Tip Of The Week - General Information
- The Commonwealth's Attorney has the ability to stop a claim cold. Per the Code, if the CA asks us to hold the claim for prosecution we must do so.
This might be necessary when the claimant is a suspect or when the victim's participation is questionable
- If an adult with custody or guardianship applies on behalf of a minor, please provide CICF with a copy of the guardianship/custody papers.
- Pre-authorizations for services: CICF can do pre-authorizations for an existing claimant whose provider is requesting information about their eligibility. The Examiner provides this type of pre-authorization after reviewing the file for eligibility and determining if the service to be rendered falls within the guidelines.
- By law, CICF can not make awards to victim's of 'hit and run'. UNLESS there was malicious intent OR if the driver was drinking. If the driver was drinking: The driver does not have to be charged with DUI...the police officer or the Commonwealth's Attorney can verify that is was a drunk driving incident OR to get extra creative...if there is a plea agreement if the defendant stipulates that he/she was drinking...we could then accept the claim! Call us if you have one of these and we may be able to help you get creative to get the claim through!.
- CICF will pay $.58.5 per mile to doctors visits related to the crime and to court, if the claimant is required to come to court or subpoenaed. (This includes adult claimants driving children for any of these reasons.) CICF has forms available or the victim can make a list of the date, where the visit was, what the visit was for, and the round trip mileage.
- As most of you know, CICF does not pay for property loss. HOWEVER, CICF will consider replacing clothing and bedding taken as evidence and lock and window replacement. For clothing and bedding, CICF will need an evidence receipt and a receipt of a "like" item to consider for payment.
Locks for windows or doors may be replaced if the victim is scared due to this crime. Windows may be replaced if they were broken during the covered crime.
- Please pay special attention to SECOND REQUEST LETTERS because they clearly list what CICF needs to make a claim to that point.
State and Local Hospitalization
- The new fiscal year for SLH allocations began May 1st. Therefore, uninsured victims (Virginia residents)who received treatment or discharged from a hospital May 1st or after must apply for State-Local Hospitalization.
- If SLH in your hospital has been exhausted: Just make a note either on the application or on the hospital bill that SLH funds were exhausted for the claimant's locality. We obtain verification of SLH balances from the DMAS website about monthly.
- The site is at www.dmas.state.va.us Look for State-Local Hospitalization balances. Their fiscal year runs from May 1 through April 30th. Therefore, the new report will usually not be provided until August or September. If you pull up the report today, it will show that all localities have a zero balance for the last fiscal year (05/01/03 thru 05/30/04
- If a victim is insured, please remember to include a copy of the front and back of the insurance card.
- Don't forget that CICF is payer of last resort. If victims have Medicaid or SLH applications pending, they must follow through with the process to then qualify for CICF. Individuals who have insurance should be sure to give their information to all providers.
Domistic Violance Victims
- Please inform all victims that CICF will put ALL convicted offenders in collections if an award is made. This may pose a risk for some victims, therefore it is important to discuss this with the victim before filing the claim.
Mental Health Counseling
- Medical providers/therapists do not have to participate in the victim's insurance for CICF to consider payment. In order to pay for treatment, the Fund needs a letter from the provider saying they are out of network, along with the denial letter from the insurance company.
- CICF can only pay for licensed therapist: Counseling must be provided by a medical doctor, clinical psychologist, clinical social worker, or professional counselor licensed pursuant to Title 54.1, Chapters 35 through 37, Code of Virginia, or by a clinical nurse specialists who renders mental health services, pursuant to Title 54.1, Chapter 30, Code of Virginia.
- The Commission has determined that life insurance WILL be considered a collateral resource in death claims, in order to comply with state and federal law, and assist in maintaining adequate funds available for claims.
- Family member's of child abuse victims are not eligible for individual counseling. HOWEVER, they are eligible to participate in "family counseling" sessions.
Please do NOT answer any questions on the application (or any forms you're completing for us) with "See report"! Just remember: there's only two of them and 130 counties!
- CICF's 2 year limit on applying: The Commission has judicially determined that the law lifting the two year deadline on the submission of claims cannot be retroactively applied to claims arising out of crimes committed prior to July 1, 2001 when the law was enacted. This determination is based on judicial precedent set by the Court of Appeals and the Virginia Supreme Court.
- This also applies to the new law tolling the filing period for minor victims until ten years after their 18th birthday. Previously, a child victim had one year after his 18th birthday to apply for CICF benefits. Now, child victims have ten years after their 18th birthday to apply. HOWEVER, this law is not retroactive. In other words, if the crime occurred prior to July 1, 2001, this law does not apply, and a denial will follow.
- Please NEVER say "see report" as this slows claims entry and processing.
- If a victim is 18 years or older at the time the claim is submitted, the victim MUST sign their own application, EVEN if they were a minor at the time of the crime.
- Please be advised that we will be returning apps if all items are not initialed and/or the app is not signed.
- "Age" on the last page of the application refers to the VICTIMS AGE AT THE TIME OF THE CRIME---not their current age.
- ON THE APPLICATION: Question #1 (C) : please indicate the name of advocate and email or phone # that is helping the claimant...that way if we have questions we can contact you directly.
PLEASE inform CICF if there is or even might be a civil case pending and supply us with the victim's attorney's name & contact info. CICF has subrogation rights, therefore if a settlement is made CICF is supposed to be reimbursed up to the amount of the award...and surprisingly enough many personal injury attorney's don't like to part with the money, so if we don't know about them...they don't come knocking on our door with our money!
- As prosecution is pending, please update your Commonwealth's Attorney as to the most current amount of restitution to request, as we make supplemental awards or request an updated letter.
- A restitution order will not stop an award from CICF if communication with the restitution monitor takes place prior to the award being made. However, BEWARE: some restitution orders can “unjustly enrich the offender”. For example: If a restitution order reads: the offender shall pay what CICF has not paid for the victim, then CICF payments have unjustly enriched the offender. This basically means CICF paid so the offender doesn't have to: so the logic is if CICF didn't pay, the offender would be responsible for the entire debt.
- It would be EXTRA helpful, in your correspondence to our office, if you could indicate the name of the ACAs and the defense attorney on the case.
- If you have a case going to court for sentencing, and is pending with CICF: Please feel free to call us (actually we love it) for the most updated information on what we have paid, are going to pay and what is/will be still outstanding for the victim, for restitution determination!
Prescription medication expenses are ever-increasing--especially for those folks who are uninsured. Please remind all victims that they may submit copies of receipts for prescriptions needed as a result of the crime injuries.
The receipts must include:
- The name of the patient,
- The name of the prescribing doctor,
- The name of the medication,
- The date filled and
- The amount charged.
If the victim/claimant did not keep his receipts, he may go to the pharmacy where they purchased the medications and request a history print-out from the pharmacy database.