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. Under the Zadroga Act, non-economic loss includes . 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 believe that your SSA earnings history does not fully account for future earnings potential, then you must provide documentation supporting any argument that the VCF should take into consideration other information in determining future earnings. Deferred or vested compensation from employment. As a general rule, under the terms of the VCF Act, the Special Master has identified the following conditions as presumptively less severe and debilitating and thus warranting lower awards, absent medical documentation of severity, than the highest allowable for a non-cancer condition: Asthma/RADS, Barretts Esophagus, Bronchiecstasis, Chronic Airway Obstruction, Chronic Bronchitis, Chronic Cough, Chronic Obstructive Pulmonary Disease, Chronic Rhinitis, Esophagitis, Gastroesophageal Reflux (GERD), Laryngitis, Nasopharyngitis, Obstructive Sleep Apnea, Pharyngitis, Respiratory Conditions due to Fumes or Vapors, Rhinosinusitis, Sinusitis, and Traumatic Injury or Musculoskeletal Disorder. payments under the September 11th Victim Compensation Fund of 2001 . Our claim analysis therefore always begins with three essential questions: was there a demonstrable loss, can we reasonably conclude the loss was caused by a WTC-related eligible condition, and what makes sense in the context of this claimant and the individual circumstances of this claim? 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. The expenses are acceptable expenses as outlined in, The claim is submitted with the required documentation and in the required format, as explained in. The VCF cannot award lost earnings for a disability that is not clearly related to an eligible condition. Income will be determined based on the documents submitted with the claim and on data obtained from SSA earnings reports. Non-Cancer VCF Payouts. To do this, the VCF needs documents describing the pension plan and how the pension would be calculated. 1. 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. Sept. 11 Victim Compensation Fund Cuts Payouts By As Much As 70 - NPR 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. This further lessens the resulting subtraction, compared to personal consumption rates typically applied in litigation, if there are other earners in the household. Employment- related benefits include pension programs, retirement contribution programs, and health benefits. 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. How Much VCF Compensation Can I Recover? - Weisfuse & Weisfuse, LLP While some of these conditions can have severe impacts on individual patients, the VCF will require evidence of such severity, in the form of recent medical records supported by impact statements and/or appeal testimony, before considering an increase in the award. For example, if a victim is certified for two different types of non-melanoma skin cancer for example, basal cell and squamous cell or for one non-melanoma skin cancer at multiple sites, the award will generally be in the range of $90,000. 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. The VCF was reauthorized on December 18, 2015, with the enactment of Title IV of Division O of the What Are the Average Compensation Amounts for 9/11 Victims? First, you need to show that you actually lost compensation. It may also include documentation that was included in the claimants pension file and was reviewed in the course of the disability determination process. 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. 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 determining household size for claims for decedents, the Special Master will assume that children will remain in the household through age 23. Official websites use .gov 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. 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. Moreover, the VCF will not disregard a determination that attributed your disability to an ineligible condition, even if it was later changed. See the Collateral Source Offsets section for more information. [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. Growth rates: The VCF projects compensable income and benefits through the victims expected work-life using growth rates that incorporate an annual inflationary or cost-of-living component, an annual real overall productivity or scale adjustment in excess of inflation, and an annual real life-cycle or age-specific increase derived using data on average full-time year-round earnings by age bracket from the 2010 Current Population Survey (CPS), a monthly survey of households conducted by the Bureau of the Census for the Bureau of Labor Statistics. 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 Note that this information should be in a letter that was sent to the victim at retirement or in a Federal Retirement Benefits printout: Date that victim entered the FERS system (date used to calculate Creditable Service for Retirement), Total years and months of credited service, Letter from Office of Personnel Management (OPM) confirming that the victims disability retirement has been approved and stating the conditions forming the basis of the disability, Amount of Monthly Disability Pension in first 12 months (already reduced by Social Security benefits), Amount of Disability Pension after 12 months (already reduced by Social Security benefits), Estimate of re-calculated Disability Pension at age 62, Type of survivor benefit (e.g., Basic Employee Death Benefit, Survivor Annuity). 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. If you are not receiving a pension, submit a letter from your union/Con Edison/Verizon stating that you are not receiving a pension. How are Economic Loss and Non-Economic Loss Determined for VCF Awards 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. 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. 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. Note: The non-economic award is not automatically tied to the degree of disability (to the extent there is an occupational disability determination as a result of an eligible 9/11-related physical injury or condition). This has the effect of decreasing offsets and, thus, increasing the amount of VCF awards. For example, if the victim left the workforce more than one year before death without a permanent partial or total occupational disability determination based on an eligible 9/11-related physical health condition, the VCF will consider the reasons the victim originally left the workforce and the likelihood that the victim would have returned to the workforce were it not for the victims eligible condition in determining whether the victim actually lost compensation as a result of an eligible condition. Other expenses that are not eligible for reimbursement include insurance premiums, expenses related to replacement services, investigational and holistic treatment, home health care or in-home aides, nursing home/live-in rehabilitation facilities, wigs, household items such as vacuum cleaners, air filters, and water filters, or home modifications. 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. Pending disability applications: What to do if you are waiting for a disability decision from a government entity or insurer. Similarly, payments from other government or private entities that are subject to liens may not be offset from the VCF award if sufficient evidence of the lien is submitted. 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. 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. 4 You should then deduct the amount you have received or are entitled to receive from any collateral sources as described above. Accordingly, non-economic loss is based generally on the severity of the condition and the effect of the condition on the victims ability to maintain normal activities of daily living. This 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. 1.8%, and 1.2%, depending on the average time to maturity consistent with the average duration of presumed losses. The VCF considers the fact that you became more (fully) disabled after your VCF1 award was issued as evidence that your same, eligible condition has worsened and that you suffered losses that were not previously fully compensated. service, disability), if applicable, Date of retirement from the military, if applicable, Most recent pay statement showing various allowances, benefits, and special pay, If receiving military retired pay: start date and benefit amount. To calculate economic loss, the VCF must first determine whether there is in fact a compensable loss. 24. 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. See the Collateral Source Offsets section for more information. The VCF will then obtain information regarding the benefits directly from the SSA. Compensation that would have been payable upon retirement or death regardless of when or why the victim retired or died is not payable as a result of the terrorist-related aircraft crashes of September 11, 2001, and therefore is not collateral source compensation. Once the VCF confirms that you have met the eligibility criteria, we begin initial review of your compensation information. Likewise, Social Security and similar benefits payable to a surviving spouse only if the spouse does not remarry or does not earn income above a certain threshold will be offset absent evidence that they have terminated. The VCF will also consider when and how a claimant left the workforce, particularly if the claimant stopped working before the disability onset date identified in the disability determination. Valuing Your Victim Compensation Fund Award - Pitta & Baione WTC volunteers are eligible to receive benefits through the WTC Volunteer Fund, which is administered by the Workers' Compensation Board. A New York firefighter amid the rubble of the World Trade Center after the September 11, 2001 attacks. You will need to submit two types of information: The VCF provides a Temporary Past Lost Earnings worksheet to help support your VCF claim. For example, the victim may suffer from multiple types of cancer or may have a severe non-cancer eligible condition along with an eligible cancer. September 11th Victim Compensation Fund - United States Department of To calculate the non-economic award for additional dependents, add an additional $100,000 for each dependent beyond the third dependent. Non-economic loss is calculated separately from an economic loss claim. 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). How Much Did Each Victim Receive Through the VCF Fund? 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. Do Multiple Certified Conditions Increase a VCF Award Amount? Each award is calculated individually. Therefore, the VCF may ask you to obtain updated LOAs if they are older than one year at the time of our request. Age, start of loss and compensable income: Establish the victims age and compensable income at death or at the time the victim was determined to be unable to work by a governmental entity, or had to reduce work, and suffered a loss of income as a result of eligible conditions. In certain situations, we may deactivate your claim and stop our review if we are missing critical information. (2) A document that demonstrates the amount of the expense that you have paid out- of-pocket, as explained below. If any part of these expenses was covered by life insurance or another source, you must provide documentation of that coverage. If you filed a claim for more than one type of economic loss, you may choose to withdraw some or all of your economic loss claims. The VCF Act establishes certain caps on non-economic awards for physical injury claims. Where survivor benefits being paid to a disabled child may continue after age 18 but are subject to evaluation for continuing disability, the Special Master has discretion not to deduct them to extent they cannot be determined with reasonable certainty. Replacement services loss is intended to replace something that was lost that is, something the victim used to do. There are some cases, however, where a victim continued to earn income at the same level after s/he was determined to be disabled by a governmental entity. 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. If you have a prior claim that has already been decided and paid, and you believe you should be considered for the exception, please amend the claim to submit the request for review. Your VCF1-eligible injury or condition has substantially worsened; b. 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. How Much Money Do World Trade Center Victims Get? Each of these types of loss is explained in the sections below. As required by the VCF Act, your final award will be calculated using this basic formula: Non-Economic Loss plus Economic Loss, minus Collateral Offsets. Thus, a determination by SSA that you were. 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 total amount of the claimed medical expenses incurred due to eligible conditions exceeds $5,000. If you do appeal, payment is authorized once a decision is rendered following your appeal. The methodology accounts for the loss of employer-provided health plans after application of the limit because such costs are exempted from gross income. Claims that have more complex compensation information take more time to review. Please review the details below specific to personal injury and deceased claims. Table 4 below shows calculated consumption rates by income bracket and for various household sizes. Doing so will unnecessarily tie up limited resources and may delay claims processing. 3. Mesothelioma. If your claim is missing documentation that we need in order to calculate your award, you will receive a missing information letter. 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. 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. 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 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. For example, documents that show hospitalization, surgery, emergency treatment, and/or treatment for side effects of the condition. 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. Personal Injury Losses, (including losses before death when the victim is deceased), Offsets Applied to To maintain the privacy of individual claimants and beneficiaries, the Fund will not list names or any other identifying information that might easily lead to the identification of individuals who have received or been notified of awards. [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. How Much Is The VCF with Cancer Claims Payouts - Parker Waichman LLP 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. If you withdraw all of your economic loss claims, the VCF will then review your claim for non-economic loss only. Understanding the VCF's Claim Review Process 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. 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 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 9/11 Breast Cancer Victims Entitled to Compensation Prior to June 26, 2013, same-sex married couples were prohibited from identifying themselves as married on their Federal tax returns because Section 3 of the Defense of Marriage Act (DOMA) prohibited the Federal Government from recognizing same-sex marriages. Those registered . 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. 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. Because you are eligible for treatment and medications once your condition is certified, the VCF will not reimburse for expenses you incur after your condition is certified if you decide to be treated by a non-WTC Health Program physician, or to have your prescriptions filled by an unaffiliated pharmacy. 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. It is important that you respond to all missing information letters within the timeframe specified in the letter. 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). In addition to evidence of a disability and a compensable loss, you must submit information about collateral source payments that the VCF may be required to offset against a lost earnings award. The VCF also offers compensation for non-economic losses to the families of 9/11 victims who died as a result of the attacks or subsequent debris removal.
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