Cancer, Chronic Illnesses Are Rising Among 9/11 First Responders—But Their Retirement Claims Keep Getting Denied

By Andy Mai | September 10, 2021

September 11th and NYPD: The Legacy
In this 20th anniversary series, WNYC/Gothamist is exploring how the September 11th attacks fundamentally changed the NYPD, its approach to policing and the city’s relationship with the nation’s largest municipal police department. For links to all of the stories we’ve published and for more about how WNYC, Gothamist and New York Public Radio is recognizing this anniversary, scroll to the bottom of this story.

Ivonne Sanchez was responding to an emergency in the Bronx when the first plane flew into the World Trade Center on 9/11. By the time the FDNY EMT was able to make it downtown, the towers had collapsed.

From that moment, she rushed to help the survivors who escaped the disaster. And for the next 10 months, she recovered the bodies of those who didn’t.

“We were just in rescue mode,” Sanchez said. “We were just trying to get all the people out quickly and safely as possible and try to figure out what was going on from there on.”

In the years after, Sanchez initially developed asthma, as did many first responders given the air pollution from the towers’ collapse. But after she retired in 2004, she developed breast cancer and had a mastectomy. The following year, the World Trade Center (WTC) Disability Law took effect across New York state and allowed people to reclassify their reasons for retirement—a procedure that could make them eligible for more benefits related to 9/11-health conditions.

According to the city, the law “established a presumption that certain disabilities for certain New York City employees were caused by rescue, recovery or clean-up operations at the WTC and entitled the employee to accidental disability retirement benefits.” That applied to any future medical condition as long as an employee had worked 40 hours or more at Ground Zero in the year after the attack and that their claim couldn’t be otherwise disproven.

But when Sanchez tried to reclassify her pension and add her breast cancer diagnosis via the New York City Employees’ Retirement System in 2014, she was denied four times. She argues the cancer was linked to her work at Ground Zero, but needs the retirement system’s medical board to reach the same conclusion. Ultimately, the retirement board approved only benefits for her asthma, a decision that came in 2018.

“I lost out on several thousands of dollars because it took four years,” Sanchez said. And if she were to die from her breast cancer, she would not get the full accidental death benefits.

First responders who worked at Ground Zero frequently run into red tape as they develop health conditions such as cancer. These types of long-term illnesses tend to emerge well after exposure to pollution or other health hazards, making it hard to prove cause and effect.

Gary Smiley is the World Trade Center Liaison for the FDNY EMS Local 2507, which represents EMTs, paramedics, and fire inspectors. Smiley said only three of his members have been approved for 9/11 retirement benefits but dozens have applied over the last year.

“When I was first fighting to get people even to sign up to the World Trade Center health program—because a lot of people still weren’t signed up— I would always tell them, it’s not if you’re going to get sick, it’s when you’re going to get sick,” said Smiley, a retired rescue paramedic who was buried under the rubble near the North Tower on 9/11.

Demand for federal 9/11 funds has significantly outpaced payouts, and survivors have long struggled to prove their eligibility. While 131,000 people have registered with the 9/11 Victim Compensation Fund since 2011, only 41,000 have been deemed eligible for payouts.

There has also been a drop in new claims in recent years relative to the number of new people signing up. Just shy of 7,000 people–survivors and responders–filed claims in 2020 versus more than 11,000 in 2019. The number of new registrants increased by more than 25,000 people in this time period. Many advocates also fear first responders are delaying treatment and appointments due to the pandemic, and it could have lasting effects on their health.

The World Trade Center Health Program, run by the Centers for Disease Control and Prevention has enrolled 81,000 first responders since 2011. In the beginning, the most common ailments were asthma, allergies and other respiratory disorders.

But since 2016, cancer rates among first responders in the WTC Health Program have more than doubled, going from 8 percent to 18 percent. About 14,000 first responders have developed some form of tumor in the programs as of this summer.

In 2019, New York-area researchers in the program reported higher rates of prostate cancer, thyroid cancer and blood-borne leukemia in 9/11 first responders. A follow-up study, released this July, suggested higher survival rates for these frontline workers, possibly due to the free health care offered by the program.

“You know, 9/11 is the only terrorist attack in history where the body count keeps going up long after the attack is over,” said John Miller, the NYPD’s deputy commissioner of intelligence and counterterrorism.

Yet the New York City Employees’ Retirement System medical board is still not approving responders for some of their conditions.

“I have members that continually express this frustration to me, and I’m concerned about them,” said Dr. Iris Udasin, the medical director of Rutgers University’s division of the World Trade Center Health Program.

The Rutgers branch of the program has compared people of the same age, in the same community, who were Ground Zero versus those who were not and found sharp contrasts.

“The people who were at the World Trade Center have a much higher likelihood of having these medical conditions,” Udasin said. She said it’s easier to prove physical injuries, such as broken bones, but chronic disease and mental illness are more difficult. About 17% of first responders in the CDC’s program have suffered PTSD, anxiety or major depression.

Deb Stewart, the director of communications for the New York City Employees’ Retirement System, declined via email to comment on specific cases such as Sanchez’s, the EMT with breast cancer. She said the medical board consists of three doctors who independently review health documentation and interview the applicant.

Sanchez, meanwhile, has given up on trying to get reclassified for her breast cancer. She said she has undergone 26 surgeries since 9/11 and that going through the retirement process has been demoralizing.

“We have to dance for our supper,” Sanchez said. “Instead of relying on the documentation and your symptoms, getting an examination, they have to question us about the credentials of the doctors we saw.”