The total amount of the claimed medical expenses incurred due to eligible conditions exceeds $5,000. If you have a personal injury claim and you later amend your claim and submit the information, the VCF will be able to calculate your economic loss. If seeking replacement services loss in the rare personal injury claim where it might be warranted, you must provide a statement describing the types of services you provided before your eligible condition hampered you from doing so, the amount of time spent on those services (per week or month), and the amount of time you are able to spend on those services now (i.e., with the eligible condition). To calculate the non-economic award for additional dependents, add an additional $100,000 for each dependent beyond the third dependent. The VCF is a federal fund authorized by Congress to provide victims of September 11th monetary awards due to losses suffered. The appropriate amount of the compensation that should be offset, taking into account the time value of money and contributions made by the injured victim or decedent in the nature of investment or savings. If the victim has more than one type of cancer, the Special Master may issue an award that makes an adjustment above $250,000 to account for multiple cancers. As a general rule, under the terms of the VCF Act, the Special Master has identified the following conditions as presumptively severe and debilitating and warranting the highest allowable non-economic loss award for a non-cancer condition, without any further documentation: Emphysema, Interstitial Lung Disease (including Asbestosis), and Sarcoidosis. See the Collateral Source Offsets section for more information. Compensation that would have been payable upon retirement or death regardless of when or why the victim retired or died is not payable as a result of the terrorist-related aircraft crashes of September 11, 2001, and therefore is not collateral source compensation. This is determined based generally on the nature and severity of your condition and the effect of the condition on youractivities of daily living; itdoes not take into account economic loss caused by the condition. Specifically, the NY Workers Compensation law, Section 29(1-b) provides as follows: 1-b. Similarly, if the victim has cancer and severe non-cancer conditions, the Special Master may issue an award that makes an adjustment above $250,000 to account for multiple conditions. The VCF has an arrangement with the PSOB program to exchange information regarding the status of any claim, the amount of any award determination and payment, and the basis of the award determination. Musculoskeletal Disorders (Responders only) Acute Traumatic Injury. Deferred or vested compensation from employment. Evidence that you are or were unable to work as a result of an eligible condition. See Required Documents to Support Lost Earnings for Certain Unions and Employers. Some survivors may be eligible for benefits or payments from certain programs that provide periodic payments subject to adjustment or termination depending on potential future events. When uploading the Supporting Documentation Packet to your claim, select the document type Medical Expense Supporting Documentation Packet. If you fail to include the required supporting documentation, your claim for medical expenses will be denied. For example, the VCF will accept disability determinations made by the Social Security Administration, the FDNY, the NYPD, NYCERS, NYSLRS, the VA, and Workers Compensation boards (see the sections below regarding FDNY, NYPD, NYCERS and NYSLRS, FERS, and the VA). If you believe you meet this threshold, you should request special circumstances consideration on appeal after your initial award has been determined. Pending disability applications: What to do if you are waiting for a disability decision from a government entity or insurer. If you were found to be partially disabled due to an eligible condition in VCF1 based on an FDNY disability determination, and the Social Security Administration subsequently determined that you became fully disabled due to the same condition after your VCF1 award was issued, you may be eligible for additional compensation. Payments made by the various State Victim of Crime Boards funded with federal funds. How Does the VCF Calculate Awards for Multiple Certified Conditions? In such a case, if medical records submitted provide no other discernable basis for the claimants SSA disability, then it will be presumed that the eligible Interstitial Lung Disease is the same as the disabling condition. Compensable expenses do not include any costs for which you have been, or will be, reimbursed by your insurance company, a secondary payer (like Medicaid, Medicare, or a second insurance provider), or any other collateral source. If a claimant requests and is approved to enter the Process, a WTC Health Program physician will conduct a one-time disability evaluation of the claimant and prepare a disability evaluation report, which the claimant will submit with his/her claim. The VCF must consider evidence of an eligible disability in light of all the evidence, including an ineligible condition that is also disabling. Note: In deceased claims, once we have finalized substantive review of your compensation claim, you will not be able to amend your claim to provide any missing information that you did not previously submit. The methodology applies adjustments for taxation, risk of unemployment, employee contributions, and personal consumption for deceased claims before applying the annual limit. Anybody with a physical health certification from the WTC Health Program and/or medical proof that they suffer from a condition the federal government has linked to 9/11 can qualify for an award for "pain and suffering", also known as "non-economic loss." Documentation showing the Effective Date and the victims final grade, step, and location the best source of this information is the most recent SF-50 (Notification of Personnel Action) prior to retirement. The $7.3 billion fund has already paid out about $5 billion. Note that this information should be in a letter that was sent to the victim at retirement or in a Federal Retirement Benefits printout: Date that victim entered the FERS system (date used to calculate Creditable Service for Retirement), Total years and months of credited service, Letter from Office of Personnel Management (OPM) confirming that the victims disability retirement has been approved and stating the conditions forming the basis of the disability, Amount of Monthly Disability Pension in first 12 months (already reduced by Social Security benefits), Amount of Disability Pension after 12 months (already reduced by Social Security benefits), Estimate of re-calculated Disability Pension at age 62, Type of survivor benefit (e.g., Basic Employee Death Benefit, Survivor Annuity). Required Documents to Support Lost Earnings for Certain Unions and Employers, Documentation Required to Support a Medical Expenses Claim, Civil Division Freedom of Information Act. The exception will be made only in the small number of non-cancer claims where the claimant has an interstitial lung disease (ILD) or other pulmonary illness where the effects of the condition are so severe that they are similar in all relevant respects to what a claimant with lung cancer might suffer. Please only submit documents that are related to your 9/11-related eligible physical conditions. The VCF also refers to non-economic loss as a "pain and suffering" award. First, you need to show that you actually lost compensation. The maximum non-economic loss for any one type of cancer condition is $250,000, and the maximum non-economic loss for any one type of non- cancer condition is $90,000. The VCF was paying 10% of the settlement amounts immediately, with 90% due on its planned . Each award is calculated individually. The information that the VCF needs depends on your employer/retirement system: See Section 2.2f for FDNY, 2.2g for NYPD, 2.2h for members of the New York City Employees Retirement System (NYCERS), 2.2i for members of the New York State and Local Retirement System (NYSLRS), 2.2j for Federal employees including the military and military reserve, 2.2k for Union/Verizon/Con Edison, and 2.2l for other employers that are not listed. Note that in general, the VCF will need medical records substantiating claims of medical procedures (surgery, etc.). If we do not receive the documents necessary to calculate economic loss, or if the documents are not submitted in a timely manner, we may issue an award for non-economic loss only. The latter figures $100,000 on account ofthe spouse and each dependent include a non-economic component of "replacement services loss.". Those registered . Claims that have more complex compensation information take more time to review. More information about Non-Economic Loss, Economic Loss, and Collateral Offsets can be found in the sections below. This means you must submit an amendment and request re-review of your economic loss claim. In a defined benefit pension plan, the employer or other sponsor promises to pay specific retirement benefits based on the employee's or members earnings history, length of service, and age. If your claim is missing documentation that we need in order to calculate your award, you will receive a missing information letter. In addition, the legislation created the WTC Health Program, which provides monitoring and treatment for 9/11-related conditions and can certify such illnesses for a VCF claim. [2] Average combined effective income tax rates by earnings bracket were calculated based on an analysis of IRS data for the most recent tax years available: 2007, 2008, and 2009. To request a review in the case of a decrease in a collateral source payment when the higher payment was used in the calculation of your award, you must file an amendment. Recent medical records or treating physician statements showing use of assistive devices that significantly impair activities of daily living such as breathing devices that may be used for Obstructive Sleep Apnea. The VCF makes one award for the non-economic loss, also referred to as pain and suffering. 300mm-22(a). Historical unemployment rates were examined and a reduction factor of 6% is applied to presumed earnings and fringe benefits to account for this risk[4]. Likewise, in a wrongful death claim, the VCF will only offset a survivor pension to the extent it is greater than the pension the victim was otherwise entitled to receive. The VCF will calculate such loss on a case-by-case basis using documentation submitted by the Personal Representative. We urge you (and your attorney, when applicable) to consider the collateral offsets that may be applicable to your claim before submission, and consider submitting a non-economic loss only claim in those cases where your earnings-related offsets are likely to exceed your economic loss. Your VCF1-eligible injury or condition has substantially worsened; b. Such payments will be assumed to continue and will be offset unless evidence is submitted that the benefits or payments in fact terminated. In the earliest years of the September 11th Victim Compensation Fund, payouts ranged from $500 to $8.6 million. Do not hesitate to contact us toll-free at 844-982-2667 if we may be of service. Add this amount to the total computed above. service, disability). The VCF will review these benefits on a case-by-case basis. Information about your earnings and benefits, so that the VCF can determine the amount of loss. If you are filing a deceased claim (i.e., a claim seeking wrongful death losses because the victim died as a result of his or her eligible 9/11-related condition), and the victim received or was entitled to receive a disability pension before death, or the victims beneficiaries are receiving or are entitled to receive a survivor pension, you must submit that information before the VCF finalizes the substantive review of the compensation claim. Recent test results and treatment prescribed that show the severity of your condition. The 9/11 attorneys at Gregory J. Cannata & Associates are highly experienced and regarded in gathering and reviewing the appropriate information to help ensure the success of an award. Some Workers Compensation laws, both domestic and foreign, contain provisions that would allow the insurance carrier to assert a lien against an award issued from the VCF. A .gov website belongs to an official government organization in the United States. Therefore, the VCF may ask you to obtain updated LOAs if they are older than one year at the time of our request. Once the award is calculated, we send you a letter explaining the breakdown of your award and an option to appeal within 30 days if you believe an error was made in the calculation. The VCF does not receive medical documentation directly from FDNY. . If any part of these expenses was covered by life insurance or another source, you must provide documentation of that coverage. The terrorist events of September 11, 2001, left thousands of victims injured or killed by the hijacked airplanes used to attack the World Trade Center, Pentagon, and other U.S. targets. The following information, which is used to calculate the victims pension. If you believe that your SSA earnings history does not fully account for future earnings potential, then you must provide documentation supporting any argument that the VCF should take into consideration other information in determining future earnings. Please do not submit another copy of the Exhibit 1 for the victim. It is important that you respond to all missing information letters within the timeframe specified in the letter. Our claim analysis therefore always begins with three essential questions: was there a demonstrable loss, can we reasonably conclude the loss was caused by a WTC-related eligible condition, and what makes sense in the context of this claimant and the individual circumstances of this claim? 10. It may be necessary to provide additional documentation that explains the relationship between the disability and your eligible condition(s). For example, if a victim is certified for two different types of non-melanoma skin cancer for example, basal cell and squamous cell or for one non-melanoma skin cancer at multiple sites, the award will generally be in the range of $90,000. This survey is widely recognized as a primary source of data on employment status and workforce characteristics of the civilian non-institutional population ages 16 years and older. World Trade Center Health Program: Approach Used to Add Cancers to List of Covered Conditions was Reasonable but Could be Improved, GAO-14-606, July 2014. In the early years of the WTC Victim Fund, claims for personal injury were awarded amounts that ranged from $500 to $8.6 million. These are generally accepted tables of work-life expectancy regarding the general population. ), If you receive a disability pension, documents showing the injuries or conditions that the pension is based upon. The Special Master has the discretion to exclude from consideration life insurance proceeds that are distributed to persons other than the beneficiaries of the VCF award. Records of state and federal agency proceedings or private insurance records that address your medical condition. Claimants who receive disability benefits under the federal Supplemental Security Income (SSI) program: If you receive disability benefits under the federal Supplemental Security Income (SSI) program (administered by Social Security) as opposed to under the regular Social Security Disability Income (SSDI) program, please indicate that you are receiving SSI benefits when you file the claim and file an Exhibit 1, making sure to select the box requesting release of Current monthly Supplemental Security Income payment amount. The information that the VCF receives from the SSAwill include information about SSI benefits if applicable. There are three types of economic loss: loss of earnings/benefits, out-of-pocket medical expenses, and replacement services loss. payments under the September 11th Victim Compensation Fund of 2001 . The Special Master will therefore recognize all same-sex marriages valid in the place where the marriage was celebrated notwithstanding that a victims Federal tax return filed before June 26, 2013, could not identify a same-sex spouse. If you are filing on behalf of a deceased victim and you have provided sufficient evidence that the cause of death was related to aneligible condition, the VCF will generally calculate lost earnings and benefits resulting from the victims death if it is clear from the information in the claim file that the victims death resulted in a compensable loss. Since each claim involves reviewing a substantial amount of documentation, and each award is calculated individually, the process can . Note that, in all cases, even though the conditions may be treated as equivalent when deciding whether a disabling condition is the same as your eligible conditions, these conditions are NOT equivalent for the purposes of determining the appropriate non-economic loss award amount, as discussed in Section 2.1 above. The VCF will treat all conditions in the category of Upper Respiratory Diseases (URD) as equivalent. Recent documentation of the medications required to manage your condition and how often you take those medications. (generic name is listed first, followed by brand name). . The VCF Act establishes certain caps on non-economic awards for physical injury claims. If your condition has limited your activities, please submit any explanation or documentation that explains this effect of your condition. The VCF will consider reimbursement of out-of-pocket medical expenses that you incurred up until the date of certification of the applicable condition(s). If you received an award in VCF1, you can amend your claim and qualify for additional compensation if: a. If you become entitled to receive additional collateral source payments after an initial notification to the VCF, you will need to submit a new form to advise the VCF of this update. In a deceased claim, where the victim died as a result of a VCF-eligible condition, if the victim regularly performed general household-related tasks, then the VCF may provide compensation for the value of those services. This component of economic loss is called replacement services loss and is typically considered to be a component of loss only in deceased claims. Do not use this form if you have had a decrease in a collateral source payment and would like to request that the VCF review your award. 4 You should then deduct the amount you have received or are entitled to receive from any collateral sources as described above. Application of statutory limitation on annual gross income: In accordance withthe VCF Act, for each year of loss, the methodology limits the annual loss of earnings and other benefits related to employment that fall under the definition of gross income in section 61 of the Internal Revenue Code of 1986 to $200,000. In order to be compensated for replacement services, the Personal Representative seeking compensation on the claim must demonstrate that the victim performed prior to his or her death from the eligible condition. Letter from the Board of Trustees of the Fire Department Pension Fund Regarding Award of Accident Disability Retirement: This is a letter issued to the individual on FDNY letterhead from the Director of the Board of Trustees of the Fire Department Pension Fund regarding whether the Board approved or disapproved the victims application for accident disability retirement. These rates are shown in Table 5 below. Following the decision of the Supreme Court in United States v. Windsor, 133 S. Ct. 2675 (2013) (finding Section 3 of DOMA unconstitutional) and pursuant to Department of Justice policy, all lawful same-sex marriages will be recognized if they were valid in the place where the marriage was celebrated. [6] Other standard expenditure categories sometimes included in litigation, namely Reading, Cash Contributions, Alcoholic Beverages, and Tobacco Products, were excluded. Any additional factors influencing military pay are assumed to be included in your reported military pay and will not be compensated separately. Replacement services loss is intended to replace something that was lost that is, something the victim used to do. Please note: For deceased victims, the VCF will submit Personal Representatives Letters of Administration to both NYCERS and NYSLRS along with the completed Exhibit B1 form you provided with the claim. Prior to June 26, 2013, same-sex married couples were prohibited from identifying themselves as married on their Federal tax returns because Section 3 of the Defense of Marriage Act (DOMA) prohibited the Federal Government from recognizing same-sex marriages. Do not contact NYCERS if we ask you for updated LOAs as the one-year rule applies to all requests for documents and this will burden their limited resources and delay the process. [8] The tax rate used to determine after-tax interest rates is the computed combined Federal, State and local income tax rate of 15.1% for New York for the $70,000 earnings bracket. Since the VCF was reauthorized last year, claims for non-cancer conditions have routinely been awarded the lowest possible amount, absent medical records to support the severity of the condition. The VCF also offers compensation for non-economic losses to the families of 9/11 victims who died as a result of the attacks or subsequent debris removal. And third, because we are spending public funds, we must ensure that every aspect of the award is adequately justified and documented. As a result, the VCF has established specific criteria about when and how you should submit your claim for medical expenses. If the breast cancer is disabling, a victim is entitled to additional compensation for lost wages. If you are not receiving a pension, submit a letter from your union/Con Edison/Verizon stating that you are not receiving a pension. In such cases, the non-economic award may be greater than $250,000, with a maximum award, under current VCF policy guidelines, of $340,000 for multiple severe conditions. The VCF may also, in an appropriate case, make a replacement services award in a personal injury claim where the claimant did not have prior earned income or worked only part-time outside the home. If you have already filed an amendment to seek medical expenses reimbursement, the VCF will review the expenses as part of our review of your amendment, provided the expenses meet the established criteria. In many cases, these issues are best addressed in the context of an appeal hearing. Compensation for military service members and uniformed service members is based on the amount of your basic pay (BPY), which is the largest component of military pay, plus any additional factors influencing military pay (e.g. For example, if you left the workforce more than one year before the onset of your eligible disability, the VCF will consider the reasons you originally left the workforce and the probability that you would have returned to the workforce were it not for your eligible condition in determining the extent of your earnings and benefits loss. Non-economic loss is calculated separately from an economic loss claim. NYCERS will only accept LOAs dated within one year of the date the VCF (or the law firm for requests already sent directly to NYCERS) sends the request for information to NYCERS. [9] The present value adjustments will be based on the period of presumed economic loss (which is in turn based on the age of the victim). See theWTC Health Program Disability Evaluation Process for complete details on the Process. SF-50 (Notification of Personnel Action) from the victims retirement. The Special Master is required under the VCF Actto offset Social Security survivor and dependent benefits as compensation paid to the surviving spouse or dependents of a disabled or deceased wage earner because of the eligible injury. longevity raises, overtime, bonuses, differential pay, etc.) The VCF will calculate pension loss for victims who worked for a New York City agency that is part of the New York City Employees Retirement System (NYCERS)(e.g., NYC Department of Sanitation, the NYC Department of Corrections, or EMS personnel employed by FDNY), and victims who worked for New York State entities that are part of the New York State and Local Retirement System (NYSLRS) (e.g., employees of New York State government agencies, municipalities in New York other than NYC, and other local government entities), if complete documentation is provided. A New York firefighter amid the rubble of the World Trade Center after the September 11, 2001 attacks. The VCF may obtain information directly from the WTC Volunteer Fund regarding VCF claimants with WTC Volunteer Fund claims, which will allow the VCF to investigate the basis of any disability benefits, the amount of such benefits, and any other information that may be relevant to the VCFs computation of loss. Three principles guide this inquiry. Non-Cancer VCF Payouts. The Special Master has determined that individual age-specific growth rates, rather than growth independent of a particular age bracket at death, better reflects the expected pattern of earnings over ones career[3] and results in more equitable and consistent projections for victims close to each other in age with otherwise similar family and employment characteristics. Therefore, this information should be viewed as a general guide to how the VCF implements our fundamental principles: fairness to the claimants, faithfulness to the statute, and accountability to the public, in the service of compensating demonstrable loss caused by an eligible condition. Bankruptcy Bankruptcy courts treat VCF benefits differently according to the facts of the individual case. To maintain the privacy of individual claimants and beneficiaries, the Fund will not list names or any other identifying information that might easily lead to the identification of individuals who have received or been notified of awards. 25 . These benefits will be set at actual levels if you provide the necessary data. [7] Although the consumption rates determined from BLS data actually represent household expenditures as a percent of before-tax household income, the actual consumption reduction used to determine the decedents personal expenditures was calculated as a percent of lower after-tax income, which significantly lowers the resulting adjustment.
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