Victim compensation form

Fillable forms may not work correctly if opened in your web browser. Publications are available on the CalVCB Publications page. The downloaded copy may be rea searched or printed. As a victim of crime, you will always be treated with dignity, compassion, and respect when being assisted through the victims compensation claim process.

Victim Compensation Program. Criminal Injuries Compensation Fund. What is a victim compensation claim? In the case of death, dependent relatives may be eligible for compensation. When requesting compensation on behalf of an incompetent adult victim, proof of legal guardianship must be attache and the applicant’s signature on the claim form must be witnessed by a Notary Public.

Separate claim numbers will be assigned. Physical Address: 5North Salisbury Street, Raleigh. If a victim has exhausted other collateral sources, such as health insurance, and has no other source of reimbursement, the Program can help pay for medical costs, wage loss, psychological.

Many crime victims measure the time from when the crime occurred until they are paid. Before filing an online claim:Watch the NEW OVS Compensation Training Series, featuring videos that outline asistance available from OVS and offer detailed instructions for filing claims. You can apply as a victim or a claimant for either compensation using the same application. You must be years of age or older to apply to CVC.

Quality Compensation In form ation from ERI. Fill out this form completely (please print), attach all required documentation, and submit to the above address. If you move or change your address, you are required to notify this office. CHECK THE TYPE OF VICTIM COMPENSATION BENEFITS YOU ARE REQUESTING: DISABILITY - compensation for the victim who suffered a permanent disability.

Note: Be sure to sign and date the form. If you have medical coverage through another source for the payment of your medical or mental health expenses, you must be treated by a provider who accepts that source of payment. V CAP is the payer of last resort.

VCAP is able to reimburse insurance co-pays, out-of-netwrok expenses and other out-of-pocket costs. Authorising a person to enquire or act on your behalf. Once your application is receive a specialist will be assigned to your claim. Request for additional information such as employment or medical records may be made. The spouse, parent, sibling, or adult child of a deceased victim.

Any elderly or disabled adult who lost property as a result of a crime. Contact your victim advocate to obtain a Crime Compensation application, and for assistance in completing the form. The victim is the same person listed as a victim on the crime incident report. The claimant is the person applying for compensation. Do not complete SECTION if the victim is the claimant.

While no amount of money can erase the impact of a violent crime, the CVCP provides up to $20in reimbursement to Rhode Islanders for expenses related to violent crime. OVC administers federal funds to support their crime victim compensation programs in all U. Virgin Islands, Puerto Rico, and Guam. Only state licensed therapists are eligible for payment.

Note: A treatment plan may be subject to discovery in court proceedings. This money comes from surcharges and penalties that are paid by criminals. Costs that may be eligible include medical treatment, counseling, funerals, crime scene clean-up, grief counseling and loss of income or support not.

To apply for DCVC services, please contact your local victim advocate for assistance or you may click the following application and follow the instructions. Not all crime victims or crime related losses are eligible for reimbursement or payment.