The letter will explain the next steps to take on your claim. In addition, if you filed your initial claim before December 18, 2020, and you did not claim medical expenses in your initial claim, you may file an amendment for medical expenses, and we will consider it, subject to the other requirements discussed in this document. Wrongful Death Losses. When considering the authority provided by the VCF Act toissue non-economic loss awards above the statutory caps in special circumstances, the Special Masters intention (consistent with the intent of Congress) is to exercise this authority in very limited and unique circumstances, and only for non-cancer claims. 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. 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. (LockA locked padlock) [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. 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. His VCF award was $1,012,392 reduced by offsets for a pension and prior lawsuit of $404,833, for a total award of $607,558. The Special Master interprets the statutory language to allow compensating these limited number of severe non-cancer claimants in the same way that a cancer claimant would be compensated meaning, $250,000 for a single condition, and 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. 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. A Pension Work History or similar document from the union, showing the number of hours worked and credits earned in every year of work. See theWTC Health Program Disability Evaluation Process for complete details on the Process. 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. Information about your earnings and benefits, so that the VCF can determine the amount of loss. ), If you receive a disability pension, documents showing the injuries or conditions that the pension is based upon. Risk of unemployment: To better reflect contingencies that the victims would have faced, all projected earnings and fringe benefits (assumed to be received during projected employment and until work-life expectancy) amounts will be adjusted for a factor to account for the risk of unemployment as lifetime jobs are not representative of the modern economy. [2] Effective income tax rates derived from IRS data for New York are shown in Table 1 below. 6. Our review includes: determining non-economic loss based on the severity of physical harm; calculating economic loss, including past and future lost earnings (if claimed); and confirming collateral offsets, including payments received from pension funds, life insurance, SSA, Workers Compensation, and settlements from 9/11-related lawsuits. It is not possible to define and categorize in advance every possible collateral source deduction. Follow the instructions on "How to File an Amendment" to amend your 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. Claimants receiving benefits through the Workers Compensation WTC Volunteer Fund should provide the VCF with their Workers Compensation file number. Non-economic loss is sometimes called a pain and suffering 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. There are three types of economic loss: loss of earnings/benefits, out-of-pocket medical expenses, and replacement services loss. The amendment may be filed at any time following receipt of your initial award determination, but no later than October 1, 2090. The methodology applies adjustments for taxation, risk of unemployment, employee contributions, and personal consumption for deceased claims before applying the annual limit. The $250,000 cap for a single cancer condition will not be exceeded under this authority. 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. The victims most recent Earning and Leave Statement prior to retirement may have all of this information except the Effective Date, so if that document is submitted in place of the SF-50, the claimant will need to also provide his/her Effective Date. 107). 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. [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. 4. (generic name is listed first, followed by brand name). If you have a diagnosis of melanoma skin cancer that you believe may be related to 9/11, click or call our Kreindler 9/11 VCF team at 877-505-0090 for helpful answers about your eligibility for compensation. 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. 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. 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. 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. 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. [6] For lower income categories where total expenditures exceed income, expenditures were scaled to income, so as not to reduce income for expenses potentially met by other forms of support. Recent test results and treatment prescribed that show the severity of your condition. The lower the after-tax discount rate, the higher the present value of presumed economic loss. CNN Editorial Research Here is a look at the September 11th Victim Compensation Fund (VCF) and the James Zadroga 9/11 Health and Compensation Act of 2010. 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. An additional $9 million was provided by the State of New York in 2016. Official websites use .gov The regulations set a presumed award for non-economic losses sustained by the victim, and the victims spouse[1] and dependents, because of the victims death as a result of the September 11th aircraft crashes or subsequent debris removal: $250,000, plus an additional $100,000 on account ofthe spouse and each dependent of the decedent. 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. For each NYPD victim who is claiming loss of future earnings and benefits and has provided the appropriate authorization, the NYPD sends the VCFthe following information, which the VCF uses to calculate economic loss: The NYPD also sends the VCF information/documentation regarding the basis of the NYPD victims disability, if applicable. 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. Once you receive your award determination, you will need to determine if the out-of-pocket medical expenses you incurred meet the $5,000 minimum threshold and other criteria noted above and are acceptable expenses as described in Acceptable Medical Expenses Claims below. Congress amended the Public Safety Officers Benefits Act (42 U.S.C. The maximum is awarded only where a condition has a consistent, sustained, and exceptionally severe impact on a victims quality of life. In certain situations, we may deactivate your claim and stop our review if we are missing critical information. or https:// means youve safely connected to the .gov website. 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. If you do not appeal, we authorize payment within 20 days of the end of the 30-day appeal period. Thus, a determination by SSA that you were. Here are popular VCF payout questions answered: If you believe you meet this threshold, you should request special circumstances consideration on appeal after your initial award has been determined. 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 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. According to the Eighth Annual Status Report, in 2019, the VCF made victim compensation payouts to nearly 26,000 claimants in the amount of $6 billion. Specifically, the NYPD sends the VCF the underlying Medical Board Police Pension Fund Article II Reports that identify the basis of the disability determination for claimants who have retired on a WTC disability. The VCF also refers to non-economic loss as a "pain and suffering" award. [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). If your condition has limited your activities, please submit any explanation or documentation that explains this effect of your condition. 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. 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). . Doing so will unnecessarily tie up limited resources and may delay claims processing. [6] Other standard expenditure categories sometimes included in litigation, namely Reading, Cash Contributions, Alcoholic Beverages, and Tobacco Products, were excluded. The VCF (which stands for "Victim Compensation Fund") provides financial compensation for those who were physically injured or died as a result of an eligible 9/11-related illness (these include cancer claims ). The VCF award will include the value of lost employment-related benefits. As an example, in the case of Social Security childrens benefits, the Special Master will determine the monthly benefit to the child, multiply that benefit by the number of months remaining until the child reaches age 18 (taking into account possible limits such as maximum family benefits available), include if consistent with Social Security guidelines a factor for inflation, and then discount the total to present value to determine the amount of the offset. 1.8%, and 1.2%, depending on the average time to maturity consistent with the average duration of presumed losses. Other examples include computed tomography scans, x-rays, endoscopies, esophagogastroduodenoscopies, laryngoscopies, polysomnography or sleep studies, or other diagnostic and treatment procedures. - An FDNY Lieutenant who became disabled from working by severe WTC related pulmonary conditions at age 52. Collateral sources may include life insurance, pension funds, death benefit programs, settlement payments from September 11th-related lawsuits, and payments by federal, state, or local governments related to the terrorist-related aircraft crashes of September 11, 2001, or debris removal in the immediate aftermath. The September 11th Victim Compensation Fund (VCF) pays compensation to women and men diagnosed with 9/11-related breast cancer. Treatment expenses covered by private health insurance, Workers Compensation, or other programs will not be reimbursed. Any additional factors influencing military pay are assumed to be included in your reported military pay and will not be compensated separately. That tragic day nearly 3,000 people perished as the planes crashed, and WTC buildings collapsed. Note: an SSI disability finding may support a claim of lost earnings. 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. To that end, the sections below provide detailed information about how we generally evaluate and calculate compensation for non-economic and economic loss. 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. If the medical records submitted with your claim meet the three-year timeframe, you do not need to continue to submit medical records on your claim unless the VCF requests them. When viewed in total, these assumptions are designed to benefit the victim and are more favorable than the standard assumptions typically applied in litigation. It may facilitate the processing of your claim, however, if you submit to the VCF any determination you have received from the PSOB program, or documentation of a payment from the PSOB program, when you submit your claim. . Historical earnings: this includes last 5-year total earnings and 3-year average of highest 3 of 5 years, Pension amount: In general, this is based on the higher of Year 5 earnings or 3-year average, Type of retirement: WTC Accidental or Reclassification, Accidental Disability (not WTC-related), Ordinary Disability (not WTC-related), or Service Retirement, Date of retirement and, if reclassified, date of WTC reclassification, Basis of disability determination generally: e.g., pulmonary, GERD, cancer, orthopedic, Date of initial entry to military service (DIEMS), Pay Date (Per Leave and Earnings Statement), Type of retirement from the military (e.g. Secure .gov websites use HTTPS There are limited circumstances in which the VCF may assume that the victim would have continued working past age 65, such as where the victim was providing financial support to minor children. 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. Some categories of offsets apply only to certain categories of loss. 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). 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. 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. The maximum amount for eligible non-cancer conditions is $90,000. 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. The fund, which was opened in 2011, compensates for deaths and illnesses due to exposure to toxins at the sites of the Sept. 11 attacks. In many cases, these issues are best addressed in the context of an appeal hearing. Non-economic loss is calculated separately from an economic loss claim. 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. The VCF will evaluate these types of payments on a case-by-case basis. Because your VCF1 non-economic loss exceeds the maximum amount allowed by law for those conditions ($90,000), no additional losses will be awarded. 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). A letter from the union/Con Edison/Verizon stating the following: The type of pension you are receiving (e.g. For single individuals without dependents, Housing, Education and Health are also included. This approach was intended to avoid a penalty to the victim. 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. 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). Do not hesitate to contact us toll-free at 844-982-2667 if we may be of service. Please only submit documents that are related to your 9/11-related eligible physical conditions. The severity of the 9/11 health condition The type of condition, cancer, or illness The ways that the condition has impacted the responder or survivor's life Contact a New York City 9/11 Victim Compensation Fund Attorney . If you are an employee of Con Edison or Verizon, pension calculation statements from Con Edison or Verizon. The lowest compensation amount was $87.02. 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. Recent medical documents that show the type and frequency of medical treatments you have had for your 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. Moreover, the VCF will not disregard a determination that attributed your disability to an ineligible condition, even if it was later changed. 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. If you withdraw all of your economic loss claims, the VCF will then review your claim for non-economic loss only. For example, a victim who has a respiratory condition that significantly restricts the victims ability to participate in activities of daily living and recreation, or that is progressive and not effectively treated, may have a higher non-economic award than a victim who has a mild respiratory condition and another mild condition which have not had a significant effect on their activities of daily living. 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. 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. This adjustment is made because work-life expectancies are based on years of expected workforce participation, which, as defined by the Bureau of Labor Statistics, include periods an individual is either working or seeking work. 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. 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 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. If balances are insufficient to pay the full amounts awarded, claimants will receive payments in proportion to the fund's balance. 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. However, the VCF limits the amount a 9/11 attorney may charge a claimant to 10% of the claimant's VCF award. 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. 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. See Table 7: Which Offsets Apply to Which Types of Loss. 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). This includes determining the types of loss being claimed. 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 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. There is a cap on certain types of non-economic awards According to VCF.gov, the maximum noneconomic award for any single type of cancer is $250,000, except skin cancer, which is in the range of $90,000. 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. It may also include documentation that was included in the claimants pension file and was reviewed in the course of the disability determination process. Income before taxes: Average annual expenditures and characteristics, Consumer Expenditure Survey, 2009, published by the Bureau of Labor Statistics (BLS). The Special Master will exercise discretion in valuing the appropriate deductions for collateral offsets by determining the following: While it is not possible to define in advance every possible collateral source deduction, the following general illustrations should provide guidance: The following are NOT considered collateral offsets: The Special Master has discretion to determine which offsets should be applied to which losses. Please do not submit another copy of the Exhibit 1 for the victim. Law No. 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.. This subtraction is a standard adjustment in evaluating loss of earnings in wrongful death claims because some amount of the income the decedent would have contributed to the household would have been consumed personally by the decedent and not available to other household members. 300mm-22(a). Pending disability applications: What to do if you are waiting for a disability decision from a government entity or insurer. Please note, however, that this presumption of an offset will be used sparingly as the VCF does not want to place claimants in a position where it overpays an award and then is required to recoup funds already paid. If you do appeal, payment is authorized once a decision is rendered following your appeal. 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. 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. payments under the September 11th Victim Compensation Fund of 2001 . Mesothelioma. 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.
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