New York's Hero Rescue Workers Face Kafkaesque Nightmare
by Joe Flood
An hour after Flight 175 crashed into the South Tower of the World Trade Center on September 11, 2001, the men of FDNY Engine Company 240 received orders at a nearby command post to enter the building and help evacuate survivors.
"As we were walking there it began to collapse and we were caught in the debris field," says fireman Thomas Dunn. "You could see absolutely nothing, we thought the building we were next to collapsed and that we were trapped…the only way I knew we were still outside was when I felt a car door next to me."
Dunn was nearly as close when the North Tower fell a half hour later, and spent the rest of the day searching for survivors. He had to go to the hospital that evening for an ankle injury, but was back the next day and every day that week searching, whether he was on duty or off.
"We lost a chief from the firehouse, about twenty guys I knew, my two best friends," he says. "It took over everything."
Nearly five years later Dunn has developed asthma, coughs when he speaks and has serious acid reflux, the most common symptoms of what has become know as the "World Trade Center Cough." For almost four years after the collapse he was able to stay on the job, fighting the cough and shortness of breath, and taking medication for the acid reflux. But last year he had a severe asthma attack and was pulled off of active duty, probably for the rest of his life.
"I haven't gotten the letter yet, but I've been told that I will be given limited status service, light duty. I can work, but only at a desk."
Dunn is just one of the growing number of city employees—including fire-fighters, police, construction workers, even office workers and a deputy mayor—to develop serious medical problems from exposure to toxic dust at Ground Zero.
So far the death of one relief worker, Detective James Zadroga, has been officially attributed to exposure to toxins at the site, but union officials attribute dozens more deaths to Ground Zero.
"We've lost three people in the last two years, people with respiratory problems," says Patrick Bahnken, president of the Uniformed EMTs and Paramedics Local 2507. "Everyone knows what it's from. One paramedic with no asbestos exposure in her life died from mesothelioma," a rare form of cancer whose only known cause is asbestos exposure. "But no one is willing to say it's from the Trade Center."
A recent Fire Department study, published April in the American Journal of Respiratory and Critical Care Medicine, found that in the single year following 9-11, fire-fighters suffered an average loss of lung capacity equivalent to 12 years of normal fire-fighting, and found that other Ground Zero workers showed signs of similar losses.
"We had baselines for all firefighters based on annual medical exams," says Thomas Von Essen, who was Fire Commissioner on September 11. "It's a good comparison to show this particular guy was fine before September 11, and now he's not. A lot of construction workers and other workers don't have that."
The worst effects, though, were found in emergency workers who were at the site when the towers collapsed.
"It was terrible. The debris, we were choking on it. I had my mask with me but it wasn't on when the tower fell," says Dunn. "The face-piece itself was filled with debris, so when I put it on and took a breath I got all dust and almost threw up. I tried to clear out the mask, put it back on and started breathing OK, but no one else had masks, so I shared it with cops and EMS."
For the first few days only surgical masks were available to workers at the WTC site, and even when enough respirators arrived, many workers did not wear them all the time.
"If 25 percent of people were wearing them at one time, that was a lot," says Jonathan Bennett, public affairs director of the non-profit New York Committee for Occupational Safety and Health. "I've worn respirators and it is hard work. Communication is impossible with them. People who normally wear them have hand signals that they've developed on the job. Wearing them eight hours is a real challenge, and wearing them for those 12-hour shifts they worked… I'm not going to say it's impossible, but it's a lot to ask."
"Looking back, it was a mixed bag," says Von Essen. "Some people didn't wear the masks all of the time, some people didn't wear them at all. It was very warm, and hard to communicate. I'm not sure how we could have prevented it. "
Von Essen experienced breathing trouble himself after working at the site.
"I had some breathing problems at first, but they didn't linger. I've developed asthma since."
A former firefighter, Von Essen says that it's hard to tell whether the asthma was from the WTC or accumulated damage from years of smoke inhalation.
"I was leaning towards it anyway. Some firefighters my age might have been predisposed, certainly anyone who was a smoker," he says. "But we're going to have many terrific firefighters that suffer."
It will be years, doctors say, perhaps decades, before the full extent of the health problems created by the WTC collapse are known. The thousands of rescue workers who risked their lives and their long-term health on September 11 and the days that followed nearly all say they have no regrets, and would gladly do it again. But many who have become sick as a result of their work are being forced to navigate an overburdened bureaucracy that some unions, employees and workers' compensation experts are calling disorganized and too restrictive.
Rudy Washington, a deputy mayor under Rudolph Giuliani who became sick from exposure at Ground Zero, made news recently over his worker's compensation claims. City lawyers first denied Washington's claims—then, when Washington won in court they appealed the decision. When the news went public in mid-May, Mayor Michael Bloomberg asked city lawyers to revisit the case, and they promptly withdrew the appeal.
Washington won his case on the merits and pulled no strings to have his case upheld; in fact he turned down an offer of assistance from Bloomberg months ago. Yet hundreds of city employees find themselves in a predicament similar to the one Mr. Washington was extricated from, and are not confident they will have any extra help form the Mayor's office
"Each case is different and it's all an uphill battle," says EMT union president Bahnken. "As these cases begin to rise this is not a problem that will go away."
New York State's worker compensation laws require that employers pay for lost wages and medical expenses incurred on the job. In the case of an injury, workers have two years from the date of the injury to file a claim; with an "occupational illness" they have two years from the onset of symptoms or diagnosis of the problem. In Washington's case, his claim was at first denied by the city's legal department because they treated his respiratory illness as an injury, and he missed the two-year deadline to file for it.
While few would argue that Washington's breathing problems, which developed years after his exposure to toxic dust at Ground Zero, are the same as a slip-and-fall injury, New York defines an occupational illness as only an infirmity which is common to an employees' line of work. Lung cancer, for instance, is considered an occupational illness for city fire-fighters, but the policy is ambiguous for EMTs and non-uniformed workers.
"An asbestos worker who comes down with lung cancer related to asbestos 20 years later would qualify," says John F. Burton Jr., a lawyer and economics professor at Rutgers University who specializes in workers' compensation. "But as the statute is interpreted, someone like an office worker with lung cancer, or a deputy mayor, would not."
In Washington's case, the city paid for his short hospitalization after 9-11. Because the city paid for an injury incurred on the job, this exempted him from the two-year time limit on filing a workers' comp claim. The court accepted this, but the city appealed on what Bloomberg called a "technicality"—prompting the city to drop the case.
But many workers have not been so fortunate. The New York Times reported May 23 that 290 people have filed claims after the deadline, and as further illnesses arise (some can take years and even decades to develop), that number is likely to increase.
In Albany a bill has been introduced which would eliminate the two-year deadline for all 9-11 workers, giving them six months from when they first notice symptoms to file workers' comp claims—essentially treating 9-11-related health problems as occupations illnesses rather than injuries. Last year a similar measure was passed in Albany applying to disability pensions, lowering the burden of proof that certain illnesses were caused by work at the Ground Zero site. But the future of the workers' comp bill is unclear.
The two-year limitation is only one of a number of bureaucratic hurdles faced by sick workers, like EMT Paul Adams. Adams was near the Trade Center crash site when the South Tower fell, helping twelve people out of the debris, and spent the day rescuing and treating victims.
"That afternoon I collapsed, I couldn't breathe," says Adams, 39, who has been an EMT since 1991. "They sent me to Mt. Sinai [hospital] in Queens with lacerated pupils and breathing problems, and after 6 hours I was discharged."
Five months later Adams started having trouble breathing, and a medical examination turned up lung problems. Because EMTs work for the Fire Department, Adams went before the FDNY's medical review board, which declared him permanently partially disabled and unfit for active duty. He filed for worker's compensation and a disability pension. Police and fire-fighters have their own pension plans, but EMTs must go through the New York City Employees Retirement System (NYCERS) for their pensions.
"I went to NYCERS and went to see their doctor. Not even two minutes into the exam and they denied me," says Adams. "I've got one board telling me I'm too sick to work, another telling me that I can work."
NYCERS director of operations Linda Chiariello says that she sees no problem with the medical board's review process.
"EMTs are our employees, examined by our medical board," she says. "I'm not familiar with the FDNY's board, but there is nothing wrong with our process."
As for EMTs like Adams who are not allowed to return to active duty but have been denied a disability pension, Chiariello says there are opportunities to have the case revisited.
"If our medical board denies disabilities, they could to the board of trustees, make an appeal, or file a lawsuit," she says. "There are a lot of opportunities, this is all spelled out in the administrative code and retirement and social security law."
Adams says he is considering a lawsuit, but is concerned about what will happen while it is being decided. For the last 18 months he has been out of work. Worker's compensation benefits have paid his medical bills to this point but they are about to expire, and without pension benefits, Adams says he's not sure how he's going to pay those bills, or get private insurance with a pre-existing conditions.
"I use three inhalers, and medication I have to take the rest of my life. It's not the pension money I want, it's the benefits," he says. "I know I'm going to get worse in the long term, I don't know how I'll pay for it."
Adams does have the option of returning to work on light duty, but says he doesn't want a desk job.
"I can't climb a set of stairs without getting out of breath," he says. "I'm not going to sit light duty for another ten years in a building breathing recycled air, it's not what I became an EMT for. I don't want to seem like I'm greedy. My concern isn't money, only medical coverage, that's all."
Firefighter Dunn finds himself in a similar limbo. While he has been declared unfit for active duty, he hasn't received a disability pension and unless something changes, the 33-year-old will be on light duty for the foreseeable future.
"It seems like the rules changed," he says. "Before if you failed your lung capacity test they put you right out on disability. Now it's different."
A group of fire-fighters suing the Fire Department are alleging just that. Since 9-11, they say, the department has made it much harder for fire-fighters to receive a disability pension. Attorney Eric Sanders has filed suits for 16 fire-fighters denied disability, and is in the process of filing 12 more.
"Pre 9-11, when firefighters failed pulmonary tests, they were given their three-quarters pensions," says Sanders. "Post 9-11 you have fire-fighters taking multiple tests and failing. The FDNY's own doctors say they are failing, and the pension board is denying them. All these firefighters are in legal limbo, they can't work and they can't retire."
Increased public attention stemming from the Rudy Washington affair, new laws, and lawsuits may smooth the path for those seeking compensation for their health problems and get benefits to those who truly deserve it. In the meantime, many city employees are left wondering about what medical problems may lie in store for them, and how they cope financially.
"I wouldn't change anything, I would do the