Letters and Statements From The Administrator

WTC Final Rule Statement

On March 28th, 2013, the World Trade Center Health Program published in the Federal Register an Interim Final Rule on the eligibility criteria for responders to receive care and treatment following the terrorist attacks at the Pentagon and in Shanksville, Pennsylvania on September 11, 2001. This action marks a major step in opening enrollment and membership in the World Trade Center Health Program to this new group of responders.

This Interim Final Rule will go into effect on May 1st, 2013. During the preceding 30-day comment period, members of the public have the opportunity to submit comments, opinions, and recommendations prior to this date. To view the Interim Final Rule and instructions for public comment: https://federalregister.gov/a/2013-07146

Frequently Asked Questions: Pentagon and Shanksville Responders

Who is affected by this rule?
The eligible population includes responders at the Pentagon and in Shanksville, Pennsylvania site including:
  • Members of a fire or police department (whether fire or emergency personnel, active or retired)
  • Workers for a recovery or cleanup contractor
  • Volunteers who performed rescue, recovery, demolition, debris cleanup, or other related services at either site
Have Pentagon and Shanksville responders been able to enroll in the program before now?

No. While the Act clearly defined WTC Health Program eligibility criteria for New York responders, the Administrator was required to develop criteria for the enrollment of Pentagon and Shanksville responders. This rule establishes those eligibility criteria.

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 eligible 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, except for musculoskeletal disorders, as per program protocols, including inpatient and outpatient medical procedures and prescribed medications. If during the diagnostic work up, a program provider determines that you do not have a covered condition, the clinic will assist you in finding medical care, but the program will not pay for these services related to a non-covered health condition. The list of conditions is below.

  • 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
  • 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
  • Specified types of cancer
    • 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)

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 any monitoring, diagnostic, and treatment services you receive for 9/11-related health conditions
  • Use pharmacies that are participating in the program to fill any prescriptions you are given by a program provider for an eligible condition related to 9/11

Does the interim final rule allow me to apply to the Victim Compensation Fund for and collect compensation for injuries or illnesses as a Pentagon or Shanksville responder?

The Victim Compensation Fund (VCF) provides compensation for any individual (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. For information about the VCF visit www.vcf.gov or call 1-855-885-1555.

Is this rule final?

Upon its effective date, an interim final rule has the same legal effect and authority as a final rule. Following consideration of public comment, the Administrator will issue a final rule in order to conclude the rulemaking process, even if no substantive changes are made to the rule.

When will the Interim Final Rule go into effect?

This interim final rule will be effective on May 1st, 30 days after publication in the Federal Register. However, if during the 30 day period the Administrator receives significant comments which result in substantial changes to the rule, those parts of the rule may be withdrawn.