We will not process your claim until a determination on your disability application is made. What is the 9/11 Victim Compensation Fund formula? Given the statutorily designated backstop through the Uninsured Employers Fund, future funding for the WTC Volunteer Fund is now certain. Facts From 2001 to 2003, the September . 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. In some cases, even where the record supports the determination that your disability is related to an eligible condition, it is not clear that your disability resulted in a compensable loss. When determining when to notify the VCF, keep in mind the following general guidelines: The obligation to report collateral source payments is ongoing, until the VCF stops taking claims on October 1, 2090. Deferred or vested compensation from employment. Collateral offsets are compensation from other sources that you received or became entitled to receive as a result of your eligible injury and must be subtracted from the award. In some cases, the VCF will apply a computation of future residual earnings for individuals who are disabled from a specific job but who are otherwise able to perform a different occupation. Thus, for example, the Special Master has determined that Workers Compensation benefits that are payable only if the spouse does not remarry will be offset throughout the period of compensated loss unless evidence is submitted that the spouse in fact remarried and the benefits in fact terminated. This approach was intended to avoid a penalty to the victim. An experienced 9/11 attorney at Pitta & Baione can help you with the VCF award process and answer any questions you have about your rights. For example, if a claim is submitted on January 1, 2020, recent medical records are those dated after January 1, 2017. In the earliest years of the September 11th Victim Compensation Fund, payouts ranged from $500 to $8.6 million. 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. The VCF will consider the SSA diagnoses of Chronic Pulmonary Insufficiency (code 4960), Chronic Respiratory Disorders (code 4960), or Other Disorders of the Respiratory System (code 5190) equivalent to the Obstructive Airways Diseases listed in this paragraph. It was determined that the net effect of these and other facilitating assumptions was to increase the potential amount of presumed economic loss to the benefit of the victim. 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). 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? The $7.3 billion fund has already paid out about $5 billion. It may be necessary to provide additional documentation that explains the relationship between the disability and your eligible condition(s). If we do not receive the documents necessary to calculate economic loss, or if the documents are not submitted in a timely manner, we may issue an award for non-economic loss only. If the paid medical expenses you incurred meet the VCF criteria, and you want to seek reimbursement of the expenses, you must submit an amendment to reactivate your request. - An FDNY Lieutenant who became disabled from working by severe WTC related pulmonary conditions at age 52. The type of medication prescribed and the frequency of use of the medication can help demonstrate the severity of the condition. 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. 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. Treatment expenses covered by private health insurance, Workers Compensation, or other programs will not be reimbursed. A personal statement discussing the impact of the eligible conditions on your life. If you do not promptly notify the VCF of the pending disability application, and the VCF processes your claim and issues only a non-economic loss award, the claim for economic loss will be reviewed in priority order based on the date of submission of the amendment advising the VCF of the completed disability determination. If you have been found partially or totally disabled by the Department of Veterans Affairs (VA) because of your military service, notify the VCF. The VCF does not reimburse recipients for attorney's fees, which are to be paid by the claimant. 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. If any part of these expenses was covered by life insurance or another source, you must provide documentation of that coverage. [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. ), If you receive a disability pension, documents showing the injuries or conditions that the pension is based upon. 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. 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. VCF's claims review process has two stages: the Eligibility Review and the Compensation Review. If you did not have SSA earnings (e.g., worked outside the United States or do not have a Social Security number), then you must provide other documents demonstrating earnings including tax returns, statements of profit/loss from a business (if self- employed), W2 forms, 1099 forms, pay stubs, or employment offer letters. 3796) to provide that the benefits paid under the Act shall be in addition to any other benefit that may be due from any other source, except . 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. In the early years of the WTC Victim Fund, claims for personal injury were awarded amounts that ranged from $500 to $8.6 million. 9. Because claims for reimbursement of out-of-pocket medical expenses require the submission and review of significant documentation establishing that the claimed medical expense was related to your eligible condition, that you personally paid for the expense out of pocket, and that the expense was incurred prior to your WTC Health Program certification for the applicable condition, processing these claims takes time and can delay your award. Work-life expectancies are based on actual experiences and behavior of the general population and measure the estimated time in years an individual of a given age will remain in the labor force (either employed or actively seeking work), allowing for age-specific mortality risks and rates of workforce transitions. The VCF can award a 9/11 cancer victim up to $250,000 for pain, suffering and loss of enjoyment of life. Claimants receiving benefits through the Workers Compensation WTC Volunteer Fund should provide the VCF with their Workers Compensation file number. 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. There is no requirement for a member of the WTC Health Program to have registered for or filed a claim with the VCF. The letter will explain the next steps to take on your claim. If your condition has limited your activities, please submit any explanation or documentation that explains this effect of your condition. If you have applied or plan to apply to PSOB Programs for a September 11th-related injury, you should note the PSOB application in the Collateral Offsets section of the claim form. For this reason, if you are filing a claim on behalf of a deceased individual we strongly urge you to submit your claim only once you can provide all materials needed to support the claim. 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). 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. Pending disability applications: What to do if you are waiting for a disability decision from a government entity or insurer. 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. 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. Offsets Applied to For example, you could submit letters or reports from specialists who treated your eligible conditions. Present value: Calculate the present value of projected earnings and fringe benefits using discount rates based on a weighted average of historical yields on mid- to long-term U.S. Treasury securities, adjusted for income taxes using a mid-range effective tax rate. If you were compensated fully through sick pay or other compensation, that means you have not lost compensation. While this information is provided for general guidance, it is important to note that these are general benchmarks, and awards may vary within the statutory caps as each claim is evaluated individually on its specific facts and at the discretion of the Special Master. 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. Other examples include computed tomography scans, x-rays, endoscopies, esophagogastroduodenoscopies, laryngoscopies, polysomnography or sleep studies, or other diagnostic and treatment procedures. 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.
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