---
kind: "section"
citation: "42 U.S.C. § 300mm–31"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300mm–31"
heading: "Identification and initial health evaluation of screening-eligible and certified-eligible WTC survivors"
release: "119-102"
url: "https://uscodex.org/usc/42/300mm-31"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXXI — World Trade Center Health Program"
  - "Part B — Program of Monitoring, Initial Health Evaluations, and Treatment"
  - "Subpart 2 — wtc survivors"
---

# §300mm–31. Identification and initial health evaluation of screening-eligible and certified-eligible WTC survivors

- (a) **Identification of screening-eligible WTC survivors and certified-eligible WTC survivors—**
  - (1) **Screening-eligible WTC survivors—**
    - (A) **Definition—** In this subchapter, the term “screening-eligible WTC survivor” means, subject to [subparagraph (C)](#a-1-C) and [paragraph (3)](#a-3), an individual who is described in any of the following clauses:
      - (i) **Currently identified survivor—** An individual, including a [WTC responder](/usc/42/300mm–21.md?p=a-1), who has been identified as eligible for medical [treatment](/usc/42/11851.md?p=11) and monitoring by the WTC Environmental Health Center as of January 2, 2011.
      - (ii) **Survivor who meets current eligibility criteria—** An individual who is not a [WTC responder](/usc/42/300mm–21.md?p=a-1), for purposes of the [initial health evaluation](/usc/42/300mm–5.md?p=6) under [subsection (b)](#b), [claims](/usc/42/1320a–7a.md?p=i-2) symptoms of a [WTC-related health condition](/usc/42/300mm–22.md?p=a-1) and meets any of the current eligibility criteria described in [subparagraph (B)](#a-1-B).
      - (iii) **Survivor who meets modified eligibility criteria—** An individual who is not a [WTC responder](/usc/42/300mm–21.md?p=a-1), for purposes of the [initial health evaluation](/usc/42/300mm–5.md?p=6) under [subsection (b)](#b), [claims](/usc/42/1320a–7a.md?p=i-2) symptoms of a [WTC-related health condition](/usc/42/300mm–22.md?p=a-1) and meets such eligibility criteria relating to exposure to airborne toxins, other [hazards](/usc/42/5165f.md?p=a-3), or adverse conditions resulting from the [September 11, 2001, terrorist attacks](/usc/42/300mm–5.md?p=12) as the WTC [Administrator](/usc/42/4005.md?p=1) determines, after consultation with the [Data Centers](/usc/42/300mm–4.md?p=b-2) described in [section 300mm–4 of this title](/usc/42/300mm–4.md) and the [WTC Scientific/Technical Advisory Committee](/usc/42/300mm–5.md?p=19) and [WTC Health Program Steering Committees](/usc/42/300mm–5.md?p=14) under [section 300mm–1 of this title](/usc/42/300mm–1.md).

      The [Administrator](/usc/42/4005.md?p=1) shall not modify such criteria under [clause (iii)](#a-1-A-iii) on or after the date that the number of certifications for [certified-eligible WTC survivors](#a-2-A) under [paragraph (2)(B)](#a-2-B) has reached 80 percent of the limit described in [paragraph (3)](#a-3) or on or after the date that the number of enrollments of [WTC responders](/usc/42/300mm–21.md?p=a-1) has reached 80 percent of the limit described in [section 300mm–21(a)(4) of this title](/usc/42/300mm–21.md?p=a-4).

    - (B) **Current eligibility criteria—** The eligibility criteria described in this subparagraph for an individual are that the individual is described in any of the following clauses:
      - (i) A [person](/usc/42/1320a–7k.md?p=d-4-C-i) who was present in the [New York City disaster area](/usc/42/300mm–5.md?p=8) in the dust or dust cloud on September 11, 2001.
      - (ii) A [person](/usc/42/1320a–7k.md?p=d-4-C-i) who worked, resided, or attended [school](/usc/42/6372.md?p=1), childcare, or adult daycare in the [New York City disaster area](/usc/42/300mm–5.md?p=8) for—
        - (I) at least 4 days during the 4-month period beginning on September 11, 2001, and ending on January 10, 2002; or
        - (II) at least 30 days during the period beginning on September 11, 2001, and ending on July 31, 2002.
      - (iii) Any [person](/usc/42/1320a–7k.md?p=d-4-C-i) who worked as a cleanup worker or performed maintenance work in the [New York City disaster area](/usc/42/300mm–5.md?p=8) during the 4-month period described in [subparagraph (B)(i)](#a-1-B-i) and had extensive exposure to WTC dust as a result of such work.
      - (iv) A [person](/usc/42/1320a–7k.md?p=d-4-C-i) who was deemed eligible to receive a grant from the Lower Manhattan Development [Corporation](/usc/42/2296b–7.md?p=1) Residential Grant [Program](/usc/42/274l–1.md?p=4), who possessed a lease for a residence or purchased a residence in the [New York City disaster area](/usc/42/300mm–5.md?p=8), and who resided in such residence during the period beginning on September 11, 2001, and ending on May 31, 2003.
      - (v) A [person](/usc/42/1320a–7k.md?p=d-4-C-i) whose place of employment—
        - (I) at any time during the period beginning on September 11, 2001, and ending on May 31, 2003, was in the [New York City disaster area](/usc/42/300mm–5.md?p=8); and
        - (II) was deemed eligible to receive a grant from the Lower Manhattan Development [Corporation](/usc/42/2296b–7.md?p=1) WTC Small Firms Attraction and Retention Act [program](/usc/42/274l–1.md?p=4) or other government incentive [program](/usc/42/274l–1.md?p=4) designed to revitalize the lower Manhattan economy after the [September 11, 2001, terrorist attacks](/usc/42/300mm–5.md?p=12).
    - (C) **Application and determination process for screening eligibility—**
      - (i) **In general—** The [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) in consultation with the [Data Centers](/usc/42/300mm–4.md?p=b-2) shall establish a process for individuals, other than individuals described in [subparagraph (A)(i)](#a-1-A-i), to be determined to be [screening-eligible WTC survivors](#a-1-A). Under such process—
        - (I) there shall be no fee charged to the applicant for making an application for such determination;
        - (II) the [Administrator](/usc/42/4005.md?p=1) shall make a determination on such an application not later than 60 days after the date of filing the application;
        - (III) the [Administrator](/usc/42/4005.md?p=1) shall make such a determination relating to an applicant’s compliance with this subchapter and shall not determine that an individual is not so eligible or deny written documentation under [clause (ii)](#a-1-C-ii) to such individual unless the [Administrator](/usc/42/4005.md?p=1) determines that—
          - (aa) based on the application submitted, the individual does not meet the eligibility criteria; or
          - (bb) the numerical limitation on certifications of [certified-eligible WTC survivors](#a-2-A) set forth in [paragraph (3)](#a-3) has been met; and
        - (IV) an individual who is determined not to be a [screening-eligible WTC survivor](#a-1-A) shall have an opportunity to appeal such determination in a manner established under such process.
      - (ii) **Written documentation of screening-eligibility—**
        - (I) **In general—** In the case of an individual who is described in [subparagraph (A)(i)](#a-1-A-i) or who is determined under [clause (i)](#a-1-C-i) (consistent with [paragraph (3)](#a-3)) to be a [screening-eligible WTC survivor](#a-1-A), the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall provide an appropriate written documentation of such fact.
        - (II) **Timing—**
          - (aa) **Currently identified survivors—** In the case of an individual who is described in [subparagraph (A)(i)](#a-1-A-i), the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall provide the written documentation under [subclause (I)](#a-1-C-ii-I) not later than July 1, 2011.
          - (bb) **Other members—** In the case of another individual who is determined under [clause (i)](#a-1-C-i) and consistent with [paragraph (3)](#a-3) to be a [screening-eligible WTC survivor](#a-1-A), the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall provide the written documentation under [subclause (I)](#a-1-C-ii-I) at the time of such determination.
  - (2) **Certified-eligible WTC survivors—**
    - (A) **Definition—** The term “certified-eligible WTC survivor” means, subject to [paragraph (3)](#a-3), a [screening-eligible WTC survivor](#a-1-A) who the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) certifies under [subparagraph (B)](#a-2-B) to be eligible for followup monitoring and [treatment](/usc/42/11851.md?p=11) under this subpart.
    - (B) **Certification of eligibility for monitoring and treatment—**
      - (i) **In general—** The [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall establish a certification process under which the [Administrator](/usc/42/4005.md?p=1) shall provide appropriate certification to [screening-eligible WTC survivors](#a-1-A) who, pursuant to the [initial health evaluation](/usc/42/300mm–5.md?p=6) under [subsection (b)](#b), are determined to be eligible for followup monitoring and [treatment](/usc/42/11851.md?p=11) under this subpart.
      - (ii) **Timing—**
        - (I) **Currently identified survivors—** In the case of an individual who is described in [paragraph (1)(A)(i)](#a-1-A-i), the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall provide the certification under [clause (i)](#a-2-B-i) not later than July 1, 2011.
        - (II) **Other members—** In the case of another individual who is determined under [clause (i)](#a-2-B-i) to be eligible for followup monitoring and [treatment](/usc/42/11851.md?p=11), the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall provide the certification under such clause at the time of such determination.
  - (3) **Numerical limitation on certified-eligible WTC survivors—**
    - (A) **In general—** The total number of individuals not described in [paragraph (1)(A)(i)](#a-1-A-i) who may be certified as [certified-eligible WTC survivors](#a-2-A) under [paragraph (2)(B)](#a-2-B) shall not exceed 75,000 at any time.
    - (B) **Process—** In implementing [subparagraph (A)](#a-3-A), the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A) shall—
      - (i) limit the number of certifications provided under [paragraph (2)(B)](#a-2-B)—
        - (I) in accordance with such subparagraph; and
        - (II) to such number, as determined by the [Administrator](/usc/42/4005.md?p=1) based on the best available information and subject to amounts made available under this subchapter, that will ensure sufficient [funds](/usc/42/12854.md?p=3) will be available to provide [treatment](/usc/42/11851.md?p=11) and monitoring benefits under this subchapter, with respect to all individuals receiving such certifications; and
      - (ii) provide priority in such certifications in the order in which individuals apply for a determination under [paragraph (2)(B)](#a-2-B).
  - (4) **Disqualification of individuals on terrorist watch list—** No individual who is on the terrorist watch list maintained by the Department of Homeland Security shall qualify as a [screening-eligible WTC survivor](#a-1-A) or a [certified-eligible WTC survivor](#a-2-A). Before determining any individual to be a [screening-eligible WTC survivor](#a-1-A) under [paragraph (1)](#a-1) or certifying any individual as a certified eligible[^1] WTC survivor under [paragraph (2)](#a-2), the [Administrator](/usc/42/4005.md?p=1), in consultation with the [Secretary](/usc/42/201.md?p=c) of Homeland Security, shall determine whether the individual is on such list.
- (b) **Initial health evaluation to determine eligibility for followup monitoring or treatment—**
  - (1) **In general—** In the case of a [screening-eligible WTC survivor](#a-1-A), the [WTC Program](/usc/42/300mm–5.md?p=15) shall provide for an [initial health evaluation](/usc/42/300mm–5.md?p=6) to determine if the survivor has a [WTC-related health condition](/usc/42/300mm–22.md?p=a-1) and is eligible for followup monitoring and [treatment](/usc/42/11851.md?p=11) benefits under the [WTC Program](/usc/42/300mm–5.md?p=15). [Initial health evaluation](/usc/42/300mm–5.md?p=6) protocols under [section 300mm–4(a)(2)(A)(ii) of this title](/usc/42/300mm–4.md?p=a-2-A-ii) shall be subject to approval by the [WTC Program Administrator](/usc/42/300mm–5.md?p=16-A).
  - (2) **Initial health evaluation providers—** The [initial health evaluation](/usc/42/300mm–5.md?p=6) described in [paragraph (1)](#b-1) shall be provided through a [Clinical Center of Excellence](/usc/42/300mm–4.md?p=b-1-A) with respect to the individual involved.
  - (3) **Limitation on initial health evaluation benefits—** Benefits for an [initial health evaluation](/usc/42/300mm–5.md?p=6) under this subpart for a [screening-eligible WTC survivor](#a-1-A) shall consist only of a [single](/usc/42/2304.md?p=m) medical [initial health evaluation](/usc/42/300mm–5.md?p=6) consistent with [initial health evaluation](/usc/42/300mm–5.md?p=6) protocols described in [paragraph (1)](#b-1). Nothing in this paragraph shall be construed as preventing such an individual from seeking additional medical [initial health evaluations](/usc/42/300mm–5.md?p=6) at the expense of the individual.

## Footnotes

[^1]: So in original. Probably should be “certified-eligible”.

## Source credit

(July 1, 1944, ch. 373, title XXXIII, § 3321, as added Pub. L. 111–347, title I, § 101, Jan. 2, 2011, 124 Stat. 3648; amended Pub. L. 114–113, div. O, title III, § 302(f), Dec. 18, 2015, 129 Stat. 3000; Pub. L. 116–59, div. B, title VI, § 1602(b), Sept. 27, 2019, 133 Stat. 1107; Pub. L. 117–328, div. FF, title VII, § 7701(b)(2), Dec. 29, 2022, 136 Stat. 5965; Pub. L. 118–31, div. A, title XVIII, § 1851(c)(2), Dec. 22, 2023, 137 Stat. 708.)

## Notes

### Editorial Notes

### Amendments

2023—Subsec. (a)(3)(B)(i)(II). Pub. L. 118–31 substituted “this subchapter” for “sections 300mm–61 and 300mm–62 of this title”.

2022—Subsec. (a)(3)(B)(i)(II). Pub. L. 117–328 substituted “sections 300mm–61 and 300mm–62 of this title” for “section 300mm–61 of this title”.

2019—Subsec. (a)(3)(A). Pub. L. 116–59 substituted “75,000” for “25,000”.

2015—Subsec. (a)(3)(B)(i)(II). Pub. L. 114–113 struck out “through the end of fiscal year 2020” after “certifications”.

### Statutory Notes and Related Subsidiaries

### Rule of Construction

Nothing in amendment made by Pub. L. 116–59 to alter the annual limitations on amounts appropriated to the World Trade Center Health Program Fund under section 300mm–61(a)(2) of this title, see section 1602(c) of Pub. L. 116–59, set out as a note under section 300mm–21 of this title.