How can you tell whether your illness or condition is linked to 9/11 debris exposure, or whether it is currently being evaluated for a potential connection? Many responders and survivors rely upon advice from their doctors and the official list of covered conditions at the World Trade Center Health Program (WTCHP), which encompasses both WTC-related and medically associated health conditions (other issues that result from treatment or progression of the underlying condition). However, this list changes with the latest data and scientific research.
Science is still catching up in many ways to the devastating effects of exposure to the 9/11 dust cloud and the aftermath of Ground Zero. In these cases, it may be possible to add to or amend the WTCHP list. The WTCHP is in place to help responders and survivors who were present in the designated Disaster Areas, as defined by federal law, receive the care and coverage that they need and deserve after the trauma of 9/11.
WTCHP Eligibility Expanded in May of 2025
In 2025, the WTCHP also finalized expanded eligibility for Pentagon and Shanksville, Pennsylvania responders. A final rule effective May 27, 2025, opened enrollment to additional categories of responders at those sites, including active-duty, retired, or reserve members of the military, civilian employees and contractors of the Department of Defense, and employees of other federal agencies who responded on or after 9/11. As of mid-2025, more than 70 new Pentagon and Shanksville responders had enrolled in the program under the expanded criteria.
If the list of covered conditions needs to be amended, anyone may submit a written petition requesting that a new condition be considered for addition. While this cannot be done overnight, there is an official review process in place to request coverage for a new condition under the WTCHP rules. However, as discussed below, this process has faced significant disruptions in recent years.
The Process for Filing a Petition to Add a Condition to the WTCHP
The first step is to file a petition for an addition at the WTCHP. Anyone may file a written petition requesting that a new condition be added to the list of official “World Trade Center-related health conditions.” The petition typically should include:
- The name and contact information of the interested party
- The name and description of the condition to be added
- The reasons for adding the condition, including the medical basis for the association between 9/11 exposures and the condition
The medical basis may reference peer-reviewed, published epidemiologic studies or clinical case reports involving 9/11-exposed responders or survivors. First-hand accounts or anecdotal information are not sufficient.
These petitions are then submitted to the Administrator of the WTCHP. This position is part of the Centers for Disease Control and Prevention (CDC) and its National Institute for Occupational Safety and Health (NIOSH).
New conditions can fall under review for eligibility at any point in time. Over the years, petitions have asked the WTCHP to consider a wide range of conditions for possible inclusion on the list.
Petitions for Additional Conditions
Notably, petitions were filed in September 2023 to add autoimmune and cardiac conditions, and a separate petition was filed in February 2025 to add dementia conditions. All three petitions have been accepted as valid under the Program’s regulations, but final decisions remain outstanding as of early 2026.
The WTCHP Conducts a Scientific Review
The second step is a scientific review to evaluate whether the evidence meets the criteria for establishing a causal link between the condition and 9/11 exposures. This review will be conducted by WTCHP doctors as well and may also involve:
- Internal analysis by NIOSH staff
- External peer-reviewed literature
- Consultation with the Scientific/Technical Advisory Committee (STAC)
STAC is a panel of independent experts that provides recommendations to the Administrator. The Administrator considers these recommendations, but is not required to adopt them. They may take STAC’s guidance into account, but can make their own decision.
Current Disruptions to the Petition Process
Responders and survivors need to understand that, as of early 2026, the petition and rulemaking process described above has been significantly disrupted. The WTCHP had announced in December 2024 that decisions on the pending autoimmune and cardiac petitions would be made by March 2025. Those decisions were not issued, and as of spring 2026, there is no clear public timeline for when they will be.
These delays stem from substantial staffing and leadership changes at the WTCHP and NIOSH beginning in early 2025. In March 2025, the program experienced the termination of more than a dozen staff members and the removal of Dr. John Howard, the long-time WTCHP Administrator and NIOSH Director. While Dr. Howard was later temporarily reinstated, the leadership situation has remained unstable.
By March 2026, the WTCHP was operating with only 84 of its 120 funded positions, a 30% vacancy rate, and some staff, including the program’s deputy director, were temporarily reassigned to other federal agencies. These staffing shortages have stalled critical functions, including research grant awards (with over $20 million in research contracts not yet awarded), enrollment processing, and the certification of new conditions for coverage. Multiple members of Congress from both parties, the FDNY’s Chief Medical Officer, and 9/11 advocacy organizations have called on HHS Secretary Robert F. Kennedy, Jr. to address these disruptions and restore the program to full operation.
Despite these operational challenges, the underlying legal framework remains intact. The Zadroga statute still requires the WTCHP to consider valid petitions and make determinations on new conditions. Responders and survivors should continue to work with their medical providers and legal counsel to document their conditions and preserve their rights.
The WTCHP Makes a Decision and Issues a Notice of Proposed Rulemaking
When the scientific review process is completed, the WTCHP Administrator will come to a determination. If the evidence is deemed sufficient for inclusion, the next step is to publish a Notice of Proposed Rulemaking (NPRM) in the Federal Register. Doing so includes writing up:
- The proposed addition of the health condition
- A summary of supporting evidence
- A request for public comments (typically a 30-day comment period)
One success story for inclusion is uterine cancer, which was officially proposed for inclusion in a rulemaking notice published in 2022. Uterine cancer was formally added in 2023 after scientific review, public comment, advocacy by firms like ours, and publication of the final rule.
The WTCHP Issues a Final Rule
After reviewing any public input during a designated comment period, the WTCHP issues a Final Rule. This will also be published in the Federal Register.
If approved, the condition is added to the official list of WTC-related health conditions. Once added, WTCHP clinicians can begin certifying the condition for treatment.
The VCF Follows Up and Accepts Claims for the Condition
The VCF does not maintain a separate scientific list of 9/11-related conditions. Instead, it treats the physical health conditions on the WTCHP’s list of WTC-Related Health Conditions as its presumptively covered conditions. When the WTCHP adds a new physical condition through its rulemaking process, that diagnosis becomes presumptively covered for VCF purposes as well, as has happened each time the WTCHP has expanded its list (for example, when cancers were first added in 2012 and uterine cancer was added in 2023).
Individual claimants must still obtain WTCHP certification for the condition and meet all other VCF eligibility requirements. It is also worth noting that the VCF has recently implemented significant policy changes affecting how compensation is calculated.
Among the most important changes, the VCF has extended work-life calculations from age 65 to age 70 for many claimants and has established new baseline calculations for individuals who are unable to work. These changes may substantially increase awards for eligible claimants. As of the end of 2025, the VCF had awarded more than $16.8 billion to over 71,000 claimants since the program reopened in 2011.
Lifetime Funding Secured for the WTCHP
In January 2026, Congress passed the FY 2026 appropriations minibus package, which included full lifetime funding for the WTCHP. This legislation corrects the program’s funding formula to reflect the true cost of care, updating it through at least 2040 and averting an impending budget shortfall. The bipartisan effort, led by Representative Andrew R. Garbarino and Senator Kirsten Gillibrand, among others, ensures that more than 140,000 enrolled responders and survivors will continue to receive medical monitoring, treatment, and mental health services without interruption.
This is a significant policy victory for the 9/11 community, even as the operational challenges described above continue to affect the program’s day-to-day functions.
Talk to a Lawyer if You’re Having Difficulty Securing 9/11-Related Compensation
If you are eligible for benefits and compensation after 9/11, Pitta & Baione LLP wants to help make sure that you receive them. As New Yorkers ourselves, we know the long shadow that 9/11 cast not only over our city, but also over many of our neighbors’ health and long-term well-being. New diagnoses arise almost every day that affect first responders and their families, those responsible for the 9/11 dust cloud debris cleanup (including 9/11-related work at the Fresh Kills landfill), and residents and workers in Lower Manhattan, among others.
Developing a new illness later in life does not erase the impact of your 9/11 exposure or your right to seek help. Contact us for a review to see how we may be able to help you pursue WTCHP certification and a VCF claim based on the applicable rules and available medical evidence.
