Policies and Procedures

Listed below are the policies used by the WTC Health Program:

Adding to the List of WTC-Related Health Conditions

• Policy and Procedures for Handling Submissions and Petitions to Add a Health Condition to the List of WTC-Related Health Conditions [PDF, 2 pages, 136 KB]

  Issue Date: May 14, 2014

  This document describes the process for handling submissions and petitions for adding a health condition to the list of WTC-related health conditions.

Policy and Procedures for Adding Non-Cancer Conditions to the List of WTC-Related Health Conditions
[PDF, 19 pages, 704 KB]

Revised: July 5, 2023

This document describes the process for adding non-cancer conditions to the list of WTC-related health conditions.

This document describes the process for adding non-cancer conditions to the list of WTC-related health conditions.

Previous Versions:

• Revised: September 11, 2019 [PDF, 19 pages, 348 KB]
• Updated: May 1, 2019 [PDF, 13 pages, 249 KB]
• Revised: February 14, 2017 [PDF, 13 pages, 342 KB]
• Revised: May 11, 2016 [PDF, 8 pages, 342 KB]
• Revised: October 21, 2014 [PDF, 7 pages, 321 KB]
• Revised: May 14, 2014 [PDF, 6 pages, 158 KB]
• Issue Date: March 21, 2014 [PDF, 6 pages, 352 KB]

Flowchart: Procedures for Adding Non-Cancer Health Conditions to the List of WTC-Related Health Conditions [PDF, 1 page, 119 KB, Print Only]

• Policy and Procedures for Adding Types of Cancer To the List of WTC-Related Health Conditions
  [PDF, 9 pages, 303 KB]

  Updated: November 18, 2021

  Policy and Procedures for Adding Types of Cancer to the List of WTC-Related Health Conditions.

  Previous Versions:

  • Issue Date: May 11, 2019 [PDF, 8 pages, 222 KB]
  • Issue Date: May 11, 2016 [PDF, 8 pages, 458 KB]
  • Issue Date: May 14, 2014 [PDF, 6 pages, 187 KB]

• Development of the Inventory of 9/11 Agents [PDF, 36 pages, 977 KB]

  Issue date: July 17, 2018

  The World Trade Center (WTC) Health Program (Program) has developed an Inventory of 9/11 Agents (Inventory) that the Program will use for administrative purposes.

Aerodigestive Disorders

• Making a Determination about Exposure Aggravating Pre-Existing Aerodigestive Disorders
  [PDF, 4 pages, 326 KB]

  Revised: February 18, 2015

  This document provides information for CCE and NPN physicians about making a determination that 9/11 exposure resulted in aggravating an aerodigestive disorder that existed on September 11, 2001.

  Aggravating the pre-existing health condition results in the aerodigestive disorder requiring medical treatment that is (or will be) in addition to, more frequent than, or of longer duration than the medical treatment that would have been required for such condition in the absence of the individual’s 9/11 exposure.

  Previous Versions:

  • Issue Date: November 7, 2014 [PDF, 4 pages, 333 KB]

• Policy and Procedures for Certification of Physician Determinations for Aerodigestive and Cancer Health Conditions [PDF, 5 pages, 411 KB]

  Issue Date: February 20, 2015
  

  This document is based on applicable sections of the James Zadroga 9/11 Health and Compensation Act of 2010 (“Zadroga Act”) and 42 C.F.R. Part 88 and defines the policies and procedures for physicians regarding the certification determinations for aerodigestive and cancer health conditions.

• Time Intervals for New Onset Aerodigestive Disorders [PDF, 15 pages, 330 KB]

  Revised: August 30, 2017

  The Administrator of the World Trade Center (WTC) Health Program has determined that no minimum time interval will be applied to the five categories of new onset aerodigestive disorders that meet the temporal sequence of symptoms requirement for certification of a WTC-related health condition.

  Previous Versions:

  • Issue Date: February 18, 2015 [PDF, 14 pages, 477 KB]
  • Issue Date: December 16th, 2013 [PDF, 14 pages, 535 KB]

Cancer

• Rare Cancers [PDF, 1 page, 247 KB]

  Issue Date: May 5, 2014

  This document defines and lists WTC-related health conditions in the category of "Rare Cancers."

• Malignant Neuroendocrine Neoplasms [PDF, 4 pages, 352 KB]

  Issue Date: October 4, 2013

  This document provides information regarding the certification of malignant neuroendocrine neoplasm as a “rare cancer,” regardless of the anatomic site where identified. Each determination of any malignant neoplasm must be considered for certification as a WTC-related health condition under the minimum latency requirements for solid cancers, and the exposure requirements specified by the WTC Health Program in the WTC-3 Certification Request form.

• Minimum Latency & Types or Categories of Cancer [PDF, 12 pages, 624 KB]

  Revised: January 6, 2015

  As new scientific information becomes available to the WTC Program Administrator on minimum latencies for the types or categories of cancers on the List of WTC-Related Health Conditions found at 42 C.F.R. § 88.1, minimum latencies may be modified. The Administrator's May 1, 2013, revision to the White Paper on Minimum Latency & Types or Categories of Cancer changes minimum latencies for mesothelioma and the category of lymphoproliferative and hematopoietic cancers.

  Previous Versions:

  • Revised: November 7, 2014 [PDF, 11 pages, 526 KB]
  • Revised: May 1, 2013 [PDF, 9 pages, 512 KB]
  • Issue Date: October 17, 2012 [PDF, 4 pages, 344 KB]

• Myeloid Malignancies [PDF, 9 pages, 381 KB]

  Issue Date: February 1, 2014

  Beginning on February 1, 2014, the World Trade Center (WTC) Health Program will consider blood or bone marrow disorders of the myeloid line to be slow-growing blood cancers. Accordingly, they will be considered WTC-related health conditions, making them available for WTC Health Program medical treatment services for eligible members. These cancers had been considered non-malignant by the Administrator because they were referred to as “pre-leukemic” hematopoietic disorders in the medical literature. Recent scientific advances, however, characterize these “pre-leukemic” myeloid neoplasms as slow-growing blood cancers, and authoritative scientific sources now consider them to be malignant myeloid neoplasms.

• Policy and Procedures for Cancer Screening [PDF, 4 pages, 348 KB]

  Issue Date: April 2, 2014

  This document describes the purpose and procedure for cancer screening

Medically Associated Health Conditions

Privacy Practices

Recoupment and Coordination of Benefits

Transportation Services