Treatment on Hold
Ill WTC Medic Gets Brush-Off by City

By ARI PAUL

Tom Carlstrom's 450 hours of 9/11 rescue and recovery work began inside the North Tower of the World Trade Center minutes before it collapsed. As an Emergency Medical Service Paramedic, he had set up a triage station at the tower and then evacuated before the collapse, moving to a mobile emergency room where he stayed until 9 a.m. the next day.

TOM CARLSTROM: 'Just got sicker and sicker.'

The next few months he worked on the pile and in the morgue. Like many first-responders, he did not wear a respirator, because they were not made available, until December.

'Got Sicker and Sicker'

"I knew I was getting sicker and sicker." he said. "I had the 9/11 cough. But everybody had it and I just figured it would go away."

It wasn't until the anniversary of 9/11 in 2004, after he had been promoted to Lieutenant, that Mr. Carlstrom found out how serious his health problems were. He collapsed coming up the ramp at Ground Zero after leaving flowers and could barely breathe. He spent the next several days in a hospital intensive-care unit. Since then, he has been diagnosed with asthma and reactive airway disease. Doctors believed that he might have sarcoidosis and gastroesophageal reflux disease as well, he said. At the age of 54, his first day of retirement was Sept. 11, 2006.

THOMAS EPPINGER: Sick workers ill-treated.

He had been seeing a pulmonologist regularly at a lung center for the last three years near his Long Island home. Even though a Workers' Compensation Judge had ordered the Law Department to pay his medical bills without prejudice, Mr. Carlstrom said, he received a call from his doctor's office Aug. 27 informing him that the doctor had only been paid once by the Law Department and that he could no longer see the doctor unless he came with a "pre-approval" form.

Mr. Carlstrom called the Law Department and left messages urging someone to look into his case, but he has yet to hear back.

'Ignored Court Orders'

"It's just so wrong," Mr. Carlstrom said. "They've been ordered by the courts, for God's sake, to pay these bills and they don't do it. I don't know how they get away with it."

Thomas Eppinger, the president of Uniformed EMS Officers Union Local 3621 of District Council 37, has testified to the City Council about doctors not receiving payments from the Law Department, leaving EMS workers unable to get medical attention.

"That's not unusual, that's a common occurrence," Mr. Eppinger said of Mr. Carlstrom's case. "That's been going on for years."

Mr. Eppinger was unsure about what more his union could do to ameliorate the situation, and Marianne Pizzitola, the president of the Uniformed FDNY EMS Retirees Association, lamented that neither the State Workers' Compensation Board nor the State Insurance Department could do much to compel the Law Department to pay Mr. Carlstrom's doctor.

'Mayor Could Stop Them'

"The one person who controls the Law Department is Mayor Bloomberg," Ms. Pizzitola said. "He can stop this behavior and he doesn't. [The Law Department is] a political entity. They're not a real insurance company."

John Sweeney, Chief of the Workers' Comp Division at the Law Department, said it often does not pay bills in full or at all if there are problems such as the fees going beyond the set schedule. Normally, if the department objected, he said, it would contact the doctor to resolve the problem.

"There are a lot of doctors who don't get paid for legitimate reasons, and because we've made a mistake too," he said. "I would suggest he contact us."

Mindy Roller, the Deputy Chief of the division, found the situation odd.

'Let Doctor Reach Out'

"If a doctor is telling his patient he can't treat him and hasn't reached out to us, it's an unusual circumstance," she said. "The doctor should reach out and we should deal with it appropriately."

Mr. Carlstrom did not blame his doctor for telling him that he could no longer treat him. He guessed that the doctor continued to see him without payment because he was a first-responder on 9/11.

"They were just being great to me and they can't do it anymore," he said. "I thought they were getting paid."

Nearing the anniversary of his retirement, Mr. Carlstrom did not know how he would treat his illnesses from now on. He needs surgery on his sinuses and he is still affected by asthma and reactive airway disease. He is able to laugh at what he sees as the absurdity of the system, only to be interrupted by coughing.

Ms. Pizzitola saw him as a victim of a Law Department unwilling to pay what they have been ordered to and a Mayor who is unwilling to pressure it to do so.

"This needs to be changed," Ms. Pizzitola said in an e-mail. "But as long as politics stays the same, the city and the state will have blood on their hands."