Responders or survivors who file a 9/11 VCF claim need to navigate some strict eligibility rules. One of the areas of confusion during the claims process is what counts as a certified condition and what is an eligible condition.
These terms are used frequently by the WTC Health Program and the September 11th Victim Compensation Fund (VCF).
The main difference is that certified conditions are recognized by the WTC Health Program as medical conditions that are related to 9/11, while eligible conditions are medical conditions that the VCF recognizes for financial compensation.
Let’s delve deeper so that victims are clear what these definitions mean, and how they affect compensation claims.
What are 9/11 “certified conditions”?
“Certified condition” is a term used by the WTC Health Program to formally designate health conditions that are caused or worsened by exposure to 9/11 toxins or traumatic events.
The WTC Health Program is a federal program set up under the James Zadroga 9/11 Health and Compensation Act to provide free medical monitoring and treatment for those who were in the exposure zone and whose health was negatively impacted by the events of 9/11.
If a condition is “certified” by the WTC Health Program, any individual who was in the exposure zone in NYC or a crash site at the Pentagon or in Shanksville, PA, between September 11, 2001, and July 31, 2002, can receive free medical care and monitoring for that condition.
Once a survivor or responder has been diagnosed with the condition, the eligibility for free medical care and monitoring from the program lasts for life, if necessary.
The most common certified conditions covered by the WTC Health program are:
- Over 70 types of cancers, including lung, thyroid, prostate, and breast cancer.
- Aerodigestive disorders, such as chronic rhinosinusitis, asthma, GERD, and sleep apnea.
- Mental health conditions, such as PTSD, depression, and anxiety.
A qualifying individual can register at any time with the WTC Health Program, whether they presently have a 9/11-related condition or not. Once a condition is certified, a certification letter is sent, which can then be used to submit a claim to the VCF.
What is a 9/11 “eligible condition”?
The VCF was created to provide financial compensation for individuals (or their families) who have suffered physical harm or death from an eligible 9/11-related health condition.
The standard process to claim compensation is:
- Obtain a diagnosis of the health condition from a certified medical professional.
- Confirm that the condition is a certified condition with the WTC Health program.
- Confirm that the condition is eligible for a VCF award.
- Submit a VCF claim with supporting documentation (often with the assistance of a dedicated 9/11 victim’s attorney).
Not every condition certified by the WTC Health Program is “eligible” for compensation under the VCF. This is where the confusion often begins.
An “eligible” condition with the VCF must meet three general requirements. It must be:
- Certified by the WTC Health Program as 9/11-related.
- Included on the VCF’s list of covered physical conditions.
- A cause of economic or non-economic loss (such as medical costs, lost wages, or pain and suffering).
In particular, mental health conditions, such as PTSD, anxiety, and depression, are certified by the WTC Health Program but not eligible for VCF compensation.
If an individual died from a certified condition without participating in the WTC Health Program, the family of the deceased may still be eligible for compensation from the VCF under the “Private Physician Process”. The Fund will collect the medical records of the deceased and work with the WTC Health Program to determine if the medical condition was eligible for compensation.
Summary: Certified vs eligible conditions
| Feature | Certified Conditions | Eligible Conditions |
|---|---|---|
| Primary Program | World Trade Center Health Program | 9/11 Victim Compensation Fund |
| Core Purpose | Health & Treatment: Provides medical monitoring and no-cost healthcare. | Compensation: Provides tax-free financial awards for losses. |
| Conditions Covered | Physical and Mental Health (e.g., PTSD, Depression). | Physical Conditions only (Mental health is generally not compensated). |
| Key Requirement | Medical Link: Proving your illness was caused by 9/11 exposure. | Certification: You must usually be certified by the WTCHP first. |
| Proof of Presence | Required (work, school, or residence in the NYC exposure zone). | Required (often uses WTCHP’s determination as a baseline). |
| Outcome | Access to doctors, medication, and specialized 9/11 care. | Monetary award for pain and suffering or lost earnings. |
Can a medical condition be added to the certified list?
The WTC Health Program and National Institute for Occupational Safety and Health (NIOSH) periodically review and add medical conditions to the certified list.
Certain skin conditions and uterine cancer were added relatively recently. Other serious conditions, like autoimmune diseases, neurological conditions, and emerging cancers, are currently under review. A medical condition can be assessed by first enrolling in the WTC Health Program and undergoing a medical evaluation.
If the WTC Health Program adds a physical condition, the VCF automatically adopts it.
To help determine whether your 9/11 condition is certified for monitoring and treatment or eligible for compensation, or to petition for inclusion of a non-covered condition, contact a 9/11 victims’ attorney for help.
To discuss your situation and learn more about how we may be able to help you, please call Weisfuse & Weisfuse, LLC at 212-983-3000 or contact us online to schedule a free consultation.
About Jason Weisfuse –
9/11 Victim Compensation Fund Attorney
About Jason Weisfuse –
9/11 Victim Compensation Fund Attorney
Jason E. Weisfuse is a seasoned 9/11 Victim Compensation Fund attorney and owner of Weisfuse & Weisfuse, LLC, a New York City-based law firm dedicated to representing individuals affected by the September 11th attacks. Since the establishment of the September 11th Victim Compensation Fund (VCF), Jason has been instrumental in assisting first responders, survivors, and families in securing the compensation and medical benefits they deserve. He will personally be submitting your claim and will be your primary contact throughout the process.
As a graduate of New York Law School (2009), Jason brings extensive experience regarding the 9/11 Victim Compensation Fund to his practice. His deep understanding of the VCF and the World Trade Center Health Program (WTCHP) has enabled him to navigate complex claims processes effectively, resulting in substantial awards for his clients.
Jason is a member of the New York State Trial Lawyers Association and the American Association for Justice and has been published in the New York Law Journal.
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