1. WTC Assistance Programs Theresa Gorman, MPH Health and Safety Assistant IAFF Department of Occupational Health and Safety September 2013

2. Today’s Presentation Recent 9/11 legislationRecent 9/11 legislation Resources for 9/11 responders:Resources for 9/11 responders: World Trade Center Health ProgramWorld Trade Center Health Program 9/11 Victim Compensation Fund9/11 Victim Compensation Fund IAFF outreach effortsIAFF outreach efforts

3. James Zadroga 9/11 Health and Compensation Act of 2010 Signed into law in January 2011, allocating federal funds to provide health care and financial aid for workers and residents affected by 9/11: Reopened the 9/11 Victim Compensation FundReopened the 9/11 Victim Compensation Fund Established the WTC Health ProgramEstablished the WTC Health Program Established a list of health conditions to be covered by the WTC Health ProgramEstablished a list of health conditions to be covered by the WTC Health Program Created a process that allows this list to be updated based on emerging scientific evidenceCreated a process that allows this list to be updated based on emerging scientific evidence

4. Programs for 9/11 Responders Two different programs with different enrollment applications: WTC Health ProgramWTC Health Program Administered by the National Institute for Occupational Safety and Health (NIOSH)Administered by the National Institute for Occupational Safety and Health (NIOSH) Provides responders with free medical monitoring exams and treatment for 9/11-related health conditionsProvides responders with free medical monitoring exams and treatment for 9/11-related health conditions 9/11 Victim Compensation Fund9/11 Victim Compensation Fund Administered by the Department of JusticeAdministered by the Department of Justice Provides financial compensation for sick or injured responders or family of deceased respondersProvides financial compensation for sick or injured responders or family of deceased responders

5. The WTC Health Program replaces the Mt. Sinai WTC Medical Monitoring program If you were enrolled in the WTC Medical Monitoring program, you are automatically enrolled in the WTC Health ProgramIf you were enrolled in the WTC Medical Monitoring program, you are automatically enrolled in the WTC Health Program No re-enrollment is necessaryNo re-enrollment is necessary You can enroll in the program even if you do not live in the NYC area You do not need to travel to NYC to see a doctor or to enroll in the programYou do not need to travel to NYC to see a doctor or to enroll in the program Through the Nationwide Provider Network, you can visit a clinic close to where you liveThrough the Nationwide Provider Network, you can visit a clinic close to where you live The WTC Health Program

6. How does the Nationwide Provider Network work? Provides referrals to physicians and specialists for monitoring and treatmentProvides referrals to physicians and specialists for monitoring and treatment Each responder is assigned a nurse case manager to identify the responder’s health care needs and locate an appropriate provider near your homeEach responder is assigned a nurse case manager to identify the responder’s health care needs and locate an appropriate provider near your home Three part process: medical history questionnaire, diagnostic testing, and clinical evaluationThree part process: medical history questionnaire, diagnostic testing, and clinical evaluation The WTC Health Program

7. What are the benefits of enrolling? Provides responders with free annual health screenings that evaluate physical and mental health statusProvides responders with free annual health screenings that evaluate physical and mental health status Provides free medical care for conditions certified to be caused, contributed to, and/or aggravated by 9/11Provides free medical care for conditions certified to be caused, contributed to, and/or aggravated by 9/11 Medical testsMedical tests Doctor visitsDoctor visits SurgerySurgery Prescription drugsPrescription drugs The WTC Health Program

8. Health Conditions Covered by the Program Airways and Digestive Disorders: AsthmaAsthma Chronic coughChronic cough Chronic laryngitisChronic laryngitis Chronic nasopharyngitisChronic nasopharyngitis Chronic rhinosinusitisChronic rhinosinusitis Gastroesophageal reflux (GERD)Gastroesophageal reflux (GERD) Chronic obstructive pulmonary disease (COPD)Chronic obstructive pulmonary disease (COPD) Interstitial lung disease (scarring of the lungs)Interstitial lung disease (scarring of the lungs) Reactive airways dysfunction syndrome (RADS)Reactive airways dysfunction syndrome (RADS) Upper airway hyperreactivityUpper airway hyperreactivity Sleep apnea exacerbated by or related to above conditionsSleep apnea exacerbated by or related to above conditions

9. Health Conditions Covered by the Program Mental health conditions: Posttraumatic stress disorder (PTSD)Posttraumatic stress disorder (PTSD) DepressionDepression Panic disorderPanic disorder AnxietyAnxiety Substance abuseSubstance abuse

10. Cancers Covered by the Program Effective October 2012, cancer was added to the list of health conditions covered by the WTC Health Program based on new researchEffective October 2012, cancer was added to the list of health conditions covered by the WTC Health Program based on new research Many, but not all, cancers are coveredMany, but not all, cancers are covered A Program physician and Program Administrator must certify that the cancer resulted from exposure related to 9/11 work based on the patient’s medical historyA Program physician and Program Administrator must certify that the cancer resulted from exposure related to 9/11 work based on the patient’s medical history Once certified, the Program will pay for approved cancer treatment, drugs, and servicesOnce certified, the Program will pay for approved cancer treatment, drugs, and services

11. Lip, tongue, gum, tonsil or other oral cavityLip, tongue, gum, tonsil or other oral cavity Nose, nasal cavities, middle earNose, nasal cavities, middle ear LarynxLarynx EsophagusEsophagus StomachStomach Colon and rectumColon and rectum Liver and bile ductLiver and bile duct Trachea, bronchus, other respiratory organsTrachea, bronchus, other respiratory organs Soft tissues (sarcomas)Soft tissues (sarcomas) Retroperitoneum, peritoneum and omentumRetroperitoneum, peritoneum and omentum LungLung BreastBreast OvaryOvary Skin, including scrotal cancerSkin, including scrotal cancer Urinary bladderUrinary bladder KidneyKidney Ureter and urinary organsUreter and urinary organs ThyroidThyroid Blood and lymphoid tissuesBlood and lymphoid tissues MesotheliomaMesothelioma EyeEye Cancers Covered by the Program

12. Eligibility Requirements Who is eligible? Fire fighters who worked at the WTC, Pentagon, or Shanksville PA crash sitesFire fighters who worked at the WTC, Pentagon, or Shanksville PA crash sites FEMA response teams and other federal respondersFEMA response teams and other federal responders Behavioral health response teamsBehavioral health response teams

13. Eligibility Requirements WTC Responders: Worked at least one day from September 11, 2001 through July 31, 2002 at one of the following locations: Lower Manhattan (south of Canal Street)Lower Manhattan (south of Canal Street) WTC Site (“Ground Zero”)WTC Site (“Ground Zero”) Staten Island landfillStaten Island landfill Barge loading piersBarge loading piers

14. Pentagon Responders: Worked for at least one day from September 11, 2001 through November 19, 2001 at one of the following locations: Pentagon office buildingPentagon office building Federal Building No. 2Federal Building No. 2 Pentagon heating and sewage plantsPentagon heating and sewage plants Pentagon parking areasPentagon parking areas Fort Belvoir, VAFort Belvoir, VA Dover Port Mortuary at Dover Air Force Base, DEDover Port Mortuary at Dover Air Force Base, DE Eligibility Requirements

15. Shanksville Responders: Worked for at least one day from September 11, 2001 through October 3, 2001 at one of the following locations: Crash site in Stonycreek Township PA bounded by Route 30 (Lincoln Highway), State Route 1019 (Buckstown Road), and State Route 1007 (Lambertsville Road)Crash site in Stonycreek Township PA bounded by Route 30 (Lincoln Highway), State Route 1019 (Buckstown Road), and State Route 1007 (Lambertsville Road) Pennsylvania National Guard Armory in Friedens, PAPennsylvania National Guard Armory in Friedens, PA Eligibility Requirements

16. Enrolling in Program Benefits You and Other Emergency Responders You can enroll in the program even if you currently don’t have any health problems The medical screening may detect health conditions that you are not aware ofThe medical screening may detect health conditions that you are not aware of Measuring your health status over time can help your doctor identify any concerning trendsMeasuring your health status over time can help your doctor identify any concerning trends Information that is learned by screening healthy 9/11 workers will help protect disaster workers and respondersInformation that is learned by screening healthy 9/11 workers will help protect disaster workers and responders

17. How to Enroll in the WTC Health Program Fill out the correct applicationFill out the correct application NYC responderNYC responder Pentagon/Shanksville responderPentagon/Shanksville responder FDNY responderFDNY responder You must provide documentation showing the dates and number of hours worked at a 9/11 site:You must provide documentation showing the dates and number of hours worked at a 9/11 site: Pay stubs, command logs, letters from employer or coworker, photos, ID cards, department communications, etc.Pay stubs, command logs, letters from employer or coworker, photos, ID cards, department communications, etc. You can download the applications at: www.cdc.gov/wtcYou can download the applications at: www.cdc.gov/wtc

18. 9/11 Victim Compensation Fund Provides financial compensation for physical injuries or illnesses specified by the Zadroga Act Eligibility: Worked at any 9/11 crash site during the period between September 11, 2001 and May 30, 2002Worked at any 9/11 crash site during the period between September 11, 2001 and May 30, 2002 Sustained a physical injury or diagnosed with an illness as a direct result of work at any 9/11 crash siteSustained a physical injury or diagnosed with an illness as a direct result of work at any 9/11 crash site VCF does not cover mental health illnessesVCF does not cover mental health illnesses

19. 9/11 Victim Compensation Fund Filing a claim involves two steps: 1.Register with the VCF – fill out a registration form online 2.File a claim – file all appropriate eligibility and claim forms with the VCF by close of fund on October 3, 2016

20. To Register with the VCF Claimant CircumstancesRegistration Deadline Learned of 9/11-related physical harm or illness (excluding cancer) before October 3, 2011 October 3, 2013 Learned of 9/11-related physical harm or illness (excluding cancer) after October 3, 2011 Two years from the date of diagnosis Diagnosed with cancer resulting from the 9/11 attacks before October 12, 2012 October 12, 2014 Diagnosed with cancer resulting from the 9/11 attacks after October 12, 2012 Two years from the date of diagnosis Diagnosed with a condition not on the original list of 9/11-related illness and added to list after October 3, 2011 Two years from the date the specific health condition was added to the list of 9/11-related injuries To File a Claim with the VCF Claimant CircumstancesDeadline ALL CLAIMANTSOctober 3, 2016

21. 9/11 Victim Compensation Fund VCF registration preserves your right to file a claim in the future. Registration is easy: Apply online at vcf.govApply online at vcf.gov Create an account with a username and passwordCreate an account with a username and password You will be assigned a claim numberYou will be assigned a claim number Fill out a questionnaire about:Fill out a questionnaire about: Your 9/11 work and exposuresYour 9/11 work and exposures Any prior claim with the original VCFAny prior claim with the original VCF 9/11 related illness or injuries9/11 related illness or injuries

22. 9/11 Victim Compensation Fund Once registration is complete, you have until October 3, 2016 (date of VCF closure) to file a claimOnce registration is complete, you have until October 3, 2016 (date of VCF closure) to file a claim The VCF calculates awards on a case by case basis involving three factors:The VCF calculates awards on a case by case basis involving three factors: Economic loss (lost wages, doctor’s bills, etc.)Economic loss (lost wages, doctor’s bills, etc.) Non-economic loss (emotional pain, suffering, inconvenience, etc.)Non-economic loss (emotional pain, suffering, inconvenience, etc.) Collateral source payments (PSOB benefits, settlement payments from other 9/11 lawsuits, etc.)Collateral source payments (PSOB benefits, settlement payments from other 9/11 lawsuits, etc.)

23. 9/11 Victim Compensation Fund Contact the Victim Compensation Fund at www.vcf.gov1-855-885-1558

24. IAFF WTC Outreach Project One website for all 9/11-related health questions: wtc.iaff.org