World Trade Center Response

The World Trade Center (WTC) Medical Monitoring and Treatment Program (MMTP) provides ongoing medical monitoring and treatment to eligible workers and volunteers who were involved in the rescue, recovery, and restoration activities following the attacks on the WTC. These medical services are provided by a network of clinics that specialize in the diagnosis and treatment of WTC-related health conditions, as well as by the Bureau of Health Services at the Fire Department of New York (FDNY).

Q: How do I find out if I qualify for this program?
A: If you have already participated in the monitoring program, you are automatically eligible for the medical treatment services. You must return for your regularly scheduled monitoring examination every 18 months. If you need treatment services before your scheduled monitoring examination, please call the network clinic where you were seen. A website link to the clinics is http://www.wtcexams.org/examlocations.html. If you are a current or retired New York City Firefighter call the FDNY Bureau of Health Services (718-999-1858).

If you are not yet enrolled in the program, you may find out whether you are eligible by doing the following:

• If you were or are working for the Fire Department of New York (FDNY), you should call the FDNY Bureau of Health Services (718-999-1858) or visit the following website for information about the program: http://www.nyc.gov/html/fdny/insider/bhs/wtcmm/index.shtml
  
  
• If you were not or are not working for the FDNY, you should call 888-702-0630 or click on http://www.wtcexams.org/contactus.html to obtain the fax number and mailing address for sending in a completed eligibility form, which can be accessed by clicking on http://www.wtcexams.org/forms.html. When you call the toll-free number, an operator will ask you questions about when and where you worked at ground zero and what kind of work you did. After you are determined to be eligible, you will be provided information about the network of clinics from which you would choose one to make an appointment for an examination.

Q: Where are the locations of the network clinics?
A: FDNY rescue workers are seen at the Bureau of Health Services office in Brooklyn. For other workers there are six clinic locations (http://www.wtcexams.org/examlocations.html) in the New York City metropolitan area for you to choose from. Additional clinics are available outside of the New York Metropolitan area, and the operator at the toll-free number will provide you with contact information for the clinics closest to you.

Q: Should I come in for a Monitoring Program exam even if I'm feeling fine now?
A: Yes. Everyone who is eligible for the Monitoring Program is strongly encouraged to participate for three main reasons. First, this program will follow your health until 2009, and provide longer-term medical monitoring if resources become available. Second, not all conditions cause symptoms that you are aware of, so by getting periodic examinations, it may be possible to detect any late-starting diseases. Finally, while the main focus of the program is to provide participants with clinical evaluations of their own health, the information that will be gained by following the group of 9/11 workers and volunteers will be extremely valuable in understanding how to protect worker health in future emergencies.

Q: Does the program provide treatment for all health problems?
A: The program will provide medical treatment for conditions that the program has classified as covered by this WTC program. If a network physician identifies one of these health conditions during an examination, that clinic will provide the necessary diagnostic and treatment services. If a health condition is identified that is not covered, the network clinic will help you locate a community health provider but will not cover the costs associated with treatment of that health condition.

Q: Does the program also cover treatment for mental health problems?
A: Yes, each participating clinic includes health providers who are experienced in treating WTC-related psychological problems. They also will help with problems related to alcohol and drug abuse.

Q: How were the health conditions covered by this program established?
A: Due to the unusual nature of the exposures experienced by WTC responders, it has been difficult to predict all of the health conditions that might occur in workers, especially for rare diseases. The conditions covered by this program have been established through the following guidelines: 1) conditions that have been reported in large numbers of patients seem through the WTC monitoring program and treatment programs, 2) rare conditions that have been diagnosed in some WTC responders and for which there is adequate scientific basis for a relation to the WTC-related exposures; 3) conditions which are anticipated because of the nature of the WTC exposures but usually do not occur until several years after the exposure.

Q: What conditions are covered by this program?
A: A list of the conditions currently covered by the program is given below. The MMTP will continue to collect, confirm, and analyze monitoring and treatment data, and this list will be updated as clinical and scientific knowledge is generated and determined to support modifications.

Aerodigestive Disorders
New onset or aggravation of pre-existing conditions for which clinical findings suggest onset is related to WTC exposure/injury:

Interstitial lung diseases
Chronic Respiratory Disorder –Fumes/Vapors
Asthma
Reactive Airways Dysfunction Syndrome (RADS)
WTC-exacerbated chronic obstructive pulmonary disease (COPD)
Chronic Cough Syndrome
Upper airway hyperreactivity
Chronic rhinosinusitis
Chronic nasopharyngitis
Chronic laryngitis
Gastro-esophageal Reflux Disorder (GERD)
Sleep apnea exacerbated by or related to the above conditions

Mental Health Conditions
New onset or aggravation of pre-existing conditions for which clinical findings suggest onset is related to WTC exposure/injury:

Post Traumatic Stress Disorder (PTSD)
Major Depressive Disorder
Panic Disorder
Generalized Anxiety Disorder
Anxiety Disorder (not otherwise specified)
Depression (not otherwise specified)
Acute Stress Disorder
Dysthymic Disorder
Adjustment Disorder
Substance Abuse
“V codes” (treatments not specifically related to psychiatric disorders, such as marital problems, parenting problems etc.)

Musculoskeletal Disorders
New onset or aggravation of pre-existing conditions for which careful review of symptoms or other clinical information suggests relationship to WTC exposure/injury:

Low back pain
Carpal Tunnel Syndrome (CTS)
Other musculoskeletal disorders

Q: If I participate in this program does that mean I don’t need to file a workers compensation or line of duty claim?
A: No, this program is not a substitute for workers compensation or line of duty claims. The doctors and social workers at the clinic will provide you with information and assistance regarding filing a workers compensation or line of duty claim.

Q: Which diagnostic and treatment services are available?
A: The program will cover all costs for the diagnosis and treatment of these covered conditions including inpatient and outpatient medical procedures and prescribed medications. If during the diagnostic work up, the physicians determine that you do not have a covered condition, the clinic will assist you in finding medical care, but the program will no longer pay for these services.

Q: Is there any copayment or other charges associated with this program?
A: There is no copayment as long as you receive your treatment through the program health providers and prescription drug program.

Q: Can my family members receive any health services through this program?
A: No this program just covers eligible WTC workers and volunteers who meet the eligibility criteria. Family members may be included in some counseling programs when the mental health provider feels that it will help the WTC worker or volunteer, such as with marital counseling.

Q: Do I have to receive my medical care at one of the network clinics?
A: Yes, the program will only cover services provided by the network clinics (this includes and referrals to outside specialists which are made by one of the network clinics).

Q: Do I have to participate in the monitoring program in order to receive treatment?
A: Yes, all patients must receive regular monitoring examinations. These monitoring examinations are important and assist the program physicians in providing better care.

Q: Can I receive services from more than one of the network clinics?
A: If you would like to change clinics, you must first notify the clinic where you are currently being seen. That clinic will arrange for your medical records to be transferred and assist you in contacting the new clinic to arrange an appointment. Only one transfer will generally be allowed, except in special situations, because continuity of care is important to maintaining quality medical care.

Q: Can I continue to see my personal physician while I am being treated by the program?
A: Yes; however, the program will not cover those medical costs. It is important that you notify your personal physician that you are receiving treatment by the program so that the program physicians can coordinate your care with your personal physician.

Q: Will anyone else have access to my medical records?
A: No. All results will be kept strictly confidential by the MMTP. No information about you will be provided to anyone outside of the MMTP without your written consent.