Do I Need to Get Copies of my Medical Records for my 9/11 Victim Compensation Fund Claim?

When filing a claim for compensation with the September 11th Victim Compensation Fund (VCF), many claimants ask us two questions: (1) Do you need to get copies of all of their medical records to submit with their VCF claim, and (2) if the World Trade Center Health Program (WTCHP) shares copies of their medical records with the VCF.  

You typically do not need to request and submit copies of all of your medical records to the VCF. There are generally two situations where you may want to submit copies of your medical records: 

If you have prostate cancer and suffer from urinary incontinence/erectile dysfunction, or
If you have a non-cancerous breathing/digestive illness that has a consistent, sustained, and exceptionally severe impact on your quality of life.

Medical records do not need to be submitted if you have a condition that the VCF considers presumptively severe: Emphysema, Interstitial Lung Disease (including Asbestosis), or Sarcoidosis. 

The WTCHP does NOT share copies of your medical records with the VCF. The only medical- related  WTCHP shares with the VCF are your eligible, certified condition, including the name of the condition, the disease category, such as cancer or respiratory disorder, and the medical diagnosis code.  

How to Gather Copies of Your Medical Records for the VCF

To allow your physicians to share your medical records with the VCF, we will complete on your behalf a HIPAA authorization form. This HIPAA form gives your doctor’s office permission to release your medical information to a third party, such as our law firm. Working with Hansen & Rosasco, our firm can request the medical records on your behalf, and with the completed HIPAA authorization form, we would be allowed to acquire your relevant medical records to submit to the VCF. 

Which Medical Records Does the VCF Require?

While the VCF relies on certification from the WTC Health Program and receives certain information from them, the VCF does not receive your full copies of your medical records from the WTC Health Program. 
As stated above, the WTC Health Program provides the VCF only with basic information that is used to determine whether you have an eligible, certified condition.

 If you have a non-cancerous breathing/digestive illness that is exceptionally severe and impacts on your quality of life, then it is advised to provide medical records that show the persistent and severe nature of your condition(s) and how they impact your daily living. These medical records will be considered when the VCF determines your award amount. These recent records related to your condition to evaluate the severity and effect of the condition, will help to determine whether an increased non-economic loss award may be applicable.

Providing this information ensures you receive the maximum award for your individual circumstances. It is important to note that for large volumes of records – over 25 pages – the VCF requires claimants to highlight the relevant information or provide a written guide to direct them to the relevant pages.

Should You Hire a Lawyer to Coordinate Between the WTC Health Program and the VCF?

While it is possible to file a claim on your own, many individuals find it helpful to work with an experienced 9/11 attorney, especially when coordinating between the two separate programs. Over 86% of 9/11 Victim Compensation Fund claims are submitted with attorney representation. 

An attorney can help:

• Ensure your WTC Health Program certification is properly documented

   

• Identify which medical records are required for your specific claim

   

• Track whether the VCF has received all necessary documentation

   

• Respond to VCF requests for additional information

   

• Avoid delays caused by missing or incomplete records

What Happens if the VCF Doesn’t Receive the Correct Records?

If the VCF does not receive the minimum documents required to process your claim during the Preliminary Review, including Exhibit A to the Eligibility Form Authorization for Release of Medical Records, your claim is placed in “Denied” status. The VCF will take your claim out of denied status and resume processing the claim once you submit the missing Exhibit A or other documents.

During the Substantive Eligibility Review, if the claim is missing documentation that is needed in order to render an eligibility decision, you will receive a “Missing Information” letter. At this point in the process, if you don’t respond to the VCF’s missing information request after 14 days, the VCF will render a decision based on the information contained in your file at that time, and your claim could be denied, or your award could be valued at less than the maximum award for your circumstances.

Contact Our Experienced 9/11 Attorneys for Help with Your VCF Claim

The experienced attorneys at Hansen & Rosasco, LLP can guide you through every step of the VCF claims process, from obtaining WTC Health Program certification to submitting a complete and accurate VCF claim. If you have questions about your medical records, eligibility requirements, or how to file your claim, contact us today for a free consultation. We are here to help you navigate the process and secure the compensation you deserve.