Getting‌ ‌Your‌ ‌September‌ ‌11‌ ‌Health‌ ‌Condition‌ ‌Certified‌ ‌if‌ ‌You‌ ‌ Live‌ ‌Outside‌ ‌the‌ ‌United‌ ‌States‌

Two federal programs assist individuals who were exposed to toxic dust from the September 11, 2001, terrorist attacks in Lower Manhattan, at the Pentagon, and in Shanksville, PA. One of these programs—the WTC Health Program—provides health care and monitoring for a list of certifiable 9/11-associated diseases, including many types of cancers and respiratory ailments. The second program, the September 11 Victim Compensation Fund (VCF), provides compensation for individuals with 9/11-related illnesses that have been certified through the WTC Health Program.

What happens, however, if you were exposed at one of the terrorist attack sites, are now a foreign resident living outside the continental U.S., and can’t obtain a physical exam at a WTC Health Program medical center in the New York City area or at one of the nationwide network affiliates? Can you still pursue compensation through the VCF?

The answer to that question is: Yes, you can, and an experienced 9/11 benefits attorney from Hansen & Rosasco can help. Our team has helped the first responders and survivors of the 9/11 terrorist attacks to obtain the benefits they deserve since the federal assistance programs began operating. We understand that the fateful day is now two decades into history, but the burden of the illnesses caused by exposure to the toxic dust remains a real and constant reality for many people across the world.

The Certification Process Outside the Continental U.S.

Nearly 3,000 people died and more than 6,000 suffered immediate injuries from the terrorist attacks on 9/11. Through the years, thousands more have been diagnosed with 9/11-related illnesses. Not all of these individuals were U.S. citizens, however. New York City, in particular, is a melting pot of different nationalities with foreign workers involved in every industry in the city, as well as several schools in the area that have long welcomed students from faraway shores.

Many of the non-U.S. citizens who were in Lower Manhattan on September 11, 2001, have now returned to their home country. Some U.S. citizens who suffered 9/11-related toxic exposures now also live abroad. All of them are probably eligible and likely entitled to compensation from the VCF if they develop health conditions related to 9/11.

However, by living overseas, these individuals can’t necessarily go to one of the NYC Metro area clinics for an exam necessary to meet the requirement of having their condition certified by the WTC Health Program because they don’t live near a WTC Health Program medical center or network-affiliated medical facility. Instead, they can meet the requirement by using the private physician process.

What Is the Private Physician Process?

As its name indicates, an eligible individual can use the private physician process instead of certification by the WTC Health Program. The process involves downloading and understanding guidance from the WTC Health Program as to the documentation that is required for a private, non-networked physician to prove a diagnosis of a certifiable condition.

These requirements often include the provision of diagnostic imaging scans. Once the individual submits this information with their VCF claim, the VCF can then work with the WTC Health Program to meet the complex criteria for certifying the condition.

You will also be required to submit proof that you were in the Lower Manhattan toxic exposure zone or were exposed to toxins at the Pentagon or in Shanksville during the initial attack or in the cleanup effort that followed. You must meet specific minimum requirements for your location and the length of time you were exposed to the toxins, depending on whether you were a first responder, a general responder, or an individual living, working, or attending school in the area when the attacks occurred.

Required Forms

When submitting the information requested in the private physician process packet, foreign residents should ensure that they have filled out a Treating Physician Information form for each physician that has provided treatment for the 9/11-related condition. This information includes a list of conditions for which the individual was treated by each specific physician, the earliest date of symptom onset, and the date of the first diagnosis.

The program needs information about when the individual first began showing symptoms of a certified illness because many presumptively eligible cancers have a latency period of years or even decades between when exposure occurred and when symptoms appeared. For example, the WTC Health Program has established minimum latency periods in which certain types of cancer appear.

If the interval between exposure and the onset of symptoms does not meet the latency period for that type of cancer, then the WTC Health Program may not attribute the cancer to 9/11 toxic exposure.

• Mesothelioma: The minimum latency period for 9/11-related mesothelioma is 11 years after direct exposure to asbestos-containing toxins.
• Most solid cancers: Four years minimum latency period, based on low estimates used for lifetime risk monitoring and low-level ionizing radiation studies.
• Lymphoproliferative and hematopoietic cancers, including all types of leukemia and lymphoma: 146 days minimum latency, based on low estimates used for lifetime risk monitoring and low-level ionizing radiation studies.
• Thyroid cancer: 2.5 years minimum latency, based on low estimates used for lifetime risk monitoring and low-level ionizing radiation studies.
• Most childhood cancers: One-year minimum latency, based on National Academy of Sciences findings.

You will also likely need to authorize the release of medical records, which the VCF and the WTC Health Program may use to review your medical documentation and collaborate to determine certification eligibility. You must print out the private physician process coversheet to submit with your claim. Foreign residents should use their national identification number or passport number for the applicable spaces on the claim form.

About the VCF

The September 11th Victim Compensation Fund was initially created in 2001 to compensate those who suffered physical harm because of the terrorist attacks. The initial VCF compensated 9/11 victims until it was closed in 2004. In 2011, the James Zadroga 9/11 Health and Compensation Act was signed into law by President Barack Obama with expanded eligibility guidelines, new filing deadlines, and limited funding. The act was reauthorized in 2015, and then permanently authorized by then-President Donald Trump in 2019 for full funding through October 1, 2090.

To obtain compensation for your illness, injury, or condition, including wage loss, out-of-pocket expenses, and pain and suffering, or to obtain wrongful death compensation if your family member died from a 9/11-related ailment, you must register with the VCF.

U.S. citizens must complete registration with the VCF by July 29, 2021, if they obtained certification of their eligible condition before July 29, 2019, or their loved one died of a 9/11-related condition before that date. All others have two years from the certification date to register. If a foreign resident cannot obtain certification of a condition by a WTC Health Program provider, they must use the private physician process instead. The dates can be complicated, so it you are not sure if you have or can meet the deadline, you are urged to contact an experienced 9/11 attorney for answers.

About the WTC Health Program

The WTC Health Program was created by the Zadroga Act in 2011 and has been continually authorized for funding alongside the VCF, with current reauthorization extended to October 1, 2090. The program provides health care services and monitoring for individuals — first responders and downton workers and residents — who were exposed to the toxic dust in the NYC disaster area any time from 9/11 through July 31, 2002 or at one of the other terrorist attack sites.

While the program provides this service to any eligible individual who meets the exposure and time requirements, individuals must access health care services at a WTC Health Program medical center or an affiliated network physician across the nation. This means the services are largely unavailable for foreign residents.

However, because the VCF requires certification of conditions to compensate individuals who suffered a 9/11-related condition and are now living outside the country, the private physician process allows these individuals to claim damages and obtain the physical exam and diagnostic testing they would have received through the VCF.

Are You a Foreign Resident Seeking VCF Funds?

Ten years after 9/11, scientists finally released information as to the contents of the dust cloud that formed over Lower Manhattan because of the planes crashing and the collapse of the Twin Towers, which included:

• 91,000 liters of jet fuel and 10,000,000 tons of building materials, heated to a temperature of about 1,000 degrees Celsius.
• Hundreds of tons of asbestos, which were used in the buildings as a flame retardant. A quarter of the dust samples taken from the area in the days and weeks after the attack measured over the threshold for significant exposure risk.
• Dioxin from melted plastic. After the September 11 attacks in Lower Manhattan, the highest ambient measurements of dioxin in the world were recorded in the area, with exposure levels 100 times higher than those found downwind of a garbage incinerator.
• Lead, which was used to make the electric cables in the towers flexible.
• Polychlorinated biphenyls, which are used in electrical transformers. PCBs are toxic on their own, but even more so when exposed to high heat, such as at Ground Zero on 9/11.
• Gypsum from the drywall in the buildings.
• Concrete.

The debris from the collapse of the World Trade Center towers smoldered for months after the attack, releasing a continual mix of toxic fumes into the air that continued to provide carcinogenic exposure to responders, cleanup workers, and survivors in the area. This toxic plume did not discriminate between nationalities, and neither does the September 11 Victim Compensation Fund.

People from more than 90 countries experienced fatalities on 9/11. The U.S. saw the most, with 2,624 fatalities from the initial event, with thousands more following in later years due to 9/11 related diseases. The UK lost 67 citizens in the initial attacks, 47 were from the Dominican Republic, 41 were from India, and 28 were from South Korea. There were 24 fatalities apiece for Japan and Canada on the day of the attacks, with many more nationals from those countries exposed.

Anyone who meets the eligibility criteria for location, exposure, and diagnosis of a condition in accordance with WTC Health Program minimum standards may recover compensation, even if they don’t hold a U.S. passport or even if they were undocumented.

The experienced 9/11 benefits attorneys from Hansen & Rosasco have a deep understanding of the private physician process and we are happy to provide this knowledge to foreign residents affected by the September 11 attacks. We can:

• Provide a free case evaluation, which is time for you to talk with one of our attorneys, learn more about our firm, obtain answers to questions you have about your specific case, and learn about your legal options for obtaining compensation through the VCF.
• Ensure the required documents for your private physician process and your VCF claim are complete and included in your submission.
• Push for an expedited review of cases involving clients with emergency circumstances if the program’s standard “first in, first out” method of prioritizing claims would cause extreme hardship.
• Appeal a decision on your claim.

Helping individuals who were exposed to toxins on September 11, 2001, obtain the compensation and health care monitoring that the federal government has promised them is the focus of our entire firm. Let our 9/11 attorneys put our experience to work for you. For your free case evaluation, contact us online or by calling (855) 353-4907.