Comments

July 15, 2011
Kenneth L. Zwick
Director, Office of Management Programs, Civil Division
U.S. Department of Justice,
Main Building, Room 3140,
950 Pennsylvania Avenue, NW.,
Washington, DC 20530
Re:

Zadroga Suggestion

Mr. Zwick:
It was a pleasure to meet with Special Master Sheila Birnbaum at the forum earlier this month in New York.
As I explained to Ms. Birnbaum, I am working with John Feal within the group of counsel that are
representing first responders and others with WTC injuries.
At the forum we briefly discussed a suggestion of keeping the overall expenses down by limiting medical
record expenses. Specifically, trying to set a maximum charge or .10/page for records from any provider
nationwide and including that as part of the regs. This would also include producing a special HIPAA
compliant authorization with the promulgated rules that would identify the specific governing regulation.
A significant example of the need for this emanates from Mt. Sinai’s WTC Health Monitoring program.
The very facility that we are going to rely heavily on charges .75/page. Given the amount of records that
each claimant typically has from Mt. Sinai, this is going to be a staggering expense. I have attached a
HIPAA redacted copy of an invoice for medical records that highlights just how expensive this will be for
the responder and how it will further diminish their award. The invoice highlights charges incurred with
medical record of four clients, each of which has been numbered one through four to highlight how the
charges for each add up. As I stated, there is no identifying information included in this attachment.
While Mt. Sinai’s per page charge is more than seven times my suggestion, it is, as you are aware, not the
most expensive facility for medical records, as some will charge more than $1/page in addition to a
processing fee. We must find a way to decrease this expense, as there are many first responders that do not
have records available to them from prior litigations or actions. Another option maybe to employ a Medical
Records retrieval service that will make the records available to the claimants as well as your group.

Finally, another suggestion for decreasing costs and expediting the process has to do with claimants that
were represented by a law firm in litigation prior to their Zadroga claim. Regardless of whether the claimant
proceeds pro se or with another firm for their Zadroga claim, that claimant should be able to get a full and
complete copy of the medical records from the prior firm free and within 30 days of request. Given that
this was an expense that was likely charged to them at settlement of the litigation, there shouldn’t be another
charge to the claimant. Even if the originating firm decides to make photocopies no charge should be
borne by the claimant.
I would gladly meet with you or any member of your team on this issue or any other.
Best Regards,
PARKER WAICHMAN ALONSO LLP

Matthew J. McCauley