VCF: Initial Payment Percentage Analysis

1 VCF: Initial Payment Percentage AnalysisJanuary 28, 2013 Objec've:*establish*a*reasonable*ini'al* Payment * Percentage *to*make*funds*availab le*to*all*claimants*within*funding*cap.* Payment * Percentage *must*be*set*now*rathe r*than*at*the*end*of*the*program*so*the* September*11th*Vic'm*Compensa'on*Fund*(V CF)*can*distribute*funds*as*required*by* statute. Evalua'on*of*ini'al* Payment * Percentage :* two*es'ma'on*op'ons*considered*for*this* purpose: Op'on*1:*Original*Congressional*Budget*O ffice*(CBO)*es'mate*refined*to*include*c ancer*claims*and*certain*modified*inputs Op'on*2:*CBOL based*es'mate*assuming*alterna've*Reside nts*/*Other*claim*filing*rates*and*that* the*causa'on*requirement*in*the*Zadroga* Act*will*limit*cancer*claimsOverview2 The*Zadroga*Act*provides*that*individual s*are*eligible*if*they*were*present*at*t he*September*11th*crash*sites*at*the*'me *of*the*crashes*or*between*September*11, *2001*and*May*30,*2002*and*suffered*phys ical*harm*as*a*direct*result*of*the*cras hes*or*debris*removal.

2 The*crash*sites*are*defined*as*the*World *Trade*Center*site,*the*Pentagon*site,*a nd*the*Shanksville,*Pennsylvania*site*as *well*as*the*buildings*or*por'ons*of*bui ldings*that*were*destroyed*as*a*result*o f*the*terroristLrelated*airplane*crashes *of*September*11,*2001,*including*the*NY C*Exposure*Zone.*( )Eligible PopulationPoten&ally*Exposed*Popula&on*( NYC*Site)Popula&on*Es&mateDescrip&on*of* Popula&onResponders123,102 FDNY,2 NYPD,2 Other2 Workers,2and2 VolunteersResidents2/2 Other558,153 Residents,2 People2in2 Schools2&2 BuildingsTotal681,2553 NYC Exposure Zone per Regulations4 Ini'ally*the*physical*injuries,*health*c ondi'ons*and*diseases*presump'vely*cover ed*under*the*VCF*excluding*cancer*are.

3 Inters''al*lung*disease Chronic*Respiratory*Disorder*L*Fumes*/*V apors Asthma Reac've*Airways*Dysfunc'on*Syndrome*(RAD S) WTCL exacerbated*Chronic*Obstruc've*Pulmonary *Disease*(COPD) Chronic*cough*syndrome Upper*airway*hyper*reac'vity Chronic*rhino*sinusi's Chronic*nasopharyngi's Chronic*laryngi's GastroLEsophageal*Reflux*Disorder*(GERD) Sleep*apnea*exacerbated*by*or*related*to *the*above*condi'ons Low*back*pain Carpal*tunnel*syndrome*(CTS) Certain*other*musculoskeletal*disorders* defined*as*"a*chronic*or*recurrent*disor der*of*the*musculoskeletal*system*caused *by*heavy*libing*or*repe''ve*strain*on*t he*joints*or*musculoskeletal*system*occu rring*during"*the*period*between*Septemb er*11,*2001*and*May*30,*2002*or*as*deter mined*by*the*Special*Master Trauma'c*injuriesCancers*that*are*presum p'vely*covered*under*the*VCF*are: lip,*tongue,*salivary*gland,*floor*of*mo uth,*gum*and*other*mouth,*tonsil,*oropha rynx,*hypopharynx,*and*other*oral*cavity *and*pharynx.

4 Nasopharynx nose,*nasal*cavity,*middle*ear*and*acces sory*sinuses larynx,*esophagus,*stomach,*colon*and*re ctum liver*and*intrahepa'c*bile*duct retroperitoneum,*peritoneum,*omentum*and *mesentery trachea;*bronchus*and*lung;*heart,*media s'num*and*pleura;*and*other*illLdefined* sites*in*the*respiratory*system*and*intr athoracic*organs Mesothelioma sob*'ssues*(sarcomas) skin*(melanoma*and*nonLmelanoma),*includ ing*scrotal*cancer breast,*ovary,*urinary*bladder,*kidney,* renal*pelvis,*ureter*and*other*urinary*o rgans eye*and*orbit thyroid blood*and*lymphoid*'ssues*(including,*bu t*not*limited*to,*lymphoma,*leukemia,*an d*myeloma) Childhood*cancers Rare*cancersDiseases Covered5 Diseases Covered & Awards Claimants)who)have)a)presump2vely)covere d)physical)injury,)health)condi2on)or)di sease)(and)representa2ves)of)individuals )who)have)died)as)a)result)of)such)a)

5 Presump2vely)covered)physical)injury,)he alth)condi2on)or)disease))that)was)cause d)as)a)result)of)September)11th)and)who) are)otherwise)eligible)may)receive)compe nsa2on)from)the)VCF)for)economic)and)non Aeconomic)loss)as)defined)in)the)Regula2 ons. All)awards)will)generally)consist)of)the )same)three)components)and)will)be)calcu lated)as)Economic)loss)plus)NonAeconomic )loss)minus)collateral)source)payments The)methodologies)for)compu2ng)economic) loss)will)be)based)on)those)from)the)ori ginal)VCF,)with)certain)updates)in)the)c omponents)of)the)economic)loss)calcula2o n)assump2ons)as)appropriate. On)9/12/2012)WTC)Health)program)(based)o n)NIOSH)STAC)recommenda2on))added)certai n)cancers)to)the)list)of)WTCAR elated)Health)Condi2ons)in)42)CFR) ) Costs)associated)with)compensa2ng)cancer )condi2ons)are)not)included)in)previous) CBO)or)other)es2mates Addi2onal)cancers)(and)other)diseases))c ould)be)added)in)the)future6 Source of Potential Claims.

6 RespondersFor*purposes*of*determining*th e*size*of*this*popula'on,*a*"Responder"* is*defined*as*an*individual*who*performe d*rescue,*recovery,*demoli'on,*debris*cl eanup*or*other*related*services*at*a*9/1 1*crash*site*in*response*to*the*Septembe r*11,*2001*terrorist*afacks,*regardless* of*whether*the*individual*was*a*state*or *federal*employee*or*member*of*the*Na'on al*Guard*or*performed*the*services*in*so me*other*capacity.*A*person*who*performe d*the*listed*services*through*a*private* employer*or*on*a*volunteer*basis*is*cons idered*a*Responder.*Individuals*who*bega n*performing*cleanup*or*maintenance*work *in*the*NYC*Exposure*Zone*months*aber*th e*September*11,*2001*terrorist*afacks*ar e*not*considered*Responders.

7 *( )Note:&the&size&of&the&eligible&popula2o n&from&the&Pentagon&and&Shanksville&site s&are&not&expected&to&be&a&limi2ng&facto r&for&the&VCF&and&have&not&been&explicit ly&accounted&for&in&these& *these*purposes*Residents*/*Other*means: *residents,*individuals*working*or*afend ing*a*school*in*the*NYC*Exposure*Zone,*i ncluding: The*buildings*or*por'ons*of*buildings*th at*were*destroyed*as*a*result*of*the*ter roristLrelated*airplane*crashes*of*Septe mber*11,*2001. Buildings*in*the*NYC*Exposure*Zone*which *consists*of*the*area*in*Manhafan*south* of*the*line*that*runs*along*Canal*Street *from*the*Hudson*River*to*the*intersec'o n*of*Canal*Street*and*East*Broadway,*nor th*on*East*Broadway*to*Clinton*Street,*a nd*east*on*Clinton*Street*to*the*East*Ri ver;*and*any*area*related*to,*or*along,* routes*of*debris*removal,*such*as*barges *and*Fresh* : Other)Residents) )the)total)is)uncertain.

8 Data)from)the)Bloomberg)report)describes )this)category)as) )Some)porEon)of)this)category)will)meet) the)VCF)geographic) of Potential Claims: Residents / Other8 'ally*Exposed*Popula'on:*defined*and*cat egorized*as*those*in*the*NYC*Exposure* 'ally*Eligible*Claimants:*those*who*mani fest*disease*in*the*Exposed& *Claimants:*those*with*proper*documenta' on*including*the*ability*to*establish*pr esence*at*a*site*with*records*and*qualif ied*physical*harm*among*Poten2ally&Eligi ble& *Claims:*those*who*file*a*claim*among*th e*Eligible& 'mated*Claims*Awarded:*Filed&Claims*that *meet*VCF* *Es'mated*Cost*of*Eligible*Claims:*Es2ma ted&Claims&Awarded**Es2mated&Award&Avera geOther*costs*evaluatedLAdministra've*co stsLWTC*Cap've*Insurer*OffsetEstimation Model: Steps9 Step*1:*Define*and*categorize*poten'al*E xposed*Popula'on*at*the*NYC*site Responders:*assume*123,102*previously*de scribed Includes*FDNY,*Police,*other*workers*(NY C*and*nonLNYC),*and*volunteers Residents*/*Other.

9 *assume*558,153*previously*described Includes*residents*south*of*Chambers,*sc hools,*and*area*building*occupants*south *of*Chambers Includes*other*residents*in*2 Lmile*radius*from*WTC*site* Can*be*considered*a*proxy*to*include*mor e*transitory*exposures,*exposures*along* debris*route,*and*Pentagon/ShanksvilleEx posed Population10 The2geographic2area2that2is2eligible2und er2the2 VCF2is2defined2differently; )2:)Poten2ally)Eligible)Claimants)are)th ose)who)manifest)presump2velyAcovered)co ndi2on)in)the)Exposed)Popula2on CBO*es'mated*propor'on*of*exposed*popula 'on*that*may*manifest*a*Title*I*disease* excluding*trauma'c*injury*(defined*based *on*Regula'ons*issued*August*2011) 50,000)Responders)(~)41%)of)exposed)popu la2on) 230,000)Residents)/)Other)(~41%)of)expos ed)popula2on)

10 CBO*numbers*were*based*on*CBO*review*of* studies*of*prevalence*of*Title*I*disease *in*affected*areas*including*Morbidity*& *Mortality*Weekly*Report Baseline*nonLcancer*Es'mate*based*on*CBO *projec'ons Cancer*es'mate*assumes*NIOSH*es'mates*of *incidence*of*listed*cancers*2002L2016 Moderate)es2mate)assumes)excess)incidenc e)only)( )general)popula2on)incidence))and)incorp orates)latency)assump2ons High)es2mate)assumes)no)dis2nc2on)assume d)between)baseline)and)excess)incidence) ( )general)popula2on)incidence))and)incorp orates)latency)assump2onsManifestation of Covered Claims11 Step)3:))Eligible)Claimants:)Those)with) proper)documenta2on)including)the)abilit y)to)produce)records)and)document)physic al)harm)rela2ng)to)exposure)among)Poten2 ally)Eligible)Claimants Claimant*must*document*covered*physical* health*condi'on(s) Claimant*must*have*sought*treatment Claimant*must*be*able*to*produce*medical *records Claimant*must*establish*a*causal*connec' on*between*exposure*and*condi'on(s) CBO*assumed*a*subset*of*those*in*the*pot en'ally*eligible*popula'on*and*manifes'n g*diseases*will*otherwise*qualify 25,000)Responders)(50%)of)Disease)Manife sta2on) 75,000)Residents)/)Other)(~)33%)of)Disea se)Manifesta2on)