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. 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. An additional $9 million was provided by the State of New York in 2016. Attorneys on Your Side. 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. 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. Rare Cancers. What is the 9/11 Victim Compensation Fund formula? Mental Health Conditions. If you submit documents after the VCF finalizes substantive review of your claim, but before your award letter is issued, we will notify you in the award letter that the documents have not been reviewed. R45969 October 17, 2019 Scott D. Szymendera Analyst in Disability Policy The type of pension (e.g., ordinary, service, disability, etc. The VCF must consider evidence of an eligible disability in light of all the evidence, including an ineligible condition that is also disabling. If you received an award in VCF1, you can amend your claim and qualify for additional compensation if: a. When filing your amendment, you must identify the specific type(s) of economic loss claim(s) you are withdrawing: past lost earnings, future lost earnings, replacement services, and/or medical expenses. Law No. First, you need to show that you actually lost compensation. 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. If you are filing a deceased claim (i.e. VCF's claims review process has two stages: the Eligibility Review and the Compensation Review. 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). [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. For example, the VCF will deduct from the award the amount that an FDNY victim receives under a WTC disability pension provided that the disability pension is for an eligible condition. Thus, a determination by SSA that you were. Other examples include computed tomography scans, x-rays, endoscopies, esophagogastroduodenoscopies, laryngoscopies, polysomnography or sleep studies, or other diagnostic and treatment procedures. In certain situations, we may deactivate your claim and stop our review if we are missing critical information. Another award is made to a successful applicant for an economic loss, which includes lost benefits, lost earnings, household services, and out of pocket medical expenses. 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). [7] Although the consumption rates determined from BLS data actually represent household expenditures as a percent of before-tax household income, the actual consumption reduction used to determine the decedents personal expenditures was calculated as a percent of lower after-tax income, which significantly lowers the resulting adjustment. 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. 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. 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. If you know that payments or benefits you have received are subject to a lien, you must notify the VCF. For eligible cancers, the non-economic award will generally range between $90,000 and $250,000, depending on the type of cancer and the medical evidence provided regarding metastasis, recurrence, and/or permanent complications. If you are receiving a lump sum pension, the amount of the lump sum pension. Once the VCF confirms that you have met the eligibility criteria, we begin initial review of your compensation information. This includes last 5 years total earnings prior to retirement, including salary, holiday pay, night shift differential pay, and overtime. The VCF does not receive medical documentation directly from FDNY. Although CPS and other data used to study lifetime earnings profiles indicate that peak real earnings typically decline at some point, in calculating life-cycle earnings growth in excess of inflation and overall productivity adjustments for victims, the Special Master has assumed that peak earnings are maintained. 24. If the victim is deceased, you should provide a clear statement of the services provided before the onset of the eligible condition and/or death from the eligible condition. A decedents expenditures were calculated as a share, based on household size, of certain expenditure categories. 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. However, this is not all of what goes into VCF cancer payouts. First, the VCF strives to be fair to all claimants. If you believe that your eligible condition has caused a loss of earnings that is distinct from any loss of earnings due to an ineligible condition, you must provide evidence to the VCF to substantiate your 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. 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. Application of statutory limitation on annual gross income: In accordance withthe VCF Act, for each year of loss, the methodology limits the annual loss of earnings and other benefits related to employment that fall under the definition of gross income in section 61 of the Internal Revenue Code of 1986 to $200,000. 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. 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). A personal statement discussing the impact of the eligible conditions on your life. If you are receiving Combat-Related Special Compensation or Concurrent Retirement and Disability Pay, submit a complete history of the amount and duration of benefits received. Recent test results and treatment prescribed that show the severity of your condition. You will need to submit two types of information: The VCF provides a Temporary Past Lost Earnings worksheet to help support your VCF claim. 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. A member of the Kreindler 9/11 VCF team can discuss all of these factors with you. 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 is determined based generally on the nature and severity of your condition and the effect of the condition on youractivities of daily living; itdoes not take into account economic loss caused by the condition. Non-economic loss is calculated separately from an economic loss claim. The type of medication prescribed and the frequency of use of the medication can help demonstrate the severity of the condition. Pending disability applications: What to do if you are waiting for a disability decision from a government entity or insurer. SF-50 (Notification of Personnel Action) from the victims retirement. And third, because we are spending public funds, we must ensure that every aspect of the award is adequately justified and documented. 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. The Special Master will use the expected work-life for active males, with a full-time beginning labor force state, to compute expected remaining years of workforce participation for both male and female victims. longevity raises, overtime, bonuses, differential pay, etc.) Aerodigestive Disorders. Note that in general, the VCF will need medical records substantiating claims of medical procedures (surgery, etc.). What are the VCF payouts and how likely you will get one? The Victim Compensation Fund periodically posts updates on the awards issued to claimants and beneficiaries. The amendment may be filed at any time following receipt of your initial award determination, but no later than October 1, 2090. 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. Non-economic loss is sometimes called a pain and suffering award. 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. The lower the after-tax discount rate, the higher the present value of presumed economic loss. Notwithstanding any other provision of this chapter to the contrary, the state insurance fund, if compensation and/or medical benefits be payable therefrom, or otherwise the person, association, corporation, insurance carrier or statutory fund liable for the payment of such compensation and/or medical benefits: (a) shall not have a lien on the proceeds of any award from the September eleventh victim compensation fund of two thousand one established pursuant to title IV of the federal air transportation safety and system stabilization act, public law 107-42, as amended; and (b) shall not terminate or reduce such compensation and/or medical benefits based upon the submission of a claim for an award from such federal fund, and/or the waiver or compromise of any cause of action resulting from such submission.. Do not contact NYCERS if we ask you for updated LOAs as the one-year rule applies to all requests for documents and this will burden their limited resources and delay the process. [9] The blended discount rates, before tax adjustment, shown in Table 5 imply real interest rates in excess of inflation of 2.1%. If Year 5 total earnings exceed 120% of average, the pension basis will be capped at 120%. If you submit medical records, please highlight the relevant information in the records so the VCF can easily find the pertinent information or provide a written guide or statement directing us to the relevant pages. Evidence that you are or were unable to work as a result of an eligible condition. You should not contact NYCERS or NYSLRS directly to obtain this information. You do not need to resubmit documents in support of your medical expenses claim if you already submitted them with your claim form, although you may submit additional documentation. The VCF awards compensation to 9/11 responders and survivors who have been diagnosed with health conditions linked to the toxins in the dust cloud. Please only submit documents that are related to your 9/11-related eligible physical conditions. If you notify the VCF within 90 days of the date you learned that you were entitled to receive a new or revised collateral source payment, your determined or paid award will not be adjusted to reflect the new or revised entitlement or payment. 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. 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. 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. 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. A New York firefighter amid the rubble of the World Trade Center after the September 11, 2001 attacks. 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. Note: If you received a non-economic loss award in VCF1, the VCF will consider the amount previously awarded when determining whether additional compensation is warranted in light of the 2015 reauthorization statutes prioritization mandate and non-economic loss caps. 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. Those registered . 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. The VCF Act establishescertain caps on non-economic awards for physical injury claims. 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. For these claims, it may be necessary to provide additional documentation that explains the relationship between your loss of earnings and benefits and your eligible condition(s). We will still review your claim to see if it includes reimbursable expenses that you incurred before the applicable condition was certified. The work-life expectancies are shown in Table 2 below. 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. The VCF will consider claims for medical expenses only if the total amount legitimately claimed in your amendment exceeds $5,000. If your condition has limited your activities, please submit any explanation or documentation that explains this effect of your condition. If you are filing on behalf of a deceased victim and you have provided sufficient evidence that the cause of death was related to aneligible condition, the VCF will generally calculate lost earnings and benefits resulting from the victims death if it is clear from the information in the claim file that the victims death resulted in a compensable loss. The VCF may obtain information directly from the WTC Volunteer Fund regarding VCF claimants with WTC Volunteer Fund claims, which will allow the VCF to investigate the basis of any disability benefits, the amount of such benefits, and any other information that may be relevant to the VCFs computation of loss. The start date and amount of the victims pension. How Does the VCF Calculate Awards for Multiple Certified Conditions? He was earning about $100,000 per year at the time of his disability. If an individual is eligible for VCF compensation and is also receiving payments from the WTC Volunteer Fund, the VCF will offset certain payments made by the WTC Volunteer Fund. 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. Treatment expenses covered by private health insurance, Workers Compensation, or other programs will not be reimbursed. 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. 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. That tragic day nearly 3,000 people perished as the planes crashed, and WTC buildings collapsed. If there is an indication that you are receiving, or are entitled to receive, a disability or survivor pension (or if the decedent received a disability pension before death), but you do not submit information necessary to calculate that pension or determine the basis of that pension, the VCF will not issue a full award and may issue only a non-economic loss award or deactivate the claim because, without that information, the VCF cannot determine whether an offset is appropriate and the amount of that offset. A schedule containing age-specific earnings growth rates reflecting the combined inflation, overall productivity, and life-cycle increases is shown in Table 3 below. 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. Other state Workers Compensation programs have not enacted similar legislation. Treatment expenses billed to you as a co-payment, after denial of insurance coverage, or that you pay because they fall within your insurance deductible, may be reimbursed if appropriate documentation is submitted. 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. It is important to note that receiving a WTC Health Program disability evaluation through the Process does not guarantee that you will be awarded lost earnings from the VCF. Personal Injury Losses, (including losses before death when the victim is deceased), Offsets Applied to The VCF Act establishes certain caps on non-economic awards for physical injury claims. An official website of the United States government. 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. 3. The lowest compensation amount was $87.02. 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 VCF provides financial compensation to individuals (or a personal representative of a deceased individual) who were present at the World Trade Center or in the VCF's NYC Exposure Zone ; the Pentagon crash site; or the Shanksville, Pennsylvania, crash site, at some point between September 11, 2001, and May 30, 2002, and who have been . 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. 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. [7] These alternative techniques included an analysis of BLS data on household expenditures reported by household size, with expenditure categories allocated equally among household members or allocated according to the methodology suggested by authors Robert Patton & David Nelson in their 1991 Journal of Forensic Economics article, Estimating Personal Consumption Costs in Wrongful Death Cases.. If you are physically injured as a result of an eligible condition, you can make a claim for earnings/benefits you lost before you submitted your claim to the VCF, and you can make a claim for earnings/benefits you expect to lose in the future (after submission of your claim) as a result of your eligible condition. It was determined that the benefit to the claimants of calculating the decedents personal consumption offset as a percent of after-tax individual earnings more than outweighed the potential effect of discounting future amounts by income-specific after-tax discount rates. 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. While unpaid volunteers are normally ineligible for Workers' Compensation benefits, the New York Workers' Compensation Law was amended to provide a unique exception for certain volunteers who assisted with World Trade Center rescue, recovery, and clean-up efforts. Claims seeking only non-economic loss are the simplest and fastest to review. 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. If the breast cancer is disabling, a victim is entitled to additional compensation for lost wages. 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. The methodology computes the loss in each year (including pensions) and caps the loss at $200,000 in each year. 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. 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. 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. If you were found to be partially disabled due to an eligible condition in VCF1 based on an FDNY disability determination, and the Social Security Administration subsequently determined that you became fully disabled due to the same condition after your VCF1 award was issued, you may be eligible for additional compensation. Please keep this in mind when considering whether to seek certification of additional conditions through the WTC Health Program. The terrorist events of September 11, 2001, left thousands of victims injured or killed by the hijacked airplanes used to attack the World Trade Center, Pentagon, and other U.S. targets. 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. 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. The VCF will evaluate these types of payments on a case-by-case basis. The VCF is committed to transparency about the claim review process.