The National Institute for Occupational Safety and Health last week put out a final rule that added about 60 cancers to be covered under the James Zadroga 9/11 Health and Compensation Act. That means responders and some survivors will be eligible for cancer screening and treatment and can apply for compensation for their cancer under the victims' compensation fund.
Q When can someone start to get treatment?
That's unclear. The rule doesn't go into effect until Oct. 12. In the meantime, NIOSH is putting together final guidelines that will detail how someone gets certified for treatment.
Q How will that work?
It will be a two-step process. In the metropolitan area, the person will have to see a doctor at one of NIOSH's clinical centers. According to Dr. Benjamin Luft, director of the World Trade Center Health Program in Suffolk, Nassau and Brooklyn, doctors will look to see that the person had "very clear environmental exposure." That will include how long and intense his or her exposure to toxins was. They will also require a cancer tissue sample, he said. The application will then be sent to NIOSH administrator Dr. John Howard, who have the final say on who is certified.
Q So just because someone has one of the 60 cancers doesn't automatically mean his or her cancer will be certified?
Right. The rule states "the inclusion of a condition on the list of WTC-related health conditions, in and of itself, does not guarantee that a particular individual's condition will be certified as eligible for treatment."
Q If a person is certified, what kind of treatment does he or she get?
For responders, the health program will provide and pay for all cancer treatments, drugs and services, Luft said. For survivors, the program is the "payer of last resort," meaning that if the person already has health insurance, that will supersede, he said. The health program will reimburse any out-of-pocket costs.
Q What about looking for cancers in those who aren't yet diagnosed?
Screening for colorectal cancer will be covered for those age 50 to 75. Mammograms will be offered every two years to women beginning at age 40.
Q How much will cancer treatments cost?
NIOSH estimates covering all the cancers would cost between $65 million and $147.5 million from 2013 to 2016, when the program is set to end. This is based on two sets of calculations. In the low end, it assumes that 60,000 responders and survivors -- the number in the WTC health program now -- will get cancer at the same rate as the U.S. population average. In the higher figure, it assumes 110,000 responders and survivors -- the maximum that can join the program -- will have a 21 percent higher incidence of cancer.
Q Is there enough money to pay for it?
The Zadroga Act allocates $1.5 billion for the health program until 2016. "Within the short term, there is money," Luft said. "The real concern is what if there's an upsurge in cancer in the next few years."
Q Will the compensation fund rely on the medical certification done by the WTC health program?
The Zadroga Act also set aside $2.8 billion to compensate responders and others for 9/11 illnesses. Generally, if a cancer sufferer's condition has been certified for treatment, he or she won't have to submit another set of medical records.
Q When will cancer sufferers be able to apply to the compensation fund?
They can submit cancer claims now by using the injury category "other." The U.S. Department of Justice is updating the application form.
Q Cancer has killed some first responders already. Can their families apply for compensation?
Yes. The fund will accept claims filed by their personal representatives.