Here are popular VCF payout questions answered: 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. 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. 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. 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). Musculoskeletal Disorders (Responders only) Acute Traumatic Injury. If you have already filed an amendment to seek medical expenses reimbursement, the VCF will review the expenses as part of our review of your amendment, provided the expenses meet the established criteria. 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. Income before taxes: Average annual expenditures and characteristics, Consumer Expenditure Survey, 2009, published by the Bureau of Labor Statistics (BLS). Deceased Claims:If you filed an amendment for medical expenses on a deceased claim on or before December 18, 2020 we will review the amendment, and will consider reimbursement for medical expenses subject to the other requirements discussed in this document. 6. This approach was intended to avoid a penalty to the victim. 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. 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. Only expenses that you have paid out-of-pocket, and that were incurred prior to WTC Health Program certification of the applicable condition, will be reimbursed. [1] The regulations provide that the Special Master will identify the spouse of a victim by looking to the victims Federal tax return. Recent test results and treatment prescribed that show the severity of your condition. You are not required to amend your claim if you decide you no longer want to seek reimbursement for medical expenses. The VCF was reauthorized on December 18, 2015, with the enactment of Title IV of Division O of the 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. The start date and amount of the victims pension. 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. Personal Injury Losses, (including losses before death when the victim is deceased), Offsets Applied to R45969 October 17, 2019 Scott D. Szymendera Analyst in Disability Policy As explainedin Section 5, amendments on deceased claims are not otherwise permitted. Thus, if you retired on a disability pension due to an eligible condition, the VCF will only offset that pension to the extent it is greater than the amount you were entitled to receive as a service pension. This means you must submit an amendment and request re-review of your economic loss claim. To calculate economic losses, however, whatever income tax rate corresponded to the victims determined compensable income bracket as of the date of death, or time the victim was unable to work or had to reduce work as a result of eligible conditions, was assumed to apply for the remainder of the victims career, without increase. Letter from the Board of Trustees of the Fire Department Pension Fund Regarding Award of Accident Disability Retirement: This is a letter issued to the individual on FDNY letterhead from the Director of the Board of Trustees of the Fire Department Pension Fund regarding whether the Board approved or disapproved the victims application for accident disability retirement. Documentation showing the Effective Date and the victims final grade, step, and location the best source of this information is the most recent SF-50 (Notification of Personnel Action) prior to retirement. Offsets Applied to 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 your condition has limited your activities, please submit any explanation or documentation that explains this effect of your condition. 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. Facts From 2001 to 2003, the September . Claims seeking only non-economic loss are the simplest and fastest to review. Obstructive Airways Diseases include asthma, bronchiectasis, chronic airway obstruction, chronic bronchitis, chronic obstructive pulmonary disease (COPD), emphysema, reactive airways disease, reactive airways dysfunction, and respiratory conditions due to fumes and vapors. See the Collateral Source Offsets section for more information. The expenses are acceptable expenses as outlined in, The claim is submitted with the required documentation and in the required format, as explained in. Non-economic loss is sometimes called a pain and suffering award. The VCF is required to consider your non-economic loss in the context of the current statutory caps. The VCF makes one award for the non-economic loss, also referred to as pain and suffering. Rare Cancers. The VCF will then compute the amount of past and/or future lost wages in light of these factors (as explained below). 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. 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. 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. Wrongful Death Losses. If, as a benefit of your employment, you are a member of a defined benefit pension plan, and you submit documentation of all information required to calculate a pension benefit under your plan, the VCF generally will calculate your benefits using that data. Law No. The World Trade Center Health Program reports that approximately 18,000 people who were exposed at Ground Zerovictims and first responders alikehave since been diagnosed with cancer related to this toxic exposure, with more diagnoses expected in the future. If you are submitting a claim for loss of future earnings/benefits from a union, or from Con Edison or Verizon, you must submit: If your employer is not listed above but offers a defined benefit pension, you must submit evidence that your employer offers a defined benefit pension and how that pension was calculated, such as a pension calculation statement, retirement statement, or a pension option letter. FDNY victims who retired on a non-WTC-related accidental pension, ordinary disability pension that is not based on VCF-eligible conditions, or service pension will not be eligible for a lost earnings award unless they can provide a disability determination from a third-party entity such as the Social Security Administration or a treating physician that identifies a VCF-eligible condition as a basis of the disability determination. 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. Independent of life-cycle increases, inflation and real overall productivity increases of 2% and 1%, respectively, are applied each year. 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. In order to accelerate the review of claims for all claimants, the VCF will not review voluminous medical records (i.e., 75 pages or more) that are submitted without highlighting or a written guide. This includes determining the types of loss being claimed. 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. VCF's claims review process has two stages: the Eligibility Review and the Compensation Review. 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). If you do appeal, payment is authorized once a decision is rendered following your appeal. The maximum award for " wrongful death " non-economic losses is $250,000, plus an additional $100,000 on account of the spouse and each dependent of the decedent. 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. If you were eligible for bonuses, deferred compensation, stock options, or any other form of compensation that might not be reflected in the SSA earnings report, you must submit proof of such forms of compensation if you want the VCF to consider such forms of compensation or increases in compensation in evaluating your claim. When uploading the Supporting Documentation Packet to your claim, select the document type Medical Expense Supporting Documentation Packet. If you fail to include the required supporting documentation, your claim for medical expenses will be denied. The VCF will calculate such loss on a case-by-case basis using documentation submitted by the Personal Representative. (generic name is listed first, followed by brand name). These rates of increase are consistent with the long- term relationship between economy-wide wage growth and risk-free interest rates, which currently reflect lowered inflationary expectations. 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. 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 work-life expectancies are shown in Table 2 below. The methodology accounts for the loss of employer-provided health plans after application of the limit because such costs are exempted from gross income. 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 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 5. If Year 5 total earnings exceed 120% of average, the pension basis will be capped at 120%. 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 . Claimants receiving benefits through the Workers Compensation WTC Volunteer Fund should provide the VCF with their Workers Compensation file number. 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. 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. 2. If your medical expenses claim does not meet the documentation requirements described in this section, the VCF reserves the right to deny the claim. The VCF will review these benefits on a case-by-case basis. . 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. To calculate the non-economic award for additional dependents, add an additional $100,000 for each dependent beyond the third dependent. 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. 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. 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 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. However, the VCF limits the amount a 9/11 attorney may charge a claimant to 10% of the claimant's VCF award. You must be certain any documentation you provide meets the requirements outlined in Documentation Required to Support a Medical Expenses Claim below. [4] Application of individualized unemployment rates by age or occupation was infeasible and determined to be unnecessary. We are committed to representing our fellow New Yorkers to secure all of the compensation your sacrifices have entitled you to. Recent medical documents that show the type and frequency of medical treatments you have had for your condition. In certain situations, we may deactivate your claim and stop our review if we are missing critical information. 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. For example, if you received a promotion before becoming disabled and if the earnings history did not reflect that promotion, then you must provide proof of the promotion and any earnings adjustment resulting from the promotion. This includes compensation paid to your dependents or to the beneficiaries of a deceased victim as a result of the eligible injury, such as benefits that the Social Security Administration pays to dependents of a disabled or deceased wage earner. In certain, very limited circumstances for example, if your claim qualifies for expedited processing due to terminal illness or significant financial hardship (see Section 8),and the Special Master determines it appropriate the VCF may issue an award that deducts a presumptive offset amount assuming that your disability application was decided favorably, and you will be able to amend your claim once the disability process is concluded for any necessary correction to your award. 3. A member of the Kreindler 9/11 VCF team can discuss all of these factors with you. Disabling conditions that fall in one category will not be deemed equivalent to conditions that fall in another category. For single individuals without dependents, Housing, Education and Health are also included. The appropriate amount of the compensation that should be offset, taking into account the time value of money and contributions made by the injured victim or decedent in the nature of investment or savings. 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. 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. Income will be determined based on the documents submitted with the claim and on data obtained from SSA earnings reports. The type of pension (e.g., ordinary, service, disability, etc. A special responsibility. The VCF does not receive medical documentation directly from FDNY. To do this, the VCF needs documents describing the pension plan and how the pension would be calculated. 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. If that is the case, then the VCF must determine the extent of that loss. 7. 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. 800-887-7299 ENEnglish ESSpanish Our Team Meet Dan Hansen Meet Troy Rosasco Our Team Why Choose Us 9/11 Victim Programs Victim Compensation Fund (VCF) WTC Health Program (WTCHP) Wrongful Death VCF Claims VCF Eligibility & Coverage Appeals & Amendments VCF Proof of Presence Claims Procedures Deadlines Pain & Suffering Damages The maximum noneconomic award for any one type of noncancerous condition is $90,000. Payments made by the various State Victim of Crime Boards funded with federal funds. The VCF award will include the value of lost employment-related benefits. The 2019 reauthorization legislation provides all necessary appropriations for VCF awards and administrative expenses through the end of FY2092. 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. To that end, the sections below provide detailed information about how we generally evaluate and calculate compensation for non-economic and economic loss. 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. This has the effect of decreasing offsets and, thus, increasing the amount of VCF awards. Typically, the VCF's . Three principles guide this inquiry. Some Workers Compensation laws, both domestic and foreign, contain provisions that would allow the insurance carrier to assert a lien against an award issued from the VCF. The September 11th Victim Compensation Fund (VCF) pays compensation to women and men diagnosed with 9/11-related breast cancer. Replacement services loss is intended to replace something that was lost that is, something the victim used to do. payments under the September 11th Victim Compensation Fund of 2001 . He was earning about $100,000 per year at the time of his disability. Under the reopened VCF, attorneys' fees were limited to 10% of the VCF award.7 VCF Reauthorization The reopened VCF was scheduled to stop taking claims on October 3, 2016. 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. WTC volunteers are eligible to receive benefits through the WTC Volunteer Fund, which is administered by the Workers' Compensation Board. ), If you receive a disability pension, documents showing the injuries or conditions that the pension is based upon. If the victim has more than one type of cancer, the Special Master may issue an award that makes an adjustment above $250,000 to account for multiple cancers. How Much Am I Eligible For? If you are not receiving a pension, submit a letter from your union/Con Edison/Verizon stating that you are not receiving a pension. If the service or medication is provided to you by the WTC Health Program, it is not eligible for reimbursement from the VCF and you should not include it with your claim. The WTC Volunteer Fund provides medical and indemnity (cash) payments for volunteers who are disabled as a result of their efforts. [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. For example, an employer might provide a statement showing your compensation history and time periods where you missed work and were not compensated. 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. Note that, in all cases, even though the conditions may be treated as equivalent when deciding whether a disabling condition is the same as your eligible conditions, these conditions are NOT equivalent for the purposes of determining the appropriate non-economic loss award amount, as discussed in Section 2.1 above. 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. If you have already filed your claim requesting economic loss, but you have a disability application pending or you are qualified to apply for disability, you should notify the VCF immediately that there is a pending disability application or that you intend to apply. 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). The maximum is awarded only where a condition has a consistent, sustained, and exceptionally severe impact on a victims quality of life. Employment- related benefits include pension programs, retirement contribution programs, and health benefits. 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. 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. You must complete and submit a consent for release of SSA information (Exhibit 1 to the Claim Form) in order for the VCF to obtain this information. 1.8%, and 1.2%, depending on the average time to maturity consistent with the average duration of presumed losses. Mental Health Conditions. 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. 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. As shown in Table 7 on page 55, PSOB benefits are offset against the total award, including non-economic loss, whether they were awarded for death or disability. NYPD victims who retired on a non-WTC-related accidental pension, ordinary disability pension that is not based on VCF-eligible conditions, or service pension will not be eligible for a lost earnings award unless they can provide a disability determination from a third-party entity such as the Social Security Administration or a treating physician that identifies a VCF-eligible condition as a basis of the disability determination. 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). 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. 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. For those who receive Workers Compensation benefits from New York State, New York amended its Workers Compensation statute in 2002 to prohibit insurance carriers from asserting liens against awards from the VCF. [3] Real life-cycle increases are typically higher in the earlier stages of ones career, one reason being unrealized opportunities for advancement and promotion that individuals in later stages of their careers have already experienced. In many cases, these issues are best addressed in the context of an appeal hearing. If you do not submit complete information about your benefits, the VCF will apply its standard default values: a 401k employer contribution equal to 4% of base salary and $2,400 per year for health insurance. The VCF will calculate pension loss for victims who worked for a New York City agency that is part of the New York City Employees Retirement System (NYCERS)(e.g., NYC Department of Sanitation, the NYC Department of Corrections, or EMS personnel employed by FDNY), and victims who worked for New York State entities that are part of the New York State and Local Retirement System (NYSLRS) (e.g., employees of New York State government agencies, municipalities in New York other than NYC, and other local government entities), if complete documentation is provided.
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