longevity raises, overtime, bonuses, differential pay, etc.) If you are filing a personal injury claim, in order to qualify for an economic loss award for loss of future earnings/benefits, you must first show that you have a permanent partial or total occupational disability based on an eligible 9/11-related physical condition. 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. 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. The following information, which is used to calculate the victims pension. If you have a defined benefit pension that was or will be reduced because you retired early due to an eligible condition, the VCF may compensate you for that loss. Under the VCF Act, the VCF does not compensate for potential or anticipated future medical expenses. 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. Upper Respiratory Diseases are those affecting the nose, sinuses, or throat. 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. That tragic day nearly 3,000 people perished as the planes crashed, and WTC buildings collapsed. 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. 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. Rupa Bhattacharyya works to ensure that fair compensation goes to the victims of the September 11th attacks. This is the bar by which the Special Master will measure the appropriateness of an increase above the cap, and it will be done in consideration of all other circumstances of the claim and the totality of the award. 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. These are generally accepted tables of work-life expectancy regarding the general population. Beginning in February 2019, the VCF's special master began to reduce some award payments because the fund's administrators anticipated that the VCF would not have sufficient funds to pay all valid claims. For example, documents that show hospitalization, surgery, emergency treatment, and/or treatment for side effects of the condition. Please only submit documents that are related to your 9/11-related eligible physical conditions. The methodology computes the loss in each year (including pensions) and caps the loss at $200,000 in each year. 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 VCF will calculate such loss on a case-by-case basis using documentation submitted by the Personal Representative. 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. You do not need to resubmit documents in support of your medical expenses claim if you already submitted them with your claim form, although you may submit additional documentation. 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. Charitable gifts - the final regulations clarify that benefits from charities (privately-funded charitable entities) disbursing private donations will not be treated as collateral source compensation, even if such charities were created or managed by governmental entities. See Required Documents to Support Lost Earnings for Certain Unions and Employers. 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? 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. 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. 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. The VCF Act establishescertain caps on non-economic awards for physical injury claims. You must submit any claim for burial or memorial service costs with the initial claim submission. If you have already filed a claim for reimbursement of expenses that you incurred after your certification date for the applicable condition, the VCF will not reimburse for these expenses. [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.. Independent of life-cycle increases, inflation and real overall productivity increases of 2% and 1%, respectively, are applied each year. SF-50 (Notification of Personnel Action) from the victims retirement. You are not required to amend your claim if you decide you no longer want to seek reimbursement for medical expenses. The VCF will consider claims for medical expenses only if the total amount legitimately claimed in your amendment exceeds $5,000. If you are an employee of Con Edison or Verizon, pension calculation statements from Con Edison or Verizon. In the event these funds are also exhausted, the NY Workers Compensation Law now provides that WTC volunteers may receive benefits directly from the Uninsured Employers Fund, which is funded by fines paid by employers who do not comply with insurance coverage requirements. The amendment may be filed at any time following receipt of your initial award determination, but no later than October 1, 2090. And third, because we are spending public funds, we must ensure that every aspect of the award is adequately justified and documented. [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. Chronic obstructive pulmonary disease (COPD), Respiratory conditions due to fumes and vapors, Cyclosporine (Restasis, Sandimmune, Neoral, Gengraf, Apo- Cyclosporine), Methotrexate (Trexall, Rheeumatrex, Rasuvo, Otrexup), Pathology Esophagus, gastric, duodenum specimens, Cryotherapy ( also known as cryoabalation, cryosurgery). VCF's claims review process has two stages: the Eligibility Review and the Compensation Review. 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. Mental Health Conditions. 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. Before you can receive a VCF award, we will register you with the World Trade Center Health Program to obtain a medical record known as certification of causation. If you do appeal, payment is authorized once a decision is rendered following your appeal. It may be necessary to provide additional documentation that explains the relationship between the disability and your eligible condition(s). If you filed a claim for economic loss and have since decided that you do not want the VCF to review your economic loss claim, you may withdraw that portion of your claim at any time by filing an amendment. 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. The VCF considers the fact that you became more (fully) disabled after your VCF1 award was issued as evidence that your same, eligible condition has worsened and that you suffered losses that were not previously fully compensated. . If you do not notify the VCF, we will assume that there are no liens. Other expenses that are not eligible for reimbursement include insurance premiums, expenses related to replacement services, investigational and holistic treatment, home health care or in-home aides, nursing home/live-in rehabilitation facilities, wigs, household items such as vacuum cleaners, air filters, and water filters, or home modifications. This section describes the evidence you must submit to substantiate your claim for lost earnings. To calculate the non-economic award for additional dependents, add an additional $100,000 for each dependent beyond the third dependent. More information about Non-Economic Loss, Economic Loss, and Collateral Offsets can be found in the sections below. Likewise, Social Security and similar benefits payable to a surviving spouse only if the spouse does not remarry or does not earn income above a certain threshold will be offset absent evidence that they have terminated. The maximum is awarded only where a condition has a consistent, sustained, and exceptionally severe impact on a victims quality of life. 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. If you submit medical records that fall outside of the three-year timeframe, you must highlight them and provide an explanation about why they are important. We will not process your claim until a determination on your disability application is made. For example, the VCF will deduct from a lost earnings award the amount that an FDNY victim receives under a WTC disability pension provided that the disability pension is for an eligible condition, but will not deduct a disability pension from the non-economic loss award. A claimant will be considered to have been fully compensated if the compensation s/he received in VCF1 exceeds the amount of compensation s/he is eligible to receive in VCF2 based on his/her eligible conditions and the circumstances of the claim. 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. The VCF has arrangements with NYCERS and NYSLRS, whereby these entities provide directly to the VCF the information and documentation needed to evaluate disability, lost earnings, and pension benefits for its members (living and deceased), upon receipt of a completed Exhibit B1. 300mm-22(a). [2] Effective income tax rates derived from IRS data for New York are shown in Table 1 below. The WTC Victim Compensation Fund has a long historyafter several reauthorizations, the Fund got permanent financing when the Senate almost unanimously voted for its permanent authorization. Chronic rhinosinusitis has typically been awarded . For example, the Special Master considered that over the course of their projected careers, younger victims could expect to cross into higher income brackets, and be subject to corresponding higher income tax rates, on account of experience-based real lifetime earnings growth in excess of economy-wide national wage increases. When viewed in total, these assumptions are designed to benefit the victim and are more favorable than the standard assumptions typically applied in litigation. 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. Once the VCF confirms that you have met the eligibility criteria, we begin initial review of your compensation information. The VCF will evaluate these types of payments on a case-by-case basis. 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. Official websites use .gov 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. Moreover, computation of the after-tax discount rate using a relatively high combined New York income tax rate, compared to other states, results in a lower after-tax discount rate. Other state Workers Compensation programs have not enacted similar legislation. If you are filing a deceased claim (i.e. The cost NIOSH incurs in reimbursing treatment under the WTC Health Program. - An FDNY Lieutenant who became disabled from working by severe WTC related pulmonary conditions at age 52. The September 11th Victim Compensation Fund (VCF) pays compensation to women and men diagnosed with 9/11-related breast cancer. 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. This means you must submit an amendment and request re-review of your economic loss claim. 5. 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. 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. Such a statement is most helpful if it provides a timeline and details on the medical treatments you have experienced. For example, the VCF will deduct from the award the amount that an FDNY victim receives under a WTC disability pension provided that the disability pension is for an eligible condition. The VCF will compensate for documented out-of-pocket burial or memorial expenses for victims who died as a result of an eligible 9/11-related physical injury. If you withdraw all of your economic loss claims, the VCF will then review your claim for non-economic loss only. Administrators of the VCF fund calculate the award amounts with a complex formula that takes into account where they were located during the period of eligibility and the amount of time they were exposed to toxic elements. Work-life expectancy: Determine a measure of the victims expected remaining years of workforce participation using the tabulated work-life expectancies for the victims age at the time of death or at the time the victim was unable to work, or had to reduce work, as a result of eligible conditions contained in the publication, Gary R. Skoog, James E. Ciecka, Kurt V. Krueger, The Markov Model of Labor Force Activity 2012-17: Extended Tables of Central Tendency, Shape, Percentile Points, and Bootstrap Standard Errors, Journal of Forensic Economics, Volume 28, Issue 1 (2019), pp. Accordingly, non-economic loss is based generally on the severity of the condition and the effect of the condition on the victims ability to maintain normal activities of daily living. 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. Economic loss is pecuniary loss caused by an eligible condition: loss of earnings or other benefits related to employment, the cost to replace household services previously provided by the victim, certain past medical expenses, and expenses associated with a burial or memorial service in the case of a deceased victim. Chronic rhinosinusitis, or sinusitis, is a prevalent respiratory condition linked to inhalation of the highly toxic dust on 9/11. A member of the Kreindler 9/11 VCF team can discuss all of these factors with you. This further lessens the resulting subtraction, compared to personal consumption rates typically applied in litigation, if there are other earners in the household. Compensable expenses include costs you have paid out-of-pocket for prescription medication, prescribed medical equipment, doctor visits, diagnostic tests, surgeries, or other medical procedures relating to your eligible condition(s). The VCF must consider evidence of an eligible disability in light of all the evidence, including an ineligible condition that is also disabling. The VCF award will include the value of lost employment-related benefits. 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. See the Collateral Source Offsets section for more information. 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. The VCF has further revised its policy with regard to non-economic loss claims for non-cancer conditions, and our ability to appeal those awards. The VCF will then compute the amount of past and/or future lost wages in light of these factors (as explained below). Likewise, if you are disabled due to an Obstructive Airways Disease and you have been deemed eligible by the VCF only for Interstitial Lung Disease, the disability determination is not a basis for awarding lost earnings. The VCF is committed to transparency about the claim review process. If you have been found partially or totally disabled by the Department of Veterans Affairs (VA) because of your military service, notify the VCF. [8] Because the period of presumed economic losses is either longer or shorter, depending on the victims age, the present value calculations are performed using yields on a blend of securities with longer or shorter times to maturity. 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. Generally speaking, a NYPD victim who has been granted a WTC disability pension does not need to submit any additional compensation/pension documentation unless the claimant asserts loss from non-NYPD employment. Recent medical documents that show the type and frequency of medical treatments you have had for your condition. The VCF enables compensation for the following categories: Victims of the 9/11 attack Family members of the deceased victims 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. If you do notrespond to our missing information request after 30 days, we will render a decision based on the information contained in your file at that time. Claims seeking only non-economic loss are the simplest and fastest to review. To do this, the VCF needs documents describing the pension plan and how the pension would be calculated. You will need to submit documents to show the benefits you received before the eligible injury/death and any claimed losses associated with employer-provided benefits. You do not need to resubmit documents you have already submitted in support of your amendment, but you must be certain the documentation you provided meets the requirements outlined in Documentation Required to Support a Medical Expenses Claim below. Given the volume and variability of claims, and the legal requirement that the Special Master consider individual circumstances in each case, however, it is not possible to cover every potential situation in this document. Below are some illustrative examples of how VCF1 awards are considered: As part of the economic loss component of your claim, you can request reimbursement for past out-of-pocket medical expenses you have paid as a result of your eligible condition(s). Money is also allocated to people who have been diagnosed with cancers, lung diseases, and numerous other non-cancerous medical conditions after being exposed to dust, debris, and other toxins at Ground Zero. 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. Note: an SSI disability finding may support a claim of lost earnings. Each person who was killed or injured in the September 11th attacks suffered grievous harm, and each person experienced the unspeakable events of that day in a unique way. 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. We will still review your claim to see if it includes reimbursable expenses that you incurred before the applicable condition was certified. To help the VCF understand the severity and effect of your condition, you may want to submit supporting documents related to your condition with your claim. 4 You should then deduct the amount you have received or are entitled to receive from any collateral sources as described above. This chart may change over time. For the VCF to consider your claim for medical expenses, you must submit the following documents in support of your claim: (1) A document that demonstrates that the expense is related to one of your eligible conditions as explained below, unless the expense is on the list of Presumptively Compensable Expenses (see Table 6 below); and. Expenses you incurred after the date of certification are not eligible for reimbursement. In order to qualify for discrete past lost earnings (i.e., losses incurred before you filed your VCF claim or losses incurred in the absence of a third-party disability occupational disability determination), you must show that you were unable to work, or unable to work at the same level, as a result of an eligible condition and that you incurred losses as a result. service, disability). This generally includes the final Medical Board report that identifies the final diagnosis and recommends approval of a WTC disability, as well as any prior Medical Board reports issued that address the claimants conditions and recommend approval, disapproval, or deferral on the claimants disability application. 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. award benefits without considering the benefits' total cost. In many cases, these issues are best addressed in the context of an appeal hearing. 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. [1] The regulations provide that the Special Master will identify the spouse of a victim by looking to the victims Federal tax return. To learn more about the World Trade Center Health Program or the World Trade Center Victim's Compensation Fund, . The VCF also refers to non-economic loss as a "pain and suffering" award. Recent test results and treatment prescribed that show the severity of your condition. 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. For these claims, it may be necessary to provide additional documentation that explains the relationship between your loss of earnings and benefits and your eligible condition(s).
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