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Zadroga Act

What to Do if Your WTC Health Claim Is Denied

November 7, 2013 | Michael Barasch

To be eligible to receive free treatment for an illness under the Zadroga Act, your medical provider at the World Trade Center Health Program must submit an evaluation of your history and condition to the program administrator. Then the program administrator must certify your condition as genuinely connected to the 9/11 attacks.

What happens if the administrator rejects your claim? In that case, you have a right to appeal the decision by following specific steps laid out by the program:

  1. When you receive your notice of denial, you have 60 calendar days from the date on the notice to file your appeal.
  2. Mail or fax a written letter to the WTC Health Program’s appeal coordinator. Your letter must be postmarked within the 60-day timeframe.
  3. Your appeal letter must include a clear statement of why you believe the denial is wrong. Your reasons must be based on improper application of facts or standard procedures — not on an objection to the procedures themselves.
  4. Your letter may also include a request to make an oral statement to the official who considers your appeal and/or your designation of a representative.
  5. You are notified within 14 days whether your appeal request has been accepted. This does not mean your claim is accepted — only that you are given the opportunity to have your denied claim reviewed by a federal official.
  6. If your appeal request is denied, no further consideration is given to your claim.
  7. If your appeal is accepted, you should receive a letter with a decision on your eligibility in less than 60 days.

The address for mailing your letter of appeal is:

Appeal Coordinator
WTC Health Program
327 Columbia Turnpike
Rensselaer, NY 12144
Fax: 1.877.646.5308

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2 replies on “What to Do if Your WTC Health Claim Is Denied”

i was declined enrollment in the wtchp although the federal official after review of my case recommended that i be enrolled. The wtchp decision was biased and not properly decided according to the zedroga act. AM I TOTALLY OUT OF LUCK? DO I HAVE ANY OPTION?

Hi Bernie, Please call us as soon as possible at 800-657-0326 so we can discuss your eligibility for the free World Trade Center Health Program or the permanently extended and funded $10+ Billion Victim Compensation Fund. Take care.

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