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How Is My Disability Evaluated by the WTC Health Program?

The WTC Health Program provides medical monitoring and health services at no cost for responders and survivors suffering from 9/11-related health conditions. While it is separate from the September 11th Victim Compensation Fund, the two organizations work closely together. Responders and survivors with eligible conditions (i.e., any form of cancer, asthma, etc.) need to have them certified by the WTC Health Program to receive compensation from the VCF. 

The WTC Health Program also works with the VCF to perform disability evaluations for responders and survivors who have suffered disabilities due to their eligible 9/11-related health conditions but have not been determined fully or partially disabled by Workers’ Compensation, the Social Security Administration, or another third-party entity. 

What Makes Me Eligible for a WTC Health Program Disability Evaluation?

The WTC Health Program disability evaluation process is designed to help qualifying claimants with a disability determination for an eligible condition in order to support an economic loss claim to VCF.

However, the WTC Health Program disability evaluation process is not for everyone.  It is intended for claimants who have a disabling eligible condition, and do not have a disability determination for that eligible condition from one of the standard third-party entities (Social Security Administration, NYCERS, Con Ed, NYPD/FDNY, etc.).

To be eligible for a disability evaluation by the WTC Health Program, you must meet the following criteria:

  • Be enrolled in the WTC Health Program
  • Have the claimed disabling eligible condition certified by the WTC Health Program
  • Be unemployed or earning less income than you were prior to the eligible disability affecting your ability to work

Additionally, you must not have a prior disability determination for your eligible condition from a third-party entity. Those employed by the FDNY or NYPD, or who are eligible for pension benefits from NYCERS or NYSLRS, are generally not eligible for a WTC Health Program Disability Evaluation because there are separate processes available for those claimants to seek disability determinations. Exceptions may be made on appeal. 

What Steps Do I Need to Take to Be Evaluated for Disability by the WTC Health Program?

The VCF identifies those who meet the criteria for a WTC Health Program disability evaluation during its claim review process. However, if you’re eligible, you may also request that the VCF consider you for the process.

The VCF allows you to resubmit a request for a disability evaluation once you’ve been found to be eligible for at least one certified condition — even if you previously requested an evaluation before your condition was certified. You can also amend your claim after a loss determination was issued.

The VCF requires that you submit several documents in support of your disability evaluation request — you must include a statement confirming that a third-party did not previously determine you were found fully disabled based on your eligible 9/11-related health condition, a Social Security Administration Consent Form, evidence of earnings history, and medical documents related to your eligible condition.

What Happens After I’m Evaluated for Disability by the WTC Health Program?

If the VCF determines you’re a candidate for the WTC Health Program evaluation process, your claim status is placed “on hold.” After you’ve had your evaluation with the WTC Health Program, the physician’s report will be mailed to you. Once you receive the report, it must be provided to the VCF for review.

Contact a New York City 9/11 Victim Compensation Fund Attorney

If you were a 9/11 responder or survivor and have a disability in connection with your eligible 9/11-related health condition, you may be entitled to compensation from the VCF. The September 11th Victim Compensation Fund was set up to ensure that you are compensated for your injuries and the medical expenses associated with its treatment. 

 

The WTC Health Program disability evaluation process can be confusing, frustrating, and complicated. A 9/11 Victim Compensation Fund attorney who is knowledgeable about the regulations and procedures involved can guide you through the disability evaluation and VCF claims process to help ensure that you receive the compensation to which you are entitled from the VCF. The 9/11 Victim Compensation Fund attorneys at The Dearie Law Firm, P.C. have represented claimants and their families in 9/11 VCF claims for over a decade. For a free consultation, contact us today. 

John P. Dearie

John P. Dearie is a graduate of Regis High School, The University of Notre Dame, and St. John’s University School of Law. After working at a corporate law firm in New York City for two years following law school graduation, he joined The Dearie Law Firm in 2011.

John represents injured New Yorkers in third-party negligence litigations, as well as first responders, workers, volunteers and residents in claims to the September 11th Victim Compensation Fund.