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. If the governmental agency determines that the cause of disability is a condition that the VCF has found eligible, then the disability determination will provide a basis for a determination of future loss of earnings/benefits. For eligible cancers, the non-economic award will generally range between $90,000 and $250,000, depending on the type of cancer and the medical evidence provided regarding metastasis, recurrence, and/or permanent complications. You must be certain any documentation you provide meets the requirements outlined in Documentation Required to Support a Medical Expenses Claim below. If you have had such tests, please submit the test results including the physicians interpretation of the tests. If the VCF, with reasonable effort, cannot clearly identify the required documentation necessary to support each claimed medical expense, the VCF reserves the right to deny your medical expenses claim. The Special Master may consider multiple conditions together to determine an aggregate award, which may exceed $250,000. Thus, there is a possibility in those states that payments to a victim or family member of a decedent might ultimately be subject to repayment from the VCF award. This includes information about collateral offsets that apply to both economic and non-economic loss, proof of cause of death for a wrongful death claim, or a missing Exhibit 1, which allows us to receive information from SSA in support of your claim. 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. Follow the instructions on "How to File an Amendment" to amend your claim. In those cases, the VCF may use the later date that is, the date when the victim actually suffered a loss in earnings. After your award is received, any changes in entitlement to survivor benefits, such as a determination of continuing disability at age 18, should be reported on the Collateral Offset Update Form.. An additional $9 million was provided by the State of New York in 2016. It is important that you respond to all missing information letters within the timeframe specified in the letter. Examples of the types of tasks that are considered for replacement services compensation are services that the victim provided to the family, such as cleaning, cooking, child care, home maintenance and repairs, and financial services. The VCF statute caps attorney fees for claimant assistance at 10% of the VCF award amount. 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 do appeal, payment is authorized once a decision is rendered following your appeal. Exceptions may be considered if the victim (or his or her authorized representative) submits evidence to support the assumption of additional years of workforce participation after age 65, such as the victims need to support minor children. The VCF focuses on recent documentation, from within three years of the claim submission date, when evaluating non-economic loss. 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. 107). 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. 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. Some categories of offsets apply only to certain categories of loss. Moreover, the VCF will not disregard a determination that attributed your disability to an ineligible condition, even if it was later changed. Each award is calculated individually. Expenses you incurred after the date of certification are not eligible for reimbursement. Facts From 2001 to 2003, the September . Personal consumption adjustment for decedents: For claims for deceased victims whose death was related to an eligible condition, the VCF subtracts from annual projected compensable income and benefits the decedents share of household expenditures or consumption as a percentage of income, using expenditure data by income level obtained from Table 2. As a result, the VCF has established specific criteria about when and how you should submit your claim for medical expenses. It was determined that the benefit to the claimants of calculating the decedents personal consumption offset as a percent of after-tax individual earnings more than outweighed the potential effect of discounting future amounts by income-specific after-tax discount rates. This approach was intended to avoid a penalty to the victim. You must submit any claim for burial or memorial service costs with the initial claim submission. 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. Although it is recognized that a different after-tax interest rate could theoretically be calculated for each age, income, and state combination, such a computation was impracticable for the large-scale valuations to be undertaken here. If you are physically injured as a result of an eligible condition, you can make a claim for earnings/benefits you lost before you submitted your claim to the VCF, and you can make a claim for earnings/benefits you expect to lose in the future (after submission of your claim) as a result of your eligible condition. partnerships with the World Trade Center ("WTC") Health Program and 9/11 advocacygroups, . The Special Master uses effective income tax rates derived from published Internal Revenue Service (IRS) data on selected income and tax items for Individual Income Tax Returns by State. service, disability). 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. 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. Under the VCF Act, the VCF does not compensate for potential or anticipated future medical expenses. 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. If you know that payments or benefits you have received are subject to a lien, you must notify the VCF. Individuals who submit a claim for a loss of future earnings/benefits from the Military or Military Reserve must submit documentation of the following: If you have been found partially or totally disabled by the Military, submit complete documentation of the basis of your medical retirement (e.g. 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. 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. 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. Thus, if you are disabled due to an Interstitial Lung Disease and you have been deemed eligible by the VCF only for Obstructive Airways Diseases, the disability determination is not a basis for awarding lost earnings. A Pension Work History or similar document from the union, showing the number of hours worked and credits earned in every year of work. Recent test results and treatment prescribed that show the severity of your condition. Such a statement is most helpful if it provides a timeline and details on the medical treatments you have experienced. 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 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. 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. 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. $340,000 for a downtown office worker with skin cancer and larynx cancer $340,000 for a retired NYPD officer with cancers of the colon and mouth [5] For purposes of determining consumption rate and household size, the term dependent refers to an individual who was financially supported by the decedent and may include individuals who are not considered when calculating the wrongful death non-economic loss award, as the definition of dependent for purposes of awarding additional non-economic loss is more stringent. This allows the VCF to obtain information from the Social Security Administration to determine earnings history. 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. . Therefore, if PSOB has paid a benefit to the eligible victim, then the VCF will offset this amount. If you're preparing to submit a claim to the VCF, you may have many questions about the September 11 th Victim Compensation Fund ("VCF") claim review process. The VCF Act establishescertain caps on non-economic awards for physical injury claims. If you receive a benefit intended to cover medical expenses from a workers compensation program or any other collateral source, please include information regarding that payment, so that it can be appropriately offset from your medical expenses award. 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. See the section below about documentation of employment-related benefits. Kreindler has been helping 9/11 victims since 2001, and to-date, we have helped our clients recover more than $3 billion through the Victim Compensation Fund. The VCF is required by the VCF Actto offset (that is, subtract) from the calculated loss the amount of compensation that you have received, or are entitled to receive, from certain collateral sources as a result of the injury that is eligible for compensation. Please review the details below specific to personal injury and deceased claims. If, however, the certified condition significantly impairs activities of daily living or if the certification does not reflect the severity of the condition, additional documentation of the types described below can help the VCF evaluate whether an increased non- economic loss award within the appropriate range is warranted. In determining household size for claims for decedents, the Special Master will assume that children will remain in the household through age 23. Note: If you received a non-economic loss award in VCF1, the VCF will consider the amount previously awarded when determining whether additional compensation is warranted in light of the 2015 reauthorization statutes prioritization mandate and non-economic loss caps. In general, you must submit: The VCF generally will use information obtained from the Social Security Administration (SSA) to determine earnings history. The VCF will treat all conditions in the category of Upper Respiratory Diseases (URD) as equivalent. . Upper Respiratory Diseases are those affecting the nose, sinuses, or throat. If you received an award in VCF1, you can amend your claim and qualify for additional compensation if: a. Chronic rhinosinusitis, or sinusitis, is a prevalent respiratory condition linked to inhalation of the highly toxic dust on 9/11. It may also include documentation that was included in the claimants pension file and was reviewed in the course of the disability determination process. Second, you need to show that you were unable to work, or unable to work at the same level, because of an eligible physical condition. . Add this amount to the total computed above. 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. However, the VCF limits the amount a 9/11 attorney may charge a claimant to 10% of the claimant's VCF award. 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. 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. 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). See Section 5 for additional information about amending your claim. When evaluating whether additional compensation should be awarded, the VCF considers the types of conditions compensated, the type, nature, and amount of compensation awarded, and the basis and timing of any lost earnings awarded in VCF1. Those registered . Check the following table to see the payout amounts per claimant category in that fiscal year: What Is the Average Compensation for 9/11 Victims? Where survivor benefits being paid to a disabled child may continue after age 18 but are subject to evaluation for continuing disability, the Special Master has discretion not to deduct them to extent they cannot be determined with reasonable certainty. Any additional factors influencing military pay are assumed to be included in your reported military pay and will not be compensated separately. After-tax income: Determine after-tax compensable income by applying the average effective combined federal, state, and local income tax rate for the victims income bracket currently applicable in the state of the victims domicile for tax purposes. If you have a prior claim that has already been decided and paid, and you believe you should be considered for the exception, please amend the claim to submit the request for review. VCF award amount, but there are limits on the amounts of individual awards for economic and noneconomic losses claimants suffered. If you received $125,000 of non-economic loss in VCF1 for asthma, and you amend in VCF2 for additional non-economic loss for newly certified interstitial lung disease and emphysema that have progressively worsened, the VCF will consider you to be fully compensated for your eligible conditions and will not award additional non-economic loss. Rare Cancers. Here are popular VCF payout questions answered: As explainedin Section 5, amendments on deceased claims are not otherwise permitted. The Special Master will only offset the present value of collateral source compensation. To learn more about the World Trade Center Health Program or the World Trade Center Victim's Compensation Fund, . For those who have been granted a WTC disability or reclassification, the pension value is 75% of the higher value, with the exception noted above. A schedule containing age-specific earnings growth rates reflecting the combined inflation, overall productivity, and life-cycle increases is shown in Table 3 below. 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 you receive, or become entitled to receive, any additional payment that constitutes a collateral offset at any time after you submit your claim including after any award has been determined and paid until the VCF closes on October 1, 2090, you are required to notify the VCF in writing within 90 days by completing and submitting the Collateral Offset Update Form found under Forms and Resources on the VCF website. When the victim demonstrates mild or negligible impairment on daily life, or if the eligible conditions have resolved over time or are reasonably well-controlled through over-the- counter medication, the non-economic award begins at $10,000 and may increase depending on the severity of the condition as demonstrated by recent medical records (medical records that are dated within three years of the claim submission date). The VCF does not receive medical documentation directly from FDNY. (LockA locked padlock) See the Collateral Source Offsets section for more information. Non-economic loss is calculated separately from an economic loss claim. The cost NIOSH incurs in reimbursing treatment under the WTC Health Program. He was earning about $100,000 per year at the time of his disability. If you submit documents after the VCF finalizes substantive review of your claim, but before your award letter is issued, we will notify you in the award letter that the documents have not been reviewed. Information aboutcompensation you received from collateral sources that must be subtracted from your lost earnings award. For that reason, even if a claimants eligible condition has worsened since VCF1, s/he may not qualify for additional losses. What is the 9/11 Victim Compensation Fund formula? Mental Health Conditions. The latter figures $100,000 on account ofthe spouse and each dependent include a non-economic component of "replacement services loss.". If your condition has limited your activities, please submit any explanation or documentation that explains this effect of your condition. Note that proof of exacerbation is required to support an additional award for economic loss in VCF2 if economic loss was awarded in VCF1. 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). How Does the VCF Calculate Awards for Multiple Certified Conditions? For married or single individuals with dependents,[5] these expenditure categories include Food, Apparel & Services, Transportation, Entertainment, Personal Care Products and Services, and Miscellaneous. The VCF has made initial award determinations on 34,464 eligible claims (see chart below), and has issued at least one amended award determination on . If you have insurance, the VCF will not compensate for any expenses that have not yet been evaluated by your insurance company or any applicable secondary payer. If Year 5 total earnings exceed 120% of average, the pension basis will be capped at 120%. 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. What are the VCF payouts and how likely you will get one? 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. as reflected in your taxable income reported to the Social Security Administration. There is no requirement for a member of the WTC Health Program to have registered for or filed a claim with the VCF. If you were compensated fully through sick pay or other compensation, that means you have not lost compensation. Examples of such documentation might include a medical report explaining that you had to miss work because of your eligible condition, determinations by an insurance carrier that provided disability coverage and which specify the disabling condition, or Workers Compensation records. Employer-provided benefits: Add the value of employer-provided benefits (or other benefits received through employment, such as from a union or government pension program).
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