When World Trade Center health issues make headlines, the stories are usually about first-responders who played a documented role in the rescue and recovery activity at the site.

There are also dozens of offices for Federal, state, and municipal agencies located within lower Manhattan and portions of Brooklyn on streets that public-health officials have said were contaminated by the toxins released by the jets flying into the Twin Towers and building collapses—which also included 7 World Trade Center—that followed. 

That means public employees who reported to their jobs in those places may have also been exposed to the WTC toxins that have already killed thousands and caused at least 10,000 cases of cancer.

Under the 9/11 Zadroga Health and Compensation Act, those employees who reported for work in contaminated locations but cannot claim that they were WTC first-responders are defined as survivors.

As explained at an Oct. 19 9/11 WTC Health Symposium convened by Manhattan Borough President Gale Brewer, there are important differences between how the WTC Health Program functions for those defined as first-responders and those considered survivors. 

WTC first-responders automatically get screening and lifelong monitoring. Survivors get screening, but only if they can demonstrate they have symptoms of a potential WTC health condition.

'No Real Screening Option'

“The survivor program doesn’t really have a screening option,” said Kimberly Flynn, executive director with 9/11 Environmental Action, during an interview. “So it is people who have symptoms who need to apply to the World Trade Center Health Program Survivor program now.”

“In the survivor program, one has to have a certifiable condition to stay in the program and be monitored,” Dr. Joan Reibman, medical director of the WTC Environmental Health Center, told a capacity crowd at Ms. Brewer’s One Centre St. offices.

She said that last year the survivors' program was deluged by new applications to the point that the agency was “very, very much overwhelmed...so there were delays in scheduling new patients, as well as delays in follow-ups and monitoring as well…By August of 2018 we had 2,800 new enrollees that had no appointment.”

Dr. Reibman said the program has added additional staff and health providers, as well as opened a new clinic on William St.

Billing Differences

She said another critical difference between the first-responder and survivor WTC programs is how their respective health-care costs are covered. For first-responders, the WTC program is the primary payer, but for survivors the WTC program kicks in only after the participant’s primary insurance carrier has been billed.

There’s also a significant variation in the geographical boundaries to be eligible for payouts from the 9/11 Victims Compensation Fund and the far-more-inclusive zone that qualifies an applicant to be a participant as a survivor in the WTC Health Program.

For VCF applicants, exposure has to have occurred south of Canal St. The WTC Health Program draws the line south of Houston St. and includes portions of Brooklyn.

“It includes Brooklyn Heights, Dumbo, and downtown Brooklyn—residents and workers in all those places have access to the WTC Health Program,” said Ms. Flynn, whose non-profit helped set up Ms. Brewer’s symposium.

Both survivors and first-responders are entitled to apply for a VCF monetary award, but only if they lived or worked in lower Manhattan south of Canal St.

Impact on Pensions

This distinction between being a WTC survivor and first-responder also has implications when it comes to pension and retirement issues.

“This is a very important distinction that could become an important issue if you have to go before a board like the New York City Employees' Retirement System on a disability claim,” Jeffrey Goldberg, a disability attorney, said in a phone interview. “We know that thousands of Federal, state and municipal workers were ordered to return to their lower-Manhattan offices based on the very public representations made by then-EPA Administrator Christie Whitman.”

Based on the latest statistics on the WTC Health Program’s website, there are close to 71,800 first-responders enrolled out of a possible universe of 90,000 who participated. Officials estimate there are about 400,000 survivors, which includes local residents, students attending school and private-sector employees working in lower Manhattan. About 16,600 of the survivors are in the WTC Health Program.

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