If you are requesting economic loss but you have a disability application pending, and if your application for disability is based on a condition that is eligible for the VCF, or if you intend to file for a disability based on your VCF-eligible condition, you should wait to submit your claim until the application is decided. A claimant may be partially disabled from performing a certain occupation due to his/her eligible injury or condition but the fact of an occupational disability alone will not warrant a non-economic award higher than the presumptive base value. This means that we consider both fairness to the individual claimant as well as fairness to the entire claimant population, with priority given to those who suffer from the most debilitating physical conditions. 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. If you notify the VCF within 90 days of the date you learned that you were entitled to receive a new or revised collateral source payment, your determined or paid award will not be adjusted to reflect the new or revised entitlement or payment. 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. - An FDNY Lieutenant who became disabled from working by severe WTC related pulmonary conditions at age 52. When considering whether the disabling condition identified in the disability determination is the same as your VCF-eligible condition, the VCF will apply the following presumptions: Thus, in each of the cases identified above, if you have been deemed disabled due to one of the listed conditions, and another condition treated as equivalent has been deemed eligible for compensation by the VCF, your disability determination supports a lost earnings award. The VCF will treat all conditions in the category of Obstructive Airways Diseases (OAD) as equivalent. These conditions include rhinitis, sinusitis, rhinosinusitis, tracheitis, laryngotracheitis, laryngitis, nasopharyngitis, and pharyngitis. Information aboutcompensation you received from collateral sources that must be subtracted from your lost earnings award. 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. Personal Injury Claims:If you have already filed a claim for medical expenses as part of your personal injury claim form submission, the VCF will not review the expenses as part of our initial review of your claim. service, disability), if applicable, Date of retirement from the military, if applicable, Most recent pay statement showing various allowances, benefits, and special pay, If receiving military retired pay: start date and benefit amount. You will need to submit two types of information: The VCF provides a Temporary Past Lost Earnings worksheet to help support your VCF claim. 1. 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. 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. Presumptive defined benefit pension values assume a five-year vesting requirement, normal retirement age of 65, and a benefit factor of 1% of average salary for the final five years of employment. For this reason, if any spouse or dependent (e.g., a minor or disabled child or an elderly parent) of the deceased victim is receiving these benefits, you must submit a separate Social Security Administration Consent Form (Exhibit 1 of the Claim Form) for the surviving spouse and/or dependents when submitting the claim. Suffering from constant nasal inflammation, stuffy nose, pain and swelling around your nose and in your sinuses, and reduced taste or smell are common indicators. The VCF Act defines non-economic loss as losses for physical and emotional pain, suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of enjoyment of life, loss of society and companionship, loss of consortium (other than loss of domestic service), hedonic damages, injury to reputation, and all other non-pecuniary losses of any kind or nature. In some cases,the VCF may estimate your benefits using presumptive values. First, the VCF strives to be fair to all claimants. The type of medication prescribed and the frequency of use of the medication can help demonstrate the severity of the condition. If you are receiving a pension (either directly or as a beneficiary of a decedent), you will be required to submit: In general, the VCF will use the following procedures and assumptions for determining future lost earnings for both deceased and injured victims: 1. The expenses were paid prior to the date the WTC Health Program certified the applicable condition as eligible for treatment (applicable condition refers to the specific condition for which the expenses were incurred). For these claims, it may be necessary to provide a disability determination or other documentation that explains the relationship between the loss of earnings and the eligible condition. If you do not appeal, we authorize payment within 20 days of the end of the 30-day appeal period. If an individual is eligible for VCF compensation and is also receiving payments from the WTC Volunteer Fund, the VCF will offset certain payments made by the WTC Volunteer Fund. The types of documents listed below can assist the VCF in the evaluation of your claim: A document from your physician summarizing the medical history of your condition and treatment will often be sufficient to prove the extent of your non-economic loss. If you are receiving a lump sum pension, the amount of the lump sum pension. [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. The Special Master will only offset the present value of collateral source compensation. In general, the standard amount used to calculate future residual earnings capacity is the minimum wage applicable to large employers in New York City ($31,200 in 2018). See the Collateral Source Offsets section for more information. Doing so will unnecessarily tie up limited resources and may delay claims processing. The lower the after-tax discount rate, the higher the present value of presumed economic loss. The VCF will also use the standard default values if you did not have benefits or if your benefits were less than the standard default values. The FDNY Medical Board Committee Report: This is a report from the Chief Medical Officer of the FDNY on FDNY letterhead regarding the Result of Medical Committee, which summarizes the FDNY members WTC-related exposure, medical history, diagnosis, and the Medical Board Committees recommendation as to the extent of the members disability and fitness for firefighting duty. Disabling conditions that fall in one category will not be deemed equivalent to conditions that fall in another category. For example, many people with respiratory injuries have pulmonary function tests. The total amount legitimately claimed means that the claimed expenses are reasonably related to your eligible conditions (as identified in your most recent eligibility determination letter) and that you have documentation demonstrating that you paid the expense out-of-pocket. What is the 9/11 Victim Compensation Fund formula? The collateral source offsets will not include monies or other investments in the injured victims or decedents 401(k) accounts. Records of state and federal agency proceedings or private insurance records that address your medical condition. If any part of these expenses was covered by life insurance or another source, you must provide documentation of that coverage. An exception to this general rule may arise in those cases where a claimant is found disabled by the SSA due to Chronic Pulmonary Insufficiency or Chronic Respiratory Disorders and his or her only eligible condition is an Interstitial Lung Disease (e.g., sarcoidosis or pulmonary fibrosis). 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 may also accept a determination of disability made by a private insurer or a treating physician if they are sufficiently detailed as to the effect of the VCF eligible condition, distinguish those effects from those of ineligible conditions, and provide sufficient information from which the onset and severity of the disabling condition may be determined. As a result, and consistent with the statute and regulations governing the VCF, the VCFwill offset any indemnity benefits a VCF claimant receives, or is entitled to receive in the future, from the WTC Volunteer Fund for an eligible condition. In addition to evidence of a compensable loss, you must submit information about collateral source payments that the VCF may be required to offset against a lost earnings award. Employment- related benefits include pension programs, retirement contribution programs, and health benefits. If you are claiming reimbursement for expenses relating to conditions that are not certified, we will consider reimbursement for expenses you incurred at any time before you filed your medical expenses claim, subject to the specific circumstances of your individual claim. You must complete and submit a Social Security Administration Consent Form (Exhibit 1 of the Claim Form) even if Replacement Services is the only type of loss you are claiming. You must submit any claim for burial or memorial service costs with the initial claim submission. A New York firefighter amid the rubble of the World Trade Center after the September 11, 2001 attacks. Recent documentation of the medications required to manage your condition and how often you take those medications. 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. Official websites use .gov See the section below about documentation of employment-related benefits. [7] These alternative techniques included an analysis of BLS data on household expenditures reported by household size, with expenditure categories allocated equally among household members or allocated according to the methodology suggested by authors Robert Patton & David Nelson in their 1991 Journal of Forensic Economics article, Estimating Personal Consumption Costs in Wrongful Death Cases.. If you are receiving Combat-Related Special Compensation or Concurrent Retirement and Disability Pay, submit a complete history of the amount and duration of benefits received. That tragic day nearly 3,000 people perished as the planes crashed, and WTC buildings collapsed. Typically, the VCF's . The VCF will treat all conditions in the category of Interstitial Lung Diseases (ILD) as equivalent. Under the VCF Act, the VCF does not compensate for potential or anticipated future medical expenses. To calculate economic loss, the VCF must first determine whether there is in fact a compensable loss. Such a statement is most helpful if it provides a timeline and details on the medical treatments you have experienced. 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. The WTC Volunteer Fund provides medical and indemnity (cash) payments for volunteers who are disabled as a result of their efforts. . Although CPS and other data used to study lifetime earnings profiles indicate that peak real earnings typically decline at some point, in calculating life-cycle earnings growth in excess of inflation and overall productivity adjustments for victims, the Special Master has assumed that peak earnings are maintained. In many cases, these issues are best addressed in the context of an appeal hearing. First, you need to show that you actually lost compensation. 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. Sections 2.2.f-i contain information specific to victims who worked for New York City (including FDNY and NYPD) and the Federal government (including military and military reserve); and. 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. This section describes the evidence you must submit to substantiate your claim for lost earnings. 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. Replacement services loss is intended to replace something that was lost that is, something the victim used to do. The Special Master will use the expected work-life for active males, with a full-time beginning labor force state, to compute expected remaining years of workforce participation for both male and female victims. VCF Policies and Procedures Section 3: Awards and Payment Date effective November 16, 2022 When the VCF has made an award determination for your claim, you will receive a letter notifying you of the amount of your award. Under the Zadroga Act, non-economic loss includes . A significant increase (more than a cost of living adjustment) in the amount of a previously reported collateral offset may constitute an additional payment that should be reported. Tax benefits received from the Federal Government as a result of the enactment of the Victims of Terrorism Tax Relief Act of 2001 (Pub. In general, the VCF will accept a determination by a governmental agency that you have a disability and will accept the governmental agencys determination of the cause of the disability. To determine the amount, the VCF will consider how the injury affects your daily life, what kind of condition you have, and the severity. We will obtain complete documentation of your service-connected disability compensation, including all rating decisions and all changes to the amount of your VA compensation, directly from the VA. Recommendation of the FDNY Pension Fund re: Accident Disability: This is a recommendation of the 1-B Medical Board on FDNY letterhead regarding whether the individual should be awarded an accident disability retirement. While unpaid volunteers are normally ineligible for Workers' Compensation benefits, the New York Workers' Compensation Law was amended to provide a unique exception for certain volunteers who assisted with World Trade Center rescue, recovery, and clean-up efforts. For more information on the WTC Health Program List of Covered Conditions and 9/11 Victim Compensation, please contact Pitta & Baione at 844-982-2667 or info@pittabaione.com. In some cases, even where the record supports the determination that the victims death was related to an eligible condition, it is not clear that the victims death resulted in a compensable loss. See Required Documents to Support Lost Earnings for Certain Unions and Employers. If you were not medically discharged for an eligible condition, you should provide other evidence and explain how it establishes that the loss of your military earnings and benefits was caused by your eligible condition(s). 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. Because published estimated work-life expectancies by gender are lower for women than men, this specification increases the duration of estimated foregone earnings, and thus presumed economic losses, for female victims and was implemented by the Special Master to accommodate for potential increases in labor force participation rates of women. It is possible that an individual victim with many relatively mild conditions would receive a non-economic award that is less than that of a victim who has only one condition that is severe. Follow the instructions on "How to File an Amendment" to amend your claim. Claims that have more complex compensation information take more time to review. 25 . For each FDNY victim who is claiming loss of future earnings and benefits and has provided the appropriate authorization, the FDNY sends the VCF the following information, which the VCF uses to calculate economic loss: Generally speaking, because we receive this information directly from the FDNY, anFDNY victim who has been granted a disability pension does not need to submit any additional pension documentation unless the claimant asserts loss from non-FDNY employment. Here is a look at the September 11th Victim Compensation Fund (VCF) and the James Zadroga 9/11 Health and Compensation Act of 2010.. Facts From 2001 to 2003, the September 11th Victim Compensation . Treatment expenses covered by private health insurance, Workers Compensation, or other programs will not be reimbursed. If you are claiming medical expenses relating to conditions with different certification dates, you can claim reimbursement for applicable expenses up to the certification date for each individual condition. If your employer provided benefits such as a 401K match or other types of benefits that you would ordinarily receive at the time of retirement, you should submit proof of such benefits in order for the VCF to compute the loss. Another award is made to a successful applicant for an economic loss, which includes lost benefits, lost earnings, household services, and out of pocket medical expenses. During the course of an individuals career, the rate of annual real life-cycle growth tends to gradually decline until a peak real earnings level is attained. In determining household size for claims for decedents, the Special Master will assume that children will remain in the household through age 23. Law No. For example, you could submit letters or reports from specialists who treated your eligible conditions.
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