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

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.

Ivonee Sanchez, in a red shirt, stands in front of a chalkboard


Ivonne Sanchez, retired FDNY EMT, worked for 10 months at Ground Zero. She later developed asthma and breast cancer, but struggled to receive 9/11 benefits.

Andy Mai / WNYC

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.

dozens of first responders stand in the dusty remains of the World Trade Center


First responders on September 12, 2001 at Ground Zero


“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.”

September 11th Special Coverage
New York Public Radio has extensive programming planned to commemorate the 20th anniversary of the attacks of September 11, 2001. It includes news analysis and coverage on WNYC radio and Gothamist, special live coverage of the memorial on September 11, news coverage in the days leading up to September 11, and music of reflection and commemoration on classical station WQXR. Details follow:

September 11 and NYPD: The Legacy
About this series: Dozens of journalists and engineers in the WNYC newsroom came together to produce this series for Gothamist and WNYC radio. The series, which ends on September 11, explores how the terror attacks 20 years ago fundamentally changed the NYPD. The 20th anniversary comes amid another critical moment in U.S. history: a reckoning over race and policing, here in New York City and across the country. Over the last two decades, the NYPD has undergone a dramatic transformation, growing in capacity, reach, and power. Those changes are evident today in virtually every aspect of policing in New York City — from the department’s enforcement around street protests, to its vast international network, to its presence on mass transit, to its all-round philosophy of public safety.
Day One: NYPD’s history from founding to 9/11

Day Two: How NYPD’s Powers Expanded After 9/11

Day Three: A Legacy of Police Surveillance (Part One and Part Two)

Day Four: See Something, Say Something

Day Five: America’s Mayor and NYPD

Day Six: Living with Trauma: COVID-19 and 9/11; The Sacrifice of Survivors

Live Memorial  Coverage
On September 11, WNYC’s Brian Lehrer will host special live coverage of official memorial ceremonies starting at 8:35 a.m. At 11 a.m., WNYC will air “Blindspot: The Road to 9/11,” a two-hour radio documentary adapted from the nine-part podcast hosted by WNYC’s Jim O Grady.

Classical music station WQXR also has special programming planned throughout the day on September 11. The program includes a asegment on John Adams’ Pulitzer Prize-winning composition “On the Transmigration of Souls,” the Brooklyn Youth Chorus and the New York Philharmonic.For other radio news programming planned during the week click here.