42 U.S.C. § 300mm–21 — Identification of WTC responders and provision of WTC-related monitoring services

(a) WTC responder defined: (1) In general — this subchapter defines "WTC responder" as any of three kinds of people, subject to the enrollment cap in paragraph (4). (A) A currently identified responder is someone already found eligible for monitoring, as of January 2, 2011, under the existing arrangement between the National Institute for Occupational Safety and Health (NIOSH) and either the Mount Sinai-coordinated consortium or the Fire Department of New York City (FDNY). (B) A responder who meets current eligibility criteria is someone who fits the detailed rules in paragraph (2), below. (C) A responder who meets modified eligibility criteria is someone who (i) did rescue, recovery, demolition, debris cleanup, or related work in the New York City disaster area after 9/11 — whether as a state employee, federal employee, National Guard member, or anyone else — and (ii) meets exposure-related rules the Administrator sets, after consulting the Advisory Committee. The Administrator cannot create or change these modified rules once responder enrollments or survivor certifications reach 80 percent of their numerical limits. (2) Current eligibility criteria — a person qualifies under any of three groups. (A) Firefighters and related personnel: either (i) a current or retired FDNY member (fire or emergency staff) who worked at least one day in the rescue and recovery effort at a World Trade Center site (Ground Zero, the Staten Island Landfill, or the Medical Examiner's Office) between September 11, 2001 and July 31, 2002; or (ii) a surviving immediate family member of an FDNY member killed at the World Trade Center site on 9/11, who got treatment for a mental health condition (described in section 300mm–22) on or before September 1, 2008. (B) Law enforcement officers and WTC rescue, recovery, and cleanup workers: someone who worked or volunteered onsite in lower Manhattan (south of Canal Street), the Staten Island Landfill, or the barge loading piers, meeting a minimum-hours threshold (4 hours in the first days after 9/11, 24 hours through the end of September 2001, or 80 hours through July 2002), and who also fits one of five specific roles — (i) meeting the general hour thresholds above; (ii) an active or retired NYPD or Port Authority Police officer meeting one of several time-and-place thresholds; (iii) a Medical Examiner's Office employee or morgue worker who handled remains through July 31, 2002; (iv) a Port Authority Trans-Hudson Tunnel worker for at least 24 hours between February and July 2002; or (v) a vehicle-maintenance worker exposed to WTC debris while servicing contaminated vehicles during the same period as subparagraph (A). (C) Responders to the Pentagon and Shanksville, Pennsylvania attacks: someone who (i) was a fire or police department member, a recovery or cleanup contractor's employee, or a volunteer performing rescue, recovery, demolition, or cleanup work at the Pentagon or Shanksville crash sites during the cleanup period, or was a Defense Department or other federal employee, a contractor's employee (working September 11–18, 2001), or a uniformed service member doing the same work at those sites; and (ii) the Administrator decides, after consulting the Advisory Committee, that the person faces increased risk of a WTC-related health condition and meets the Administrator's exposure-based criteria. (3) Enrollment process: (A) The Administrator must set up an enrollment process where (i) currently identified responders are automatically enrolled; (ii) the Administrator enrolls people found to be WTC responders, subject to (iii); (iii) the Administrator must deny enrollment once the cap in paragraph (4) is reached; (iv) applying is free; (v) the Administrator must decide within 60 days of an application; and (vi) anyone denied enrollment can appeal. (B) Timing — (i) currently identified responders must be enrolled by July 1, 2011; (ii) other qualifying responders must be enrolled as soon as they're found eligible, subject to the cap in paragraph (4). (4) Numerical limitation on eligible WTC responders: (A) No more than 75,000 people outside the automatic categories may be enrolled at any one time, and no more than 2,500 of those may qualify only under the modified eligibility criteria in paragraph (1)(C); separately, no more than 500 people may be enrolled based on the Pentagon/Shanksville eligibility rules described in paragraph (2)(C)(i)(III) or (IV). (B) The Administrator must (i) keep enrollments within these limits and within available funding, so there's enough money to treat and monitor everyone enrolled; and (ii) give priority to applicants in the order they applied. (5) Disqualification of individuals on terrorist watch list: Anyone on the Department of Homeland Security's terrorist watch list cannot qualify as a WTC responder. Before enrolling anyone, the Administrator must check that list with the Secretary of Homeland Security. (b) Monitoring benefits: (1) An enrolled WTC responder (other than the surviving-family-member category) gets monitoring benefits — clinical exams and long-term health monitoring and analysis — following protocols the Administrator approves. An active-duty FDNY responder gets these benefits as part of their regular company medical exams. (2) A Clinical Center of Excellence provides these benefits for the responder's category; for someone living outside the New York metropolitan area, benefits come through the nationwide arrangement in section 300mm–23.