Nell McCarthy, the deputy special master of the September 11th Victim Compensation Fund, pointed to two boxes. One contained files about 2 inches thick; the other, a file about 2 feet thick.
That, she said in the fund's nondescript Washington, D.C., offices, showed the range of differences among claims filed by 9/11 responders.
The thinner file was submitted online by a former first responder in law enforcement who had hired an experienced lawyer. The second was filed by a former deliveryman for a restaurant -- with no attorney -- and included entire notebooks containing handwritten statements in nearly indecipherable block printing that often spilled over and encircled the pages.
Both received compensation, McCarthy said. But the first -- who recently died of brain cancer -- was a fairly straightforward case and it took eight months to determine his compensation. The second -- who for a time called the VCF help line every day, even on the weekends -- was not so straightforward. That claim took 2½ years to resolve.
"I am really proud of the work we did with him," McCarthy said of the second claimant, who still calls the VCF.
McCarthy -- a former White House staffer who herself was a block from Ground Zero on Sept. 11, 2001 -- was hired in April to help expedite claims for ailing responders under the $2.775 billion James Zadroga 9/11 Health and Compensation Act of 2010. The VCF had come under heavy criticism for the glacial pace and small number of payments made; in 2013 only about 1 percent of responders who had filed eligibility claims had received a decision.
'A very complex process'
In response, Special Master Sheila Birnbaum hired McCarthy to head the fund's D.C. office. Since then, McCarthy has expanded the staff from 75 to 103 and has worked closely with lawyers and responders to figure out ways to make the process easier on both ends.
"They get better all the time," said Noah Kushlevsky of Kreindler & Kreindler in Manhattan, who with Michael Barasch represents about 7,500 responders. "They have been trying to invent ways to deal with a very complex process and learn from things that come up as they are implementing it."
John Feal, founder of the responders' advocacy group FealGood Foundation, said improvements in the process are "night and day" compared with two years ago. "It's a victory, but it's a shallow victory until everyone gets the help they deserve," he said.
Benjamin Chevat, executive director of 9/11 Health Watch, a nonprofit formed by unions, agreed.
"Clearly more work needs to be done, but the level of processing is getting to where it needs to be," he said.
The latest figures show the pace of awards has picked up. As of Sept. 30, 2,042 decisions had been rendered and more than $551 million awarded -- compared with 112 decisions and $27 million awarded less than a year before.
But of the 16,833 eligibility claims the VCF had received, 44 percent were stalled because they lack some paperwork. And of those that have been determined eligible for compensation, 31 percent were also missing documentation.
Kushlevsky said that as the Oct. 3, 2016, deadline for filing a claim looms closer, he worries that the VCF won't be able to handle all the last-minute filings and be able to make payouts within the next year as required.
"It's going to be extremely difficult to meet the statutory requirements of having all claims filed by Oct. 3, 2016, and paid by Oct. 3, 2017," he said. "The amount of work the VCF is going to have to do is monumental."
Asked if this could be an problem, McCarthy said the VCF "encourages all claimants or their attorneys to file well before the Oct. 3, 2016, deadline to ensure that their claims and payments are processed as early as possible."
But she added: "It is absolutely not the case that claims will not be completed because we just didn't get to them in time. That is not an option."
To be eligible, a responder must prove he was at a crash site on 9/11 or worked on a recovery or cleanup site and that he suffers from specified medical problems as a result. All of these require getting affidavits from employers or others -- in some cases more than a decade later -- or medical records from physicians, which can easily approach a dozen for those who have multiple medical conditions.
When someone is determined eligible, the VCF staff pores over a numbing array of documents that the responders must submit, ranging from tax returns to prescription drug bills. These help determine how much the person should be compensated for both economic loss and pain and suffering, minus whatever other compensation the person has already received. To aid with the often voluminous and abstruse medical records, the VCF hired a team of nurses and two doctors.
Once the file is complete, the special master has 120 days to decide what the compensation will be and notify the responder, followed by another 20 days to authorize payment. Under the law, $875 million is available to pay claims in the VCF's first five years and the rest will be awarded in the sixth year, so initial awards are 10 percent of the total.
McCarthy and others said they are acutely aware they are dealing with people often in dire straits. A special team has expedited about 80 claims for those either close to death or about to lose their homes.
LaKiicha Moore, supervisor of the VCF's help line, which gets about 800 calls a week, is part of that expediting team. "I am personally invested," she said.
It is she who still has a standing once-a-week phone call with the former deliveryman. Although he got 10 percent of his compensation, she said he is still unhappy and wants to get the rest now. Asked how she deals with him and others, she said: "I often take the long way home."
All of that well-intentioned concern can seem far, far away, however, to those still waiting for their awards.
"I've been waiting a year and a half," said Joe Greco, 46, of Bethpage. Greco, a former NYPD detective who retired at age 37 after working at Ground Zero and the Staten Island landfill for about 2½ years, said he is on 12 medications for his chronic obstructive pulmonary disease, severe asthma, gastroesophageal reflux disease and other problems. One medication alone for his lungs costs $1,800 a month, he said.
"This is security for my family," he said.
His friend and former NYPD officer, Pat Triola, who turns 52 next month, said the same. He moved from Wantagh to Youngsville, North Carolina, in July to save money. He worked at Ground Zero for about six months and has already lost a kidney to cancer. He also suffers from lung damage, sinus problems, sleep apnea and gastroesophageal reflux disease.
"I don't want to be a statistic," he said. "I want to be able to open accounts for my four kids and secure money for them and not have to worry."