Can I Recoup Medical Expenses I Paid as a Result of My 9/11-Related Condition?

The short answer is yes. If you paid for care for your compensable condition out-of-pocket, either because treatment was not available through the WTC Health Program at the time or because of another reason, reimbursement for those costs is generally available from the VCF.

The longer answer, however, is that the VCF only reimburses for medical expenses when the requests meet certain criteria. The criteria is pretty simple, but worth becoming familiar with before filing a claim for this kind of compensation.

To begin with, the program cautions claimants that processing reimbursements can delay the payment of their award. Reimbursement requests, after all, involve a huge amount of documentation and take a tremendous amount of time to review. Because of this, the VCF has adjusted their process to ensure that claimants who want to include out-of-pocket medical expenses in their claim still get their primary awards in a timely fashion.

The VCF generally only accepts claims for medical expenses as compensation amendments, meaning they must be filed after your initial claim and generally only after the initial award determination has been made. That way they can issue an initial reward before embarking on the more onerous process of considering a medical expense claim. Additionally, the VCF will only consider claims for out-of-pocket medical expenses when they exceed $5,000.

With that said, the Special Master has the ability to waive some of these requirements when it’s appropriate in a specific circumstance, and the VCF helpline, as well as your VCF attorney, can help you figure out whether that means you.

It’s also important to note that claimants do not need to have incurred financial costs in order to qualify for the VCF. Anybody with a compensable condition who meets the VCF criteria will qualify for a basic award for pain and suffering, whether or not they have substantial medical expenses or lost income.