The World Trade Center Program Benefits
According to the U.S. Centers for Disease Control and Prevention (CDC), the World Trade Center (WTC) Health Program provides medical monitoring and treatment for emergency responders, recovery and cleanup workers, and volunteers who helped after the terrorist attacks of September 11, 2001 at the World Trade Center in Manhattan; the Pentagon in Washington, D.C.; and the crash site near Shanksville, Pennsylvania.
The WTC Health Program provides health evaluations and treatment for eligible people exposed to the dust cloud on 9/11 or who worked, resided, or attended school or childcare in the New York City disaster area for a period of time on 9/11 and/or during the following months.
Other WTC Health Program Benefits
The WTC Health Program provides an array of benefits to eligible individuals, as well as conducting continuing research. Specifically, the WTC Program provides education and outreach to potentially eligible individuals, collection and analysis of physical and mental health data with members’ permission; and research to better understand health conditions related to the attacks.
Another benefit of the WTC Program is that there are no out-of-pocket costs for members who use healthcare providers approved by the Program for eligible medical evaluation, monitoring, and treatment and who use pharmacies that participate in the Program to fill any prescriptions given for a WTC-related health condition by an approved Program healthcare provider. The specific information is available on the website for the CDC at CDC.gov.
Responders who enroll in the WTC Health Program will receive yearly medical monitoring. Should an individual be diagnosed with a health condition or conditions certified as a WTC-related health condition, the WTC Health Program’s healthcare providers would provide quality medical treatment for that WTC-related health condition or conditions.
A WTC-related health condition is “an illness or health condition for which exposure to airborne toxins, other hazards, or other adverse conditions resulting from the September 11, 2001, terrorist attacks that was substantially likely to be a significant factor in aggravating, contributing to, or causing the illness or health condition,” according to the CDC.gov.
How does the WTC Health Program Work?
Survivors who enroll in the program will receive an initial health evaluation. This evaluation is conducted to determine if the survivor suffers from a health condition eligible for coverage by the WTC Health Program, according to the CDC.gov.
If you are diagnosed with a health condition that is deemed WTC-related, the doctor will request that the WTC Health Program certify the condition(s) as eligible for treatment under the Program. Once it is determined that an individual is diagnosed with a health condition(s) certified as a WTC-related health condition as defined by the Zadroga Act, the WTC Health Program’s healthcare providers will provide medical treatment for the WTC-related health condition.
The WTC Health Program must certify the evaluation and diagnosis to allow treatment for the specific health condition(s) through the patient’s Clinical Center of Excellence or the Nationwide Provider Network.
WTC Health Program Coverage for Inpatient and Dental Care
Inpatient care is covered if the reason for hospitalization is for treatment of a “strongly suspected or certified WTC-related health condition.” In so, the WTC Health Program will pay for inpatient care.
Inpatient needs should be discussed with the patient’s Clinical Center of Excellence or the Nationwide Provider Network. This information is provided at the time of original certification.
In some cases, dental care is covered under the Program if deemed for a medically necessary dental care for members diagnosed with a certified WTC-related head and neck cancer.
Availability of Diagnostic and Treatment Services
The WTC Health Program will cover all medically necessary diagnostic evaluation and treatment costs for WTC-related health conditions. These include inpatient and outpatient medical procedures and prescribed medications.
During the diagnostic work-up, if an individual’s provider determines that patient does not have a covered health condition or the health condition is not related to 9/11 terrorist site exposures, the Clinical Center of Excellence will assist the individual in finding medical care outside the WTC Health Program. The WTC Health Program will no longer pay for services related to those conditions.
Medically necessary means that the treatment has been shown to manage, cure, or improve a WTC-related health condition or a sickness that was caused by a WTC-related condition. This is also known as a medically associated condition.
Is My WTC Health Program Care Covered If I Am Seeing My Personal Physician?
Although patients may continue to see their personal physicians, if a physician is not affiliated with the WTC Health Program, any treatment or services received from him or her will not be reimbursed by the WTC Health Program.
For a WTC Health Program member to obtain coverage for the treatment of any health condition on the List of WTC-Related Health Conditions—including any cancer on the List—the condition must certified by the WTC Health Program.
All care for the WTC Health Program must be provided by a healthcare provider affiliated with the WTC Health Program. Should a patient’s current provider be affiliated with the WTC Health Program, certified patients will be able to continue seeing their physicians.
If the current provider is not affiliated, the provider should contact the patient’s Clinical Center of Excellence or the Nationwide Provider Network to determine if it is possible to become a WTC Health Program provider.
Details on this information, as well as the location of National Provider Network physicians and Clinical Centers of Excellence are available on CDC.gov.
If I Feel Okay, Should I Schedule A Monitoring Exam?
Everyone eligible for medical monitoring within the WTC Health Program is strongly encouraged to participate in regular monitoring exams. The exam may detect changes in body function that patients are not aware of and that may be corrected or slowed with early intervention.
Also, although the primary focus of the WTC Health Program is to assess patient health, the information that is learned about 9/11 responders will be very valuable in understanding how to protect workers in the event of future emergency or disaster operations.
Questions Concerning the Zadroga Act’s WTC Health Program
Parker Waichman promises to continue its efforts to protect those who were exposed to Ground Zero’s toxic cloud and the trauma of the 9/11 attacks, and ensure that all the deserved Zadroga Act compensation is received.
To determine your eligibility for WTC Program benefits, the illnesses covered, and filing a claim, please contact our experienced team of Zadroga Act attorneys.
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