WTC P-11 Compensation Fund To Publish Procedure on How to Add Non-Cancer Conditions to List of Eligible Claims

The website of the 9-11 Claims Fund (Zadroga Act) indicates that on March 21, 2014 the Fund will post Policy and Procedures for Adding Non-Cancer Conditions To the List of WTC-Related Health Conditions (6 pages, 352 KB)
Issue Date: March 21, 2014


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

The document is not yet linked to the new policy and regulations but the listing indicates a roll of potential expansion for the Fund.

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The James Zadroga 9/11 Health & Compensation Act of 2010

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Workers' Compensation: Zadroga 9-11 Fund to Make Payments for ...

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Zadroga Health Fund: Utility Workers Suffer Increased Anxiety

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New York Dignitaries Celebrate The Zadroga Act Taking Effect

Jul 01, 2011

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….
Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades theLaw Offices of Jon L Gelman jon@gelmans.com have been representing injured workers and their families who have sufferedoccupational accidents and illnesses.

The World Trade Center Health Fund Will Seek Reimbursement of Workers' Compensation Payments

The World Trade Center (WTC) Health Program established under the 9-11 Health Claim Program (Zadroga Act) will identify and seek recoup funds from workers’ compensation when available. The program imposes duties on Responders, Clinical Centers of Excellence, Workers’ Compensation Insurers and other employers providing illness and injury benefits to Responders.

The WTC Health Program is delaying the effective date for the component of the policy and procedures relating to recoupment from lump sum settlements of workers’ compensation cases. The policy was originally scheduled to apply to any lump sum settlement entered into after September 1, 2013. The recoupment policy will now apply to proposed settlement agreements filed with the New York Workers’ Compensation Board (NY WCB) on or after October 1, 2013. Any proposed settlement filed with the NY WCB on or after October 1, 2013, and which releases an employer/insurer’s liability for any future medical expenses must be reviewed by the WTC Health Program or the parties may be financially responsible for treatment expenses. The effective date for the policy as it relates to active workers’ compensation cases where the claimant has not filed a lump sum settlement remains September 1, 2013.

General Recoupment Scheme

1. The WTC Health Program will seek to recoup from medical providers of the WTC
Health Program and from WC insurers. The Program does not anticipate that it will be
necessary to seek recoupment directly from individual WTC responders, unless the
Responder accepts a lump sum settlement from WC and the settlement either releases
or has the effect of releasing the WC insurer from its obligation to pay future medical
expenses. 42 U.S.C. § 1395y(b)(2)(B)(iii) incorporated in 42 U.S.C. § 300mm-41(b)(1).

2. If the primary payer seeks to shift costs onto the WTC Health Program, and the
Program cannot recover WC payments voluntarily, it may seek double damages from
the payer in a recoupment action.

This means that if either a medical provider or a Responder receives payment from a WC insurer for services already paid for by the WTC Health Program, the Program has a duty to reduce further payments or recoup funds from that medical provider who received funds from the WC insurer.42 U.S.C. § 300mm-41(b)(1).

3. If evidence suggests that a WC insurer has improperly shifted WC costs onto the WTC
Health Program, the Program may recommend that a recoupment action be filed
against an insurer, even if the insurer has already paid the claim. 42 U.S.C. § 1395y(b)(2)(B)(iii) incorporated in 42 U.S.C. § 300mm-41(b)(1).

Click here to read the entire WTC Health Fund Policy Statement
….

Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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Read more about The Zadroga Fund

Workers' Compensation: Zadroga 9-11 Fund to Make Payments for ...

Jul 09, 2013

On January 2, 2011, President Obama signed the James Zadroga 9/11 Health and Compensation Act (“Zadroga Act”) providing a total of $4.3 billion in health benefits and financial compensation for victims, responders, and .

http://workers-compensation.blogspot.com/

The James Zadroga 9/11 Health & Compensation Act of 2010

Feb 16, 2011

On January 2, 2011, President Obama signed the James Zadroga 9/11 Health and Compensation Act (“Zadroga Act”) providing a total of $4.3 billion in health benefits and financial compensation for victims, responders, and ...

http://workers-compensation.blogspot.com/

Zadroga Health Fund: Utility Workers Suffer Increased Anxiety

Feb 24, 2011

The study may significantly increase the potential benefits that utility workers may obtain under the James Zadroga 9/11 Health and Compensation Act (“Zadroga Act”) providing a total of $4.3 billion in health benefits and ...

http://workers-compensation.blogspot.com/

New York Dignitaries Celebrate The Zadroga Act Taking Effect

Jul 01, 2011

Signed into law in early January, the Zadroga Act provides sustained funding for the WTC Centers of Excellence and ensures that those facing 9/11-related health problems continue to receive monitoring and treatment ...

http://workers-compensation.blogspot.com/

Prostate Cancer: Now on the 9-11 Fund Compensable List

Prostate Cancer has now been approved as a compensable condition for benefits for those who are eligible to claim benefits from the 9-11 Health Claim Fund. The deadline to claim benefits for some, October 3, 2013, is rapidly approaching.

Click here for more information for about filing a claim.

….

Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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