September 11th Victim Compensation Fund Appeals and Amendments

The September 11, 2001 terrorist attacks were the worst attacks on American soil since Pearl Harbor in 1941. Nearly 3,000 people were killed on 9/11. Thousands more have died from 9/11-related illnesses in the years since the attacks. Countless more will be diagnosed with, suffer, and likely die from illnesses resulting from exposure to toxic dust caused by the attacks.

In the wake of 9/11, the September 11^th Victim Compensation Fund (VCF) was established to provide financial assistance for medical expenses and lost wages to those who were injured or made sick in the attacks or the response to the attacks, as well as to the families or personal representatives of those who died.

The September 11^th Victim Compensation Fund claims process is complex and not all applicants are deemed eligible or approved for compensation from the Fund. Others may be found eligible and approved for compensation, but the award amount may not be an amount they consider to be accurate based on their claim. Depending on the specifics of their case, September 11^th Victim Compensation Fund claimants may submit an appeal or an amendment to their claim.

What is the difference between an appeal and an amendment?

The September 11^th Victim Compensation Fund offers claimants an opportunity to appeal or amend their claim, if necessary. An appeal challenges the September 11^th Victim Compensation Fund’s determination on the claim, while an amendment seeks to change the award based on new information. The appropriate option depends on the claimant’s specific situation.

In deciding between filing an appeal on a determination or amending a claim, the September 11^th Victim Compensation Fund advises claimants to consider if they are “waiving or compromising a particular claim or argument by accepting payment on the original determination and choosing to pursue an amendment rather than an appeal.” Additionally, if the September 11^th Victim Compensation Fund determines that an issue submitted on appeal should be addressed through an amendment, it is within their jurisdiction to make that decision.

When should an amendment be filed?

Typically, an amendment should be filed when there is new information or if information has changed that the claimant believes is relevant to the claim. This includes a variety of specific circumstances, such as:

• New Information – If a claimant is now in possession of new information that supports their claim but which was not submitted to the September 11^th Victim Compensation Fund before their award was determined and which may affect the amount of their calculated loss, they should file an amendment.
• Worsening Condition – If the claimant’s 9/11-related illness or injury takes a significant turn for the worse and causes a loss that was not previously compensated, or if their eligible injury or condition results in new or additional financial losses, the claimant should file an appeal.
• Diagnosis of a New 9/11-Related Condition – A claimant should file an appeal if the World Trade Center Health Program certifies the claimant for a condition that was not previously certified, or if the claimant is diagnosed with a new injury or condition related to 9/11 that meets the verification criteria through the September 11^th Victim Compensation Fund Private Physician process and additional compensation is necessary due to the new condition.
• Denial Based on Inactivity – The September 11^th Victim Compensation Fund may deny a claim or deem it inactive if the claimant does not respond to requests for missing information. If a claimant failed to respond or supply missing information but is now ready to provide the requested documentation, they should file an amendment.
• Changes to Personal Representative – An amendment should be filed to add, remove, or otherwise change the personal representative or parent/guardian listed on an existing claim.
• Reimbursement of Out-of-Pocket Expenses – The claimant should file an amendment if they have already received the initial September 11^th Victim Compensation Fund award determination and are seeking reimbursement for out-of-pocket medical expenses that total more than $5,000 and which were incurred before the World Trade Center Health Program certified their 9/11-related condition.
• Withdrawal of Any Portion of a Claim – A claimant who already submitted a claim for economic loss and now wants to withdraw any components of that claim should amend their claim.
• The WTC Health Program Disability Evaluation Process – Requests for consideration for the WTC Health Program Disability Evaluation Process or the submission of a WTC Health Program Disability Evaluation report for September 11^th Victim Compensation Fund review should be handled via amendment.
• Late Submission of Information – If a claimant responded to a September 11^th Victim Compensation Fund request for missing information after the deadline and the information submitted was not considered in the award calculation, the claim should be amended. Likewise, if the claimant’s online claim status is listed as “Determination Made: Processing” and they now have new documents, they must file an amendment to have the new documents reviewed by September 11^th Victim Compensation Fund.

When should an appeal be filed?

A person seeking to appeal a September 11^th Victim Compensation Fund determination may do so only if an Appeal Request Form was included with their eligibility denial letter or award letter. There are two types of appeals:

• Eligibility Determinations – An individual may file an eligibility appeal if their claim is denied because they are deemed ineligible to receive an award. If an eligibility appeal is filed, the September 11^th Victim Compensation Fund will not begin the compensation review process until after a decision is made on the appeal. A claim may be paid while under appeal only if the claimant has met applicable criteria and been approved for expedited status.
• Compensation Determinations – If a person believes that the amount of their September 11^th Victim Compensation Fund award was calculated in error, they may submit a compensation appeal. When an award decision is appealed, the September 11^th Victim Compensation Fund will not process any payment due to the claimant until the appeal hearing is held and a decision is rendered on the appeal.

The eligibility denial or award letter will include detailed information outlining the specific steps that must be taken in order to appeal the September 11^th Victim Compensation Fund’s decision. Failure to take the required steps within the prescribed deadline could result in the appeal being denied.

If a claimant decides to appeal a September 11^th Victim Compensation Fund determination, they must file the appeal within 30 days of receiving notification regarding the eligibility or compensation decision of their claim. Filing the appeal is only the first step; the Appeal Package must be completed and submitted within 60 days of receipt of the original September 11^th Victim Compensation Fund determination letter.

How an attorney can help.

The decision to file an appeal or an amendment on a September 11^th Victim Compensation Fund determination is not always simple. The process of filing and submitting the appeal or amendment can also be complicated and time-consuming. An experienced 9/11 Victim Compensation Fund attorney can provide guidance regarding the benefits and potential risks of an appeal versus an amendment. Once a decision is made, they can handle all of the paperwork, ensuring it is completed accurately and submitted on deadline.

Contact our September 11^th Victim Compensation Fund attorneys today.

The horrors of the September 11, 2001 terrorist attacks did not end that day, month, or year. They continue even now as the brave first responders, workers, and volunteers, as well as the innocent people who happened to live, work, or attend school in the New York City Exposure Zone, fall ill and are diagnosed with 9/11-related conditions. The illnesses caused by the toxic dust in the NYC Exposure Zone can be incredibly debilitating and deadly. If you or a loved one have been diagnosed with a 9/11-related illness, you may be eligible for compensation through the September 11^th Victim Compensation Fund. The experienced September 11^th Victim Compensation Fund attorneys at Weisfuse & Weisfuse, LLP can help ensure you receive the compensation you deserve. Contact us today to schedule a free consultation.