[1] The regulations provide that the Special Master will identify the spouse of a victim by looking to the victims Federal tax return. Medical Evaluation Board and/or Physician Evaluation Board report). In general, you must submit: The VCF generally will use information obtained from the Social Security Administration (SSA) to determine earnings history. 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. 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. A special responsibility. The VCF will not compensate for any travel expenses you incurred while seeking medical treatment, including the cost of gas, public transportation, hotels, and meals, except in extraordinary circumstances. 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. See Table 7: Which Offsets Apply to Which Types of Loss. The type of survivor option selected (e.g., 100% joint and survivor). Rupa Bhattacharyya '95 can pinpoint the hardest decision she had to make in her 25 years as a government attorney. payments under the September 11th Victim Compensation Fund of 2001 . You will need to submit two types of information: The VCF provides a Temporary Past Lost Earnings worksheet to help support your VCF claim. The Special Master has determined that individual age-specific growth rates, rather than growth independent of a particular age bracket at death, better reflects the expected pattern of earnings over ones career[3] and results in more equitable and consistent projections for victims close to each other in age with otherwise similar family and employment characteristics. Interstitial Lung Diseases include asbestosis, granulomatosis, interstitial pneumonia, pneumonitis, pulmonary fibrosis, and sarcoidosis. The $7.3 billion fund has already paid out about $5 billion. To learn more about the World Trade Center Health Program or the World Trade Center Victim's Compensation Fund, . 107). This includes last 5 years total earnings prior to retirement, including salary, holiday pay, night shift differential pay, and overtime. 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. 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. 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. 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. 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. See the Collateral Source Offsets section for more information. 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. Employer-provided benefits: Add the value of employer-provided benefits (or other benefits received through employment, such as from a union or government pension program). [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). The $250,000 cap for a single cancer condition will not be exceeded under this authority. Each award is calculated individually. The WTC Volunteer Fund provides medical and indemnity (cash) payments for volunteers who are disabled as a result of their efforts. If any part of these expenses was covered by life insurance or another source, you must provide documentation of that coverage. [2] Average combined effective income tax rates by earnings bracket were calculated based on an analysis of IRS data for the most recent tax years available: 2007, 2008, and 2009. Whether the particular offsets fall within the definition of collateral sources; Whether particular offsets should apply to all or some categories of loss (for example, certain disability benefits are offset only against lost earnings; see Table 7: Which Offsets Apply to Which Types of Loss); Whether the collateral source compensation is certain or can be computed with sufficient certainty to enable its offset while ensuring that beneficiaries receive the full amount of compensation that is appropriate; and. See Section 2.3 for a detailed explanation of the methodology used to calculate future lost earnings. For these claims, it may be necessary to provide a disability determination or other documentation that explains the relationship between the loss of earnings and the eligible condition. Historical unemployment rates were examined and a reduction factor of 6% is applied to presumed earnings and fringe benefits to account for this risk[4]. 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. To calculate economic loss, the VCF must first determine whether there is in fact a compensable loss. Disabling conditions that fall in one category will not be deemed equivalent to conditions that fall in another category. If you received an award in VCF1, you can amend your claim and qualify for additional compensation if: a. Here are popular VCF payout questions answered: The 9/11 victim compensation fund formula is generally as follows: Non-Economic Losses + Economic Losses - Collateral Offsets = Award Amount. 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. See Required Documents to Support Lost Earnings for Certain Unions and Employers. Under the Zadroga Act, non-economic loss includes . 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. [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. 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. Add this amount to the total computed above. 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 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. A personal statement discussing the impact of the eligible conditions on your life. This has the effect of decreasing offsets and, thus, increasing the amount of VCF awards. A .gov website belongs to an official government organization in the United States. Recent test results and treatment prescribed that show the severity of your condition. The collateral source offsets will not include monies or other investments in the injured victims or decedents 401(k) accounts. 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. The VCF will evaluate these types of payments on a case-by-case basis. Given the statutorily designated backstop through the Uninsured Employers Fund, future funding for the WTC Volunteer Fund is now certain. 3. Therefore, the VCF may ask you to obtain updated LOAs if they are older than one year at the time of our request. Likewise, if the victim was 65 years old or older at the time of death, the VCF generally will not award lost earnings and benefits, based on the presumption that the victim had already reached the end of his or her reasonable work-life expectancy. 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. 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. Mental Health Conditions. The VCF has an arrangement with the PSOB program to exchange information regarding the status of any claim, the amount of any award determination and payment, and the basis of the award determination. (generic name is listed first, followed by brand name). 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. Generally, the Special Master will consider the three calendar years of employment history before the decrease in the victims earnings capacity as a result of the victims disability due to the eligible conditions or the victims death, but the Special Master also may consider other factors or other years or combinations of years in evaluating the claim. If services are no longer relevant, they will not be compensated (for example, child care services will not be compensated after the child reaches age 18). If you notify the VCF more than 90 days after the date you learned that you were entitled to receive a new or revised collateral source payment, the VCF may adjust your determined or paid award to reflect the new or revised entitlement or payment as an offset, which may result in a lower award. 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. See the Collateral Source Offsets section for more information. Thus, a determination by SSA that you were. An official website of the United States government. The lowest compensation amount was $87.02. Non-Disabling Cancer Awards The following are some of the hundreds of noneconomic loss awards that the VCF has issued to our clients with non-disabling cancers and other WTC-related illnesses. 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. Since the VCF was reauthorized last year, claims for non-cancer conditions have routinely been awarded the lowest possible amount, absent medical records to support the severity of the condition. For example, many people with respiratory injuries have pulmonary function tests. 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. 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. 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). 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. The VCF will award the lowest end of the range for your conditions and request that you submit an amendment with the required information if you would like the VCF to consider the medical records submitted when assessing severity for purposes of awarding non-economic loss. Claims seeking only non-economic loss are the simplest and fastest to review. In those cases, the VCF may use the later date that is, the date when the victim actually suffered a loss in earnings. 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. 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. 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. Non-economic loss is sometimes called a pain and suffering award. Please review the details below specific to personal injury and deceased claims. 2. 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. If you wish to seek a waiver, please contact the VCF Helpline. award benefits without considering the benefits' total cost. Aerodigestive Disorders. 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. 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. See theWTC Health Program Disability Evaluation Process for complete details on the Process. 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. Three principles guide this inquiry. Other examples include computed tomography scans, x-rays, endoscopies, esophagogastroduodenoscopies, laryngoscopies, polysomnography or sleep studies, or other diagnostic and treatment procedures. An additional $9 million was provided by the State of New York in 2016. If you submitted a claim for economic losses, but the VCF issues an award for non-economic loss only because of missing documents, the VCF will reconsider the economic loss award only on amendment. Records of state and federal agency proceedings or private insurance records that address your medical condition. 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. 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. 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 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). 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. The Special Master will only offset the present value of collateral source compensation. The expenses are acceptable expenses as outlined in, The claim is submitted with the required documentation and in the required format, as explained in. 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. Since each claim involves reviewing a substantial amount of documentation, and each award is calculated individually, the process can . You have a new physical injury or condition that you had not suffered at the time of the VCF1 claim filing or that was not compensable at the time of VCF1; c. You have not already been fully compensated for your losses. First, the VCF strives to be fair to all claimants. The 2019 reauthorization legislation provides all necessary appropriations for VCF awards and administrative expenses through the end of FY2092. You must submit any claim for burial or memorial service costs with the initial claim submission. In addition, the victims consumption is determined as a share of the victims own earnings only, rather than the standard share of total household earnings. Deferred or vested compensation from employment. 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. 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. Doing so will unnecessarily tie up limited resources and may delay claims processing. To do this, the VCF needs documents describing the pension plan and how the pension would be calculated. What is the 9/11 Victim Compensation Fund formula? Pending disability applications: What to do if you are waiting for a disability decision from a government entity or insurer. The lower the after-tax discount rate, the higher the present value of presumed economic loss. ), If you receive a disability pension, documents showing the injuries or conditions that the pension is based upon. Federal employees in the Federal Employees Retirement System (FERS) or Civil Service Retirement System (CSRS) who are claiming loss of future earnings/benefits must submit the following: Individuals who receive a disability pension from FERS should also submit: Personal Representatives filing a wrongful death claim must submit a letter from OPM confirming the following: For union members and employees of Con Edison or Verizon, the VCF models typically include: (1)a defined benefit pension equal to 15% of base salary, and (2)an annuity equal to 7% of base salary if your union offers an annuity fund. If you are submitting a personal injury claim and you claim a loss of earnings, the VCF must determine whether you are unable to work, or have a reduced ability to work, as a result of an eligible 9/11-related physical condition. If you are an employee of Con Edison or Verizon, pension calculation statements from Con Edison or Verizon. Replacement services loss is intended to replace something that was lost that is, something the victim used to do. $340,000 for a downtown office worker with skin cancer and larynx cancer $340,000 for a retired NYPD officer with cancers of the colon and mouth 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. 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. 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. Specifically, the NY Workers Compensation law, Section 29(1-b) provides as follows: 1-b. The VCF was paying 10% of the settlement amounts immediately, with 90% due on its planned . longevity raises, overtime, bonuses, differential pay, etc.) 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. A Pension Work History or similar document from the union, showing the number of hours worked and credits earned in every year of work. Amount ($000s) 2020 Enacted [37] [29] $0* 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 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. 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. Share sensitive information only on official, secure websites. 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. Expenses you incurred after the date of certification are not eligible for reimbursement. 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. If you do not provide sufficient evidence of the benefits you received through employment, the VCF willassume that the employers retirement contribution is 4% of base salary and that medical benefits are $2,400 per year in current year dollars and will adjust for applicable inflation.