---
kind: "section"
citation: "42 U.S.C. § 300mm–21"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300mm–21"
heading: "Identification of WTC responders and provision of WTC-related monitoring services"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300mm-21"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXXI — World Trade Center Health Program"
  - "Part B — Program of Monitoring, Initial Health Evaluations, and Treatment"
  - "Subpart 1 — wtc responders"
---

# §300mm–21. Identification of WTC responders and provision of WTC-related monitoring services

- (a) **WTC responder defined—**
  - (1) **In general—** For purposes of this subchapter, the term “WTC responder” means any of the following individuals, subject to [paragraph (4)](#a-4):
    - (A) **Currently identified responder—** An individual who has been identified as eligible for monitoring under the arrangements as in effect on January 2, 2011, between the National Institute for Occupational Safety and Health and—
      - (i) the [consortium](/usc/42/17061.md?p=4) coordinated by Mt. Sinai [Hospital](/usc/42/300s–3.md?p=1) in New York City that coordinates the monitoring and [treatment](/usc/42/11851.md?p=11) for enrolled WTC responders other than with respect to those covered under the arrangement with the Fire Department of New York City; or
      - (ii) the Fire Department of New York City.
    - (B) **Responder who meets current eligibility criteria—** An individual who meets the current eligibility criteria described in [paragraph (2)](#a-2).
    - (C) **Responder who meets modified eligibility criteria—** An individual who—
      - (i) performed rescue, recovery, demolition, debris cleanup, or other related [services](/usc/42/201.md?p=a) in the New York City [disaster](/usc/42/5204.md?p=2) area in response to the September 11, 2001, terrorist attacks, regardless of whether such [services](/usc/42/201.md?p=a) were performed by a [State](/usc/42/201.md?p=f) or Federal [employee](/usc/42/300gg–91.md?p=d-5) or member of the National Guard or otherwise; and
      - (ii) meets such eligibility criteria relating to exposure to airborne toxins, other hazards, or adverse conditions resulting from the September 11, 2001, terrorist attacks as the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4), after consultation with the WTC Scientific/Technical [Advisory Committee](/usc/42/17061.md?p=2), determines appropriate.

      The WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) shall not modify such eligibility criteria on or after the date that the number of enrollments of WTC responders has reached 80 percent of the limit described in [paragraph (4)](#a-4) or on or after the date that the number of certifications for certified-eligible WTC survivors under [section 300mm–31(a)(2)(B) of this title](/usc/42/300mm–31.md?p=a-2-B) has reached 80 percent of the limit described in [section 300mm–31(a)(3) of this title](/usc/42/300mm–31.md?p=a-3).

  - (2) **Current eligibility criteria—** The eligibility criteria described in this paragraph for an individual is that the individual is described in any of the following categories:
    - (A) **Firefighters and related personnel—** The individual—
      - (i) was a member of the Fire Department of New York City (whether fire or emergency personnel, active or retired) who participated at least one day in the rescue and recovery effort at any of the former World Trade Center sites (including Ground Zero, Staten Island Landfill, and the New York City Chief Medical Examiner’s Office) for any time during the period beginning on September 11, 2001, and ending on July 31, 2002; or
      - (ii)
        - (I) is a surviving immediate [family member](/usc/42/300gg–91.md?p=d-15) of an individual who was a member of the Fire Department of New York City (whether fire or emergency personnel, active or retired) and was killed at the World Trade site on September 11, 2001; and
        - (II) received any [treatment](/usc/42/11851.md?p=11) for a WTC-related health condition described in [section 300mm–22(a)(1)(A)(ii) of this title](/usc/42/300mm–22.md?p=a-1-A-ii) (relating to mental health conditions) on or before September 1, 2008.
    - (B) **Law enforcement officers and WTC rescue, recovery, and cleanup workers—** The individual—
      - (i) worked or volunteered onsite in rescue, recovery, debris cleanup, or related support [services](/usc/42/201.md?p=a) in lower Manhattan (south of Canal St.), the Staten Island Landfill, or the barge loading piers, for at least 4 hours during the period beginning on September 11, 2001, and ending on September 14, 2001, for at least 24 hours during the period beginning on September 11, 2001, and ending on September 30, 2001, or for at least 80 hours during the period beginning on September 11, 2001, and ending on July 31, 2002;
      - (ii)
        - (I) was a member of the Police Department of New York City (whether active or retired) or a member of the Port Authority Police of the Port Authority of New York and New Jersey (whether active or retired) who participated onsite in rescue, recovery, debris cleanup, or related [services](/usc/42/201.md?p=a) in lower Manhattan (south of Canal St.), including Ground Zero, the Staten Island Landfill, or the barge loading piers, for at least 4 hours during the period beginning September 11, 2001, and ending on September 14, 2001;
        - (II) participated onsite in rescue, recovery, debris cleanup, or related [services](/usc/42/201.md?p=a) at Ground Zero, the Staten Island Landfill, or the barge loading piers, for at least one day during the period beginning on September 11, 2001, and ending on July 31, 2002;
        - (III) participated onsite in rescue, recovery, debris cleanup, or related [services](/usc/42/201.md?p=a) in lower Manhattan (south of Canal St.) for at least 24 hours during the period beginning on September 11, 2001, and ending on September 30, 2001; or
        - (IV) participated onsite in rescue, recovery, debris cleanup, or related [services](/usc/42/201.md?p=a) in lower Manhattan (south of Canal St.) for at least 80 hours during the period beginning on September 11, 2001, and ending on July 31, 2002;
      - (iii) was an [employee](/usc/42/300gg–91.md?p=d-5) of the Office of the Chief Medical Examiner of New York City involved in the examination and handling of human remains from the World Trade Center attacks, or other morgue worker who performed similar post-September 11 functions for such Office staff, during the period beginning on September 11, 2001, and ending on July 31, 2002;
      - (iv) was a worker in the Port Authority Trans-Hudson [Corporation](/usc/42/2297h.md?p=2) Tunnel for at least 24 hours during the period beginning on February 1, 2002, and ending on July 1, 2002; or
      - (v) was a vehicle-maintenance worker who was exposed to debris from the former World Trade Center while retrieving, driving, cleaning, repairing, and maintaining vehicles contaminated by airborne toxins from the September 11, 2001, terrorist attacks during a duration and period described in [subparagraph (A)](#a-2-A).
    - (C) **Responders to the September 11 attacks at the Pentagon and Shanksville, Pennsylvania—** The individual—
      - (i)
        - (I) was a member of a fire or police department (whether fire or emergency personnel, active or retired), worked for a recovery or cleanup contractor, or was a volunteer; and performed rescue, recovery, demolition, debris cleanup, or other related [services](/usc/42/201.md?p=a) at the Pentagon site of the terrorist-related aircraft crash of September 11, 2001, during the period beginning on September 11, 2001, and ending on the date on which the cleanup of the site was concluded, as determined by the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4);
        - (II) was a member of a fire or police department (whether fire or emergency personnel, active or retired), worked for a recovery or cleanup contractor, or was a volunteer; and performed rescue, recovery, demolition, debris cleanup, or other related [services](/usc/42/201.md?p=a) at the Shanksville, Pennsylvania, site of the terrorist-related aircraft crash of September 11, 2001, during the period beginning on September 11, 2001, and ending on the date on which the cleanup of the site was concluded, as determined by the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4);
        - (III) was an [employee](/usc/42/300gg–91.md?p=d-5) of the Department of Defense or any other Federal [agency](/usc/42/8262.md?p=1), worked during the period beginning on September 11, 2001, and ending on September 18, 2001, for a contractor of the Department of Defense or any other Federal [agency](/usc/42/8262.md?p=1), or was a member of a regular or reserve component of the [uniformed services](/usc/42/201.md?p=p); and performed rescue, recovery, demolition, debris cleanup, or other related [services](/usc/42/201.md?p=a) at the Pentagon site of the terrorist-related aircraft crash of September 11, 2001, during the period beginning on September 11, 2001, and ending on the date on which the cleanup of the site was concluded, as determined by the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4); or
        - (IV) was an [employee](/usc/42/300gg–91.md?p=d-5) of the Department of Defense or any other Federal [agency](/usc/42/8262.md?p=1), worked during the period beginning on September 11, 2001, and ending on September 18, 2001, for a contractor of the Department of Defense or any other Federal [agency](/usc/42/8262.md?p=1), or was a member of a regular or reserve component of the [uniformed services](/usc/42/201.md?p=p); and performed rescue, recovery, demolition, debris cleanup, or other related [services](/usc/42/201.md?p=a) at the Shanksville, Pennsylvania, site of the terrorist-related aircraft crash of September 11, 2001, during the period beginning on September 11, 2001, and ending on the date on which the cleanup of the site was concluded, as determined by the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4); and
      - (ii) is determined by the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) to be at an increased risk of developing a WTC-related health condition as a result of exposure to airborne toxins, other hazards, or adverse conditions resulting from the September 11, 2001, terrorist attacks, and meets such eligibility criteria related to such exposures, as the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) determines are appropriate, after consultation with the WTC Scientific/Technical [Advisory Committee](/usc/42/17061.md?p=2).
  - (3) **Enrollment process—**
    - (A) **In general—** The WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) shall establish a process for enrolling WTC responders in the WTC [Program](/usc/42/274l–1.md?p=4). Under such process—
      - (i) WTC responders described in [paragraph (1)(A)](#a-1-A) shall be deemed to be enrolled in such [Program](/usc/42/274l–1.md?p=4);
      - (ii) subject to [clause (iii)](#a-3-A-iii), the [Administrator](/usc/42/300bb–8.md?p=4) shall enroll in such [program](/usc/42/274l–1.md?p=4) individuals who are determined to be WTC responders;
      - (iii) the [Administrator](/usc/42/300bb–8.md?p=4) shall deny such enrollment to an individual if the [Administrator](/usc/42/300bb–8.md?p=4) determines that the numerical limitation in [paragraph (4)](#a-4) on enrollment of WTC responders has been met;
      - (iv) there shall be no fee charged to the applicant for making an application for such enrollment;
      - (v) the [Administrator](/usc/42/300bb–8.md?p=4) shall make a determination on such an application not later than 60 days after the date of filing the application; and
      - (vi) an individual who is denied enrollment in such [Program](/usc/42/274l–1.md?p=4) shall have an opportunity to appeal such determination in a manner established under such process.
    - (B) **Timing—**
      - (i) **Currently identified responders—** In accordance with [subparagraph (A)(i)](#a-3-A-i), the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) shall enroll an individual described in [paragraph (1)(A)](#a-1-A) in the WTC [Program](/usc/42/274l–1.md?p=4) not later than July 1, 2011.
      - (ii) **Other responders—** In accordance with [subparagraph (A)(ii)](#a-3-A-ii) and consistent with [paragraph (4)](#a-4), the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) shall enroll any other individual who is determined to be a WTC responder in the WTC [Program](/usc/42/274l–1.md?p=4) at the time of such determination.
  - (4) **Numerical limitation on eligible WTC responders—**
    - (A) **Limit—**
      - (i) **In general—** The total number of individuals not described in paragraph [(1)(A)](#a-1-A) or [(2)(A)(ii)](#a-2-A-ii) or subclause [(III)](#a-2-C-i-III) or [(IV)](#a-2-C-i-IV) of paragraph (2)(C)(i) who may be enrolled under [paragraph (3)(A)(ii)](#a-3-A-ii) shall not exceed 75,000 at any time, of which no more than 2,500 may be individuals enrolled based on modified eligibility criteria established under [paragraph (1)(C)](#a-1-C).
      - (ii) **Certain responders to the September 11 attacks at the Pentagon and Shanksville, Pennsylvania—** The total number of individuals who may be enrolled under [paragraph (3)(A)(ii)](#a-3-A-ii) based on eligibility criteria described in subclause [(III)](#a-2-C-i-III) or [(IV)](#a-2-C-i-IV) of paragraph (2)(C)(i) shall not exceed 500 at any time.
    - (B) **Process—** In implementing [subparagraph (A)](#a-4-A), the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) shall—
      - (i) limit the number of enrollments made under [paragraph (3)](#a-3)—
        - (I) in accordance with such subparagraph; and
        - (II) to such number, as determined by the [Administrator](/usc/42/300bb–8.md?p=4) based on the best available information and subject to amounts available under this subchapter, that will ensure sufficient funds will be available to provide [treatment](/usc/42/11851.md?p=11) and monitoring benefits under this subchapter, with respect to all individuals who are enrolled; and
      - (ii) provide priority (subject to [paragraph (3)(A)(i)](#a-3-A-i)) in such enrollments in the order in which individuals apply for enrollment under [paragraph (3)](#a-3).
  - (5) **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 an eligible WTC responder. Before enrolling any individual as a WTC responder in the WTC [Program](/usc/42/274l–1.md?p=4) under [paragraph (3)](#a-3), the [Administrator](/usc/42/300bb–8.md?p=4), in consultation with the [Secretary](/usc/42/201.md?p=c) of Homeland Security, shall determine whether the individual is on such list.
- (b) **Monitoring benefits—**
  - (1) **In general—** In the case of an enrolled WTC responder (other than one described in [subsection (a)(2)(A)(ii)](#a-2-A-ii)), the WTC [Program](/usc/42/274l–1.md?p=4) shall provide for monitoring benefits that include monitoring consistent with protocols approved by the WTC [Program](/usc/42/274l–1.md?p=4) [Administrator](/usc/42/300bb–8.md?p=4) and including clinical examinations and long-term health monitoring and analysis. In the case of an enrolled WTC responder who is an active member of the Fire Department of New York City, the responder shall receive such benefits as part of the individual’s periodic company medical exams.
  - (2) **Provision of monitoring benefits—** The monitoring benefits under [paragraph (1)](#b-1) shall be provided through the Clinical Center of Excellence for the type of individual involved or, in the case of an individual residing outside the New York metropolitan area, under an arrangement under [section 300mm–23 of this title](/usc/42/300mm–23.md).

## Source credit

(July 1, 1944, ch. 373, title XXXIII, § 3311, as added Pub. L. 111–347, title I, § 101, Jan. 2, 2011, 124 Stat. 3635; amended Pub. L. 114–113, div. O, title III, § 302(d), Dec. 18, 2015, 129 Stat. 2999; Pub. L. 116–59, div. B, title VI, § 1602(a), Sept. 27, 2019, 133 Stat. 1107; Pub. L. 117–328, div. FF, title VII, § 7701(b)(1), Dec. 29, 2022, 136 Stat. 5965; Pub. L. 118–31, div. A, title XVIII, § 1851(a)(2), (c)(1), Dec. 22, 2023, 137 Stat. 706, 708.)

## Notes

### Editorial Notes

### Amendments

2023—Subsec. (a)(2)(C)(i)(III), (IV). Pub. L. 118–31, § 1851(a)(2)(A), added subcls. (III) and (IV).

Subsec. (a)(4)(A). Pub. L. 118–31, § 1851(a)(2)(B), substituted “Limit” for “In general” in subpar. heading, designated existing provisions as cl. (i) and inserted cl. heading, inserted “or subclause (III) or (IV) of paragraph (2)(C)(i)” after “or (2)(A)(ii)”, and added cl. (ii).

Subsec. (a)(4)(B)(i)(II). Pub. L. 118–31, § 1851(c)(1), substituted “this subchapter” for “sections 300mm–61 and 300mm–62 of this title”.

2022—Subsec. (a)(4)(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)(4)(A). Pub. L. 116–59 substituted “75,000” for “25,000”.

2015—Subsec. (a)(4)(B)(i)(II). Pub. L. 114–113 struck out “through the end of fiscal year 2020” after “who are enrolled”.

### Statutory Notes and Related Subsidiaries

### Rule of Construction

Pub. L. 116–59, div. B, title VI, § 1602(c), Sept. 27, 2019, 133 Stat. 1107, provided that: “Nothing in this section [amending this section and section 300mm–31 of this title], or the amendments made by this section, shall alter the annual limitations on amounts appropriated to the World Trade Center Health Program Fund under section 3351(a)(2) of the Public Health Service Act (42 U.S.C. 300mm–61(a)(2)).”