. Current or eligible responders may not recognize that some cancers, a chronic cough, difficulty sleeping, or frequent heartburn could be a 9/11 related condition. Doctors with the WTC Health Program are experts in identifying these illnesses and providing the highest quality care.

• How do I get treatment?

  Responders from the Pentagon and Shanksville, Pennsylvania will be able to select a participating health provider through the WTC Health Program's Nationwide Provider Network. The Network links members with nearby medical experts who are familiar with diagnosing and treating 9/11 related health conditions. You also have the option to receive care in New York City at one of the Program's eight Clinical Centers of Excellence. Once your application is approved you may select where you would like to receive your care.

• Can I still keep my doctor?

  Yes. Most members continue to see their regular primary care doctor or other specialists for conditions not related to the 9/11 terrorist attacks. It is important to inform your providers of any treatments or medicines prescribed through the WTC Health Program. Good communication will help your doctors coordinate care.

• Where can I get more information?

  The call center for the WTC Health Program helps thousands of people a year with questions about the Program. Representatives are available Monday through Friday from 9:00 a.m. to 5:00 p.m. They can be reached toll-free at 1-888-982-4748. The Program's website also contains helpful information. Please visit www.cdc.gov/wtc to learn more and find application materials.