9/11 Benefits Lawyer

Does the VCF Receive Copies of My Medical Records from the WTC Health Program

By Troy Rosasco

Do I Need to Submit Them With My Claim?

Yes, the VCF will receive certain copies of your 9/11 related medical records from the WTC Health Program  . When you sign the “VCF form Exhibit A” you give the WTC Health Program the permission to share medical information with the  9/11 Victim Compensation Fund.  Specifically, when you sign this document, you give permission to your doctors, health care providers or other entities listed below to disclose your health information to the September 11th Victim Compensation Fund (VCF), the United States Department of Justice (DOJ), and the World Trade Center (WTC) Health Program administered by the National Institute for Occupational Safety and Health (NIOSH) for purposes of evaluating your claim for compensation to the VCF. By signing this document, you also give permission to the VCF to disclose your health information to the WTC Health Program and to the WTC Health Program to disclose your health information to the VCF for the purpose of evaluating your claim for compensation under the VCF.

You may also be required to submit some medical records to the 9/11 Victim Compensation Fund directly with your claim. The paralegals at Hansen & Rosasco will do this for you.

The WTC Health Program, developed to aid victims of the 9/11 attacks as they seek medical care for conditions developed as a result of dust cloud exposure following the terrorist attacks, provides free medical care to those victims. It, along with the VCF, compensates victims for the losses they suffered in connection with 9/11t.

The VCF and the WTC Health Program, while they have a shared purpose and offer benefits to the same population of 9/11 victims and survivors, are separate entities with distinct structures. The WTC Health Program does not automatically submit records to the VCF, and the status or outcome of your VCF claim does not impact your treatment through the WTC Health Program.

However, you may need to submit WTC Health Program records to the VCF to establish your VCF claim, so let’s take a closer look at both.

What Does the WTC Health Program Do?

The WTC Health Program provides monitoring services and health care for individuals impacted by the 9/11 attacks. In addition to screening for a variety of conditions, including cancer and respiratory ailments that many people in the area suffered because of their involvement at or around Ground Zero or in Lower Manhattan following the attacks, the WTC Health Program provides free treatment for a host of WTC related “covered medical conditions. Immediately after the attacks, the WTC Health Program also helped provide treatment for traumatic injuries.

Covered individuals may include:

  • Those who lived and/or worked in Lower Manhattan and faced dust cloud exposure as a result
  • Students who attended school, including preschool or elementary school, in Lower Manhattan
  • First responders at the scene of the attacks
  • Volunteers who came to aid in recovery following the attacks
  • Volunteers and employees who aided with cleanup after the attacks, including removing debris from the scene

While the WTC Health Program serves the same people who have the right to compensation through the VCF, it does not automatically submit records to it.

What Information Does the WTC Health Program Submit to the VCF?

The WTC Health Program does submit some information to the VCF.

That information includes:

  • The name of the condition with which you have been diagnosed and “certified”.
  • The WTC Health Program category under which the condition falls (for example, Cancer or Upper Respiratory Disorder)
  • The associated medical diagnosis code

If the WTC Health Program notifies you that you have received a diagnosis of a VCF-certified condition, you can use that information to inform your decision to file a claim through the VCF.

Why Does the VCF Need to See My Medical Records?

Your medical records contain important information about the extent of your injuries and, therefore, how they impact your life. If you used the WTC Health Program for your medical care, then you may not have as many direct economic expenses related to your VCF claim as someone who did not use the Program (and thus incurred medical costs). As a result, you will not need to show medical bills to establish grounds for your VCF claim.

However, your medical records, as distinct from your medical bills, will show several key pieces of information that can help establish the non-economic damages related to your VCF claim, namely:

Your Exact Diagnosis and/or Conditions

To receive compensation through the VCF, you will need to demonstrate that you have a specific diagnosis or condition covered by the program, and that condition occurred because of your exposure to the dust cloud on 9/11 or due to your direct involvement at the scene. Your medical records serve to establish your exact diagnosis and any secondary conditions caused by that problem.

The Severity of Your Diagnosis

While no one wants to receive a cancer diagnosis or a diagnosis of mesothelioma, the severity of those diseases may depend on how long it went undetected and the extent of your symptoms. Some patients may have much more severe cases, requiring more in-depth treatment than others. Medical records establish that relative degree of severity.

The Length of Your Treatment

Your medical records show how long your treatment for a covered condition has gone on: when it started, how long you pursued treatment, and any gaps in treatment when you may have had the chance to resume your usual activities. It will also give the VCF a look at how long you underwent treatments and, therefore, the degree to which those treatments may have impacted your life, such as by preventing you from going about your usual daily tasks or causing you to miss work.

Are You Eligible for 9/11 Related Social Security Disability?

Often, severe 9/11 certified covered conditions and the treatments associated with them can leave you with long-term limitations even after you win your battle with an illness. If you cannot work due to your 9/11 related health condition, you should apply for 9/11 related Social Security Disability (SSD) benefits. In addition to receiving both monthly cash benefits and Medicare for non-9/11 related  medical conditions, For example, if you suffer from bone cancer that results in limb amputation, then you will permanently lose that limb and face those challenges, and the expenses that may go along with them.

Likewise, if you have lung cancer, then you may sustain long-term lung damage that prevents you from engaging in your usual activities. Even chemotherapy can sap your strength or leave you with a compromised immune system with a diminished ability to fight off common illnesses.

Your medical records can help show those limitations and give the VCF an idea of how they impact your life, which can make it easier to determine both the economic impact and the non-economic impact associated with your claim.

Should I Submit My Medical Records as Part of My Claim?

Every case differs, but submitting medical records to support your VCF claim can help you obtain maximum compensation.

As discussed above, your medical records serve as a vital piece of evidence of your diagnosis and its severity, no matter whether you received treatment through the WTC Health Program or you received or paid for treatment from a non-Program provider.

You may have heard, however, that you do not need to submit your medical records to receive VCF claim benefits.

For instance, you may have found this language on the VCF website,

“If the WTC Health Program has certified your condition, you do not need to submit medical records to support a claim for non-economic loss at the lowest end of the range for your eligible condition. Similarly, if you have an eligible condition the VCF has identified as presumptively severe and debilitating, you do not need to submit medical records to qualify for the highest non-economic loss award allowed by the statutory caps.”

It is true, in other words, that as a victim affected by the 9/11 attacks, you may apply for VCF benefits without submitting medical records in support of your claim, if you received treatment through the WTC Health Program and the Program has certified your condition.

However, that does not mean it is always in your interest to forego submitting medical records. For one thing, you will likely need to submit medical records related to any 9/11-related health condition, or secondary condition, treated outside of the WTC Health Program.

For another, even if you received WTC Health Program treatment, you may yet want to submit your medical records in support of a VCF claim, for several reasons.

1. You want to increase the amount you claim under non-economic damages.

You may not have to submit your WTC Health Program records, or other medical records, to qualify for the minimum non-economic damages awarded to victims with that diagnosis. However, in many cases, that amount may not accurately reflect the full extent of the harm you have suffered.

Talk to an experienced VCF claims attorney about the compensation you deserve. It may far exceed the minimum award, and if so, then you may have the right to apply for additional non-economic damages. In that case, you may need to submit your medical records as evidence.

2. You need to show a secondary diagnosis.

In some cases, you may have a secondary diagnosis not included with your initial qualifying condition, but which may increase the amount of compensation you have a right to receive from the VCF. To prove the existence, nature, and severity of that condition, and its impact on your life, you may need to submit medical records in support of your claim. Talk to an experienced VCF claim attorney about how you might go about proving your secondary diagnosis (whether or not it was treated through the WTC Health Program).

3. Your condition is not considered “presumptively severe and debilitating”.

Patients diagnosed with “presumptively severe and debilitating” 9/11-related health conditions certified by the WTC Health Program can obtain the highest allowed amount of non-economic damages from the VCF without submitting documentation.

If your condition does not qualify as “presumptively severe and debilitating”, however, obtaining maximum non-economic damages may require providing extra information to the VCF.

Medical records supporting a request for higher non-economic may include information about the scans and tests you went through, the treatments you received, and what losses you faced as a result of your diagnosis. Through those records, the VCF can assess the extent of your non-economic losses related to that diagnosis, which can help you acquire additional compensation for those losses.

What Portion of My Medical Records Do I Need to Provide?

Your medical records can serve as vital evidence in your VCF claim since they establish the extent of your diagnosis and the pain and suffering you faced because of the terrorist attacks. However, that does not mean that you need to submit your full WTC Health Program record, including every treatment you ever received or every scan you ever went through.

In some cases, you may want to submit a statement from your doctor, rather than your existing medical records.

That statement should summarize the medical care you have received, including:

  • What treatments and testing you have received
  • What symptoms you have suffered
  • How your illness and treatments have impacted you
  • Your long-term prognosis related to those injuries and treatments

The VCF itself generally recommends that you do not submit your full medical records with your claim. The full medical records associated with a cancer diagnosis and treatment can take a long time to go through. Instead, you may want to submit only the specific records that establish the extent of your losses and what you have suffered.

Talk to an experienced VCF claim attorney to learn more about what records you may need to provide and how to determine which portion of your medical records to submit as part of your claim.

Is There Anything I Need to Do to Streamline Handling of My Medical Records?

Many victims of the 9/11 attacks do not begin the VCF claim process until they have bills piling up or a genuine, pressing need for funds. Unfortunately, it can take time to process your VCF claim and to receive the compensation you deserve. You can, however, take several steps that may decrease the time needed to handle your medical records, assess the extent of your losses, and process your claim.

1. Submit only needed documents.

You should submit only medical records that relate directly to the conditions you face as a result of your presence at or near Ground Zero. Do not submit full medical records, including medical records from before your diagnosis or that involve unrelated health conditions.

If, for example, you broke your leg in a car accident and needed surgery and physical therapy to hear from it, the VCF probably does not need to see those records, even if you suffered the injury in the same time-frame as receiving 9/11-related cancer treatment. Unrelated information will only slow down your claim and extend the time when you may receive compensation.

If you have questions about distinguishing between related and unrelated health conditions, and the medical records showing them, speak with an experienced 9/11 VCF claim attorney.

2. Highlight relevant information.

The VCF website recommends highlighting relevant information in the records you submit. That highlighted content can make it easier for reviewers evaluating your claim to absorb the information pertinent to understanding the nature and extent of your illness.

Talk to your attorney about the specific records you need to include and how to eliminate unnecessary medical information from your claim filing. If you have specific challenges that may require you to receive that compensation sooner, including a pending eviction or trouble paying your utility bills, the VCF can streamline your claim.

For answers to your questions about submitting your medical records as part of a VCF claim, and for assistance filing your claim, contact an experienced 9/11claim attorney today.

Posted under: The Victims' Compensation Fund

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