Code of Massachusetts Regulations
940 CMR - OFFICE OF THE ATTORNEY GENERAL
Title 940 CMR 14.00 - Compensation Of Victims Of Violent Crimes
Section 14.06 - Compensable Expenses
Universal Citation: 940 MA Code of Regs 940.14
Current through Register 1531, September 27, 2024
The following expenses are compensable in accordance with the following requirements:
(1) Fund of Last Resort. A claimant must demonstrate that his compensable losses or legal liability exceed reimbursements or eligibility for reimbursement or compensation from any other source including all sources listed in 940 CMR 14.08(2)(e). Awards for compensation shall be reduced by all amounts reimbursed, reimbursable or otherwise compensable by any other source.
(2) Funeral and Burial Expenses. The maximum award for funeral and burial expenses incurred as a result of crimes occurring before November 5, 2010, shall be regulated by 940 CMR 14.00 effective on May 5, 1995. The maximum award for funeral and burial expenses incurred as a result of crimes occurring on or after November 5, 2010, shall be $6,500. For crimes occurring on or after July 1, 2013, the maximum award for funeral and burial expenses shall be $8,000. An award for funeral and burial expenses to be provided in the future may be based on a bona fide contract for services.
A legal guardian, dependent or other family member of the victim or a person who actually incurs funeral and burial expenses directly related to the death of a victim shall be eligible for compensation for such funeral and burial expenses.
(3) Ancillary Expenses. The maximum award or compensation for expenses other than funeral and burial expenses associated with the interment of a victim whose death is the direct result of a crime shall be $800. For purposes of 940 CMR 14.06(3) compensable expenses shall include, but not be limited to:
(a) transportation of the victim to the
location of interment;
(b) travel
of a legal guardian or family member to accompany the victim to the location of
interment;
(c) memorial markers at
the location of interment or other associated expenses as determined by the
program director in accordance with 940 CMR 14.00.
(d) in order to receive payment under 940 CMR
14.06(3) the claimant must submit receipts, cancelled checks, bills for
products and services provided, or other proof of payment or liability for
products or services. An award for expenses under this category may be based on
a bona fide contract for services to be provided. It does not
include compensation for public transportation, or for mileage or parking when
private transportation is used.
(4) Medical Expenses. A victim shall be eligible for compensation for reasonable medical care obtained as a result of the crime.
(a) Compensation for medical expenses is
limited to services, supplies and equipment that are medically necessary as a
direct result of the crime. Compensation shall not be awarded for unrelated
conditions or services, or for preexisting conditions except to the extent they
were exacerbated by the crime.
(b)
Compensation for transportation costs incurred while obtaining medical care is
limited to costs incurred for emergency and non-emergency ambulance service,
chair car service, dial-a-ride service or taxi service obtained when public
transportation is unavailable or unsuitable for medical needs. It does not
include compensation for public transportation, or mileage or parking when
private transportation is used.
(c)
The claimant must demonstrate an out-of-pocket loss or legal liability for
payment of compensable medical expenses which are not reimbursed or
reimbursable by any other source. In order to make this demonstration, the
claimant must:
1. submit all bills to
insurance providers;
2. exhaust all
other sources of public reimbursement including medicaid, medicare, workers
compensation, social security, veterans benefits, and care funded by the Health
Safety Net Trust Fund under M.G.L. c. 118G;
3. comply with all reasonable requests by the
Division to secure information and verifications necessary to investigate the
claim.
(d) Upon request
by the Division, medical providers are required to:
1. verify that the services rendered are
medically necessary as a direct result of the crime. Where medical services or
therapy extend beyond six months or 30 sessions (whichever is greater), the
Division may, as a condition of further payment, require current verification
that the services are medically necessary as a direct result of the
crime.
2. provide current billing
and balance information, including information about amounts covered by
insurance, public benefits or other sources, and current information about any
amounts paid and by whom;
3.
certify whether the services rendered are reimbursable by medicaid;
4. in the case of hospitals, assist the
claimant in applying for health insurance or care funded by the Health Safety
Net Fund under M.G.L. c. 118G.
(e) All medical providers must be licensed by
the Massachusetts Board of Registration in Medicine or an equivalent state
licensing authority, or must be certified by the recognized national
certification body for that profession.
(f) The Division may authorize an award for
outstanding medical expenses payable directly to the medical provider, but only
if the provider has fully cooperated with the Division in the investigation of
the claim. Otherwise, awards shall be made payable solely to the
claimant.
(g) If an acute or
non-acute hospital provides compensable medical services, any award made
payable jointly to the claimant and the hospital shall be based on current
payment rates established by the contract between the hospital and the
Executive Office of Health and Human Services in accordance with M.G.L. c.
118E, § 12 and M.G.L. c. 118G, § 11. Amounts awarded for all other
medical services shall be based on reasonable fees charged. If the provider
employs a sliding scale fee structure for any category of patient or service,
the award shall not exceed the amount the claimant would be charged if he or
she qualified under the provider's sliding scale fee structure.
(h) Any medical provider that receives
payment from the Commonwealth for medical services, supplies or equipment
pursuant to an award under M.G.L. c. 258C shall, as a condition of the receipt
of such payment, accept such payment as discharging in full any and all
obligations of the claimant to pay, reimburse or compensate the provider for
medical services, supplies or equipment, that have been reimbursed under M.G.L.
c. 258C.
(5) Mental Health Counseling. A victim, the dependents and family members of a homicide victim, or the parent or legal guardian of a victim who is a minor shall be eligible for compensation for reasonable mental health counseling expenses incurred as a direct result of the crime. Compensation shall not be awarded for treatment of unrelated conditions, or for preexisting conditions except to the extent they were exacerbated by the crime.
(a) Upon request of the Division, the
treating mental health provider must submit a mental health treatment plan on a
form prescribed by the Division. If mental health treatment extends beyond six
months or 30 sessions (whichever is greater), the Division may require, as a
condition of further payment, the submission of a current mental health
treatment plan by the treating mental health provider.
(b) All mental health providers must be
licensed by, or under the direct supervision of a person who is licensed by,
either the Massachusetts Board of Registration in Medicine, the Massachusetts
Board of Registration of Social Workers, the Massachusetts Board of
Registration of Psychologists, the Massachusetts Board of Registration of
Allied Mental Health Professionals or by an equivalent state licensing
authority.
(c) In making
determinations regarding claims for mental health counseling, the Program
Director may obtain an advisory opinion of a peer review panel consisting of
volunteer members of the mental health provider community.
(d) The Division shall compensate mental
health counseling expenses based on reasonable rates charged by a mental health
provider. If the mental health provider employs a sliding scale fee structure
for any category of client, patient or service, the award shall not exceed the
amount the claimant would be charged if he or she qualified under the
provider's sliding scale fee structure.
(e) Compensation for mental health counseling
may be denied for expenses incurred in the following instances:
1. missed or cancelled
appointments;
2. non-therapeutic
testimonial court appearances by a mental health provider;
3. non-therapeutic investigatory
consultations;
4. photocopying and
report writing;
5. tele-therapy or
dial-for-therapy services unconnected to any face-to-face consultation or
diagnosis.
(f) The
Division may authorize payment directly to a mental health provider, but only
if the provider has fully cooperated with the Division in the investigation of
the claim. Any mental health provider that receives payment from the
Commonwealth pursuant to an award under M.G.L. c. 258C shall, as a condition of
the receipt of such payment, accept such payment as discharging in full any and
all obligations of the claimant to pay, reimburse or compensate the provider
for services that have been reimbursed under M.G.L. c. 258C.
(6) Lost Wages. If, at the time of the crime, the victim was employed or had received a bona fide employment offer, or if the victim was a minor who will be disabled from working beyond the age of 18, he or she may be eligible for compensation for lost wages.
(a) In order to be eligible for lost wages,
the victim must demonstrate that, as a direct result of injuries caused by the
crime, he or she is medically disabled from working and, further, the period of
time for which he or she will be disabled from working. Upon request by the
Division, the victim must submit a disability letter from a treating physician
or mental health provider demonstrating that the victim is disabled from
working as a direct result of the crime and specifying when the victim is able
to resume working.
(b) An award for
lost wages shall be based on the victim's actual earnings at the time of the
crime. If the victim was performing salaried employment at the time of the
crime, the award shall be based on the victim's salary at the time of the
crime. If the victim was performing seasonal, nonsalaried or intermittent work
at the time of the crime, the Division may look to the victim's earnings
history and the value of the victim's contractual work obligations in order to
determine the victim's lost wages.
(c) If the victim was not employed at the
time of the crime but had received a bona fide offer of
salaried employment, the award shall be based on the victim's net starting
salary. If the victim was not working at the time of the crime but had received
a bona fide offer of seasonal, nonsalaried or intermittent
employment, the Division may look to the victim's earnings history and the
value of the victim's contractual work obligations and offers of employment in
order to determine the victim's lost wages.
(d) If the victim was a minor at the time of
the crime and was not employed, he or she shall be eligible for compensation
for lost wages after the age of 18 if he or she provides a disability letter
from a treating physician or mental health provider demonstrating that he or
she will be disabled from working after the age of 18 as a direct result of the
crime and specifying when, if ever, he or she will be able to commence working.
An award for lost wages issued under 940 CMR 14.06(6)(d) shall be based on the
prevailing minimum wage.
(e) If, at
the time of the crime, the victim was not employed or had not received a
bona fide employment offer, or if the victim was not a minor
who will be disabled from working beyond the age of 18, the Division shall not
make an award for lost wages.
(f)
Upon request by the Division, the claimant must provide:
1. verification from his or her employer (or,
if self-employed, from his or her own records) that he or she was employed at
the time of the crime; and of the dates he or she was absent from work, his or
her net weekly earnings at the time of the crime, and any sick and vacation
benefits used in his or her absence;
2. verification from his or her prospective
employer of when the offer of employment was made, when the employment was to
begin, net weekly starting salary, and sick and vacation benefits to which he
or she would have been entitled;
3.
proof of employment and earnings history for one year preceding the
crime.
(g) An award for
lost wages shall be based on loss of reported income. Unreported income may not
form the basis of an award for lost wages.
(h) An award for lost wages shall be based on
net (after tax) earnings. Any compensation awarded shall be reduced by any
money received or receivable from any other public or private source including
workers compensation benefits, social security benefits, disability benefits,
and sick and vacation benefits.
(i)
Failure to provide proof of lost wages, or failure to provide proof of medical
disability, may result in denial of a claim for lost wages.
(7) Homemaker Services. If the sole occupation of the victim at the time of the crime, and for one year preceding the crime, was limited to performing the duties and responsibilities of a homemaker, and if, as a direct result of injuries from the crime, the victim is disabled from continuing to provide some or all of the duties and responsibilities of a homemaker, the Division may award reimbursement for the reasonable costs of maintaining such services.
(a) Homemaker services include housekeeping,
shopping, errands, meal preparation, laundry and supervision of
children.
(b) In order to
demonstrate the victim's occupation at the time of the crime, and for the year
preceding the crime, the claimant must submit copies of the victim's tax
returns, and such other information and verifications as the Division
requires.
(c) Except in the case of
homicide, the claimant must submit a disability letter from a treating
physician or mental health provider demonstrating that, as a direct result of
injuries from the crime, the victim is disabled from performing some or all of
the duties and responsibilities of a homemaker, and specifying the duties and
responsibilities the victim is unable to perform. The letter must also specify
when the victim is able to resume the duties and responsibilities of a
homemaker.
(d) Upon request by the
Division, the claimant must submit verification that replacement homemaker
services were obtained as a direct result of the victim's inability to perform
such homemaker services as a direct result of injuries due to the
crime.
(e) Except as provided in
940 CMR 14.06(7)(f), reimbursement for replacement home-maker services is
limited to reasonable out-of-pocket losses or liability for payment of such
services. In order to receive reimbursement for homemaker services, the
claimant must submit either:
1. receipts,
cancelled checks, bills for services provided, or other proof of payment or
liability for such services; or
2.
where the claimant demonstrates that he or she is unable to purchase homemaker
services prior to receipt of an award for compensation, a bona fide
contract for services to be provided. In this circumstance, the
initial award shall be made payable to the claimant but shall not exceed $200.
In order to be eligible for a supplemental award under 940 CMR 14.06(7)(e), the
claimant must demonstrate that compensation already received was actually
expended for the purchase of homemaker services.
(f) When a victim's family member or a person
on whom the victim is dependent ceases or reduces paid employment in order to
assume the homemaker responsibilities the victim is disabled from performing as
a direct result of the crime, the Division may reimburse the claimant for
actual losses resulting from the assumption of homemaker responsibilities. In
order to qualify for compensation under 940 CMR 14.06(7)(f), the claimant must
demonstrate that:
1. the victim qualifies as
an eligible homemaker under 940 CMR 14.06(7)(a) through (c);
2. the claimant was employed at the time of
the crime, and ceased or reduced paid employment as a direct result of the
victim's inability to continue to perform the duties and responsibilities of a
homemaker; and
3. the claimant has
assumed homemaker duties and responsibilities that were previously performed by
the victim.
Reimbursement under 940 CMR 14.06(7)(f) is limited to lost earnings directly attributable to the assumption of replacement homemaker services. Reimbursement shall be based on the claimant's net lost earnings but shall not exceed a maximum rate of $15.00 per hour.
(8) Eligibility for Compensation for Loss of Financial Support. Dependents of homicide victims shall be eligible for loss of the victim's financial support in accordance with the following requirements:
(a) A dependent who is not a
minor child of the victim must demonstrate that he was living with the victim
at the time of the crime.
(b) In
order to demonstrate that he or she was living with the victim at the time of
the crime, a claimant must demonstrate that, at the time of the crime, he and
the victim shared the same primary residence as shown by tax returns, utility
bills, voting lists, school records, residential leases, property deeds or
other such documents evidencing primary residence. Proof of frequent visitation
does not constitute proof that the claimant was living with the victim at the
time of the crime.
(c) In order to
be eligible for loss of financial support, the claimant must demonstrate that,
at the time of the crime, he or she was wholly or partially dependent on the
victim for financial support. A claimant shall be presumed wholly financially
dependent on the victim if he or she demonstrates that:
1. he or she is a minor child of the victim
who was living with the victim at the time of the crime and receiving financial
support from the victim; or
2. at
the time of the crime, was living with the victim and the victim's income
constituted his or her primary source of financial support.
(d) A claimant may establish that
he or she was partially financially dependent on the victim by demonstrating
that:
1. he or she is a minor child of the
victim who, at the time of the crime, was not living with the victim but was
either:
a. receiving financial support
directly from the victim; or
b. the
beneficiary of a court order or judicially enforceable agreement entitling him
or her to receive financial support directly from the victim; or
2. at the time of the crime, he or
she was living with the victim and dependent on financial support received
directly from the victim as shown by joint loan agreements, bank accounts or
other documents evidencing financial dependence.
(e) A mutual living arrangement does not, in
itself, establish financial dependency. A claimant shall not be eligible for
compensation for loss of the victim's rent payments, or room and board
payments, to the claimant.
(9) Calculation of Award for Loss of Financial Support. A loss of support award shall be calculated based on the annual financial support provided by the victim to the claimant, multiplied by the number of years for which the claimant would have remained financially dependent on the victim.
(a) If
the claimant was wholly dependent on the victim for financial support, the
determination of annual financial support shall be based on the victim's
earnings. The determination of the victim's earnings shall be based on the
victim's net earnings at the time of the crime or the victim's average net
earnings for one year preceding the crime, whichever is greater.
(b) If the claimant was partially dependent
on the victim for financial support, the determination of annual financial
support shall be based on:
1. the actual
amount of financial support received directly from the victim at the time of
the crime; or
2. if the claimant is
a minor child of the victim, the greater of:
a. the actual amount of financial support
received directly from the victim at the time of the crime; or
b. the amount the claimant was entitled to
receive from the victim as a result of a court order or judically enforceable
agreement.
(c) The claimant must demonstrate the number
of years for which he would have remained financially dependent on the victim.
In making this determination, the following limitations shall apply:
1. if the claimant is a minor, the period of
dependency shall continue until the claimant reaches the age of 18 or until
such time as the claimant was legally entitled to receive support from the
victim as a result of a court order or judicially enforceable agreement,
whichever is greater.
2. the period
of dependency shall not exceed the life expectancy of either the victim or the
claimant, whichever is sooner.
(d) If two or more claimants seek
compensation for loss of financial support from the same victim, the award
shall be apportioned based on each claimant's loss of financial support from
the victim.
(e) As a condition of
making an award to a minor dependent of a crime victim, the Division may
require that such funds be placed in a trust account for the benefit of the
minor dependent. If, at the time of the award, a permanent guardian has not
been appointed for the minor dependent, the Division may defer issuance of all
or part of the award until such time as a permanent guardian has been
appointed, or until the dependent reaches the age of 18, whichever is
sooner.
(10) Attorneys' Fees. If the claimant is represented by an attorney in the filing of a claim for compensation, the Division may make an award of attorneys' fees. An attorney's fee award shall be deducted from, and not in addition to, the total award for compensation.
(a) In order to be eligible for an attorney's
fee award, the following conditions must apply:
1. the attorney must fully cooperate with the
Division in the investigation of the claim, including fully and promptly
responding to all requests for information and verification; and
2. the attorney must submit an affidavit
which sets forth hours worked and services rendered for representing the
claimant in the claim for compensation.
(b) In determining the amount of an
attorney's fee award, the Program Director shall make a determination, based on
the attorney affidavit and a review of the file, of a reasonable amount of time
spent representing the claimant in the claim for compensation. Attorneys shall
be compensated at a rate of no more than $75 per hour. In no event shall an
attorney's fee award exceed 15% of the total award for compensation.
(11) Professional Crime Scene Clean Up Services. Expenses incurred for professional crime scene clean up services necessary as the direct result of the commission of a crime at a private residence or in a motor vehicle that is owned or leased by a victim, family member, or other dependent shall be compensable.
(a) In order to be eligible for reimbursement
under 940 CMR 14.06(11)(a) claimants must provide documentation demonstrating
the residence or motor vehicle was owned or leased by the victim, family
member, or other dependent. Acceptable methods of proof include, but are not
limited to, purchase and sale agreements, lease or rental contracts, law
enforcement reports or correspondence, or other methods at the discretion of
the Division.
(b) In order to be
eligible for reimbursement under 940 CMR 14.06(11), "professional crime scene
clean up services" providers must act in compliance with 105 CMR 480.000:
Minimum Requirements for the Management of Medical or Biological Waste
(State Sanitary Code Chapter VIII). Additionally, providers must act
in compliance with applicable standards of 29 CFR 1910 including but not
limited to Bloodborne Pathogen Standard 1910.1030, Personal Protective
Equipment 1910.132, and Hazard Communication 1910.1200, which can be found at
www.osha.gov . Providers must provide
verification of adherence to each of these standards to the Division.
(c) In order to receive payment the victim
must submit receipts, cancelled checks, bills for services provided, or other
proof of payment or liability for services. An award for crime scene cleanup
may be based on a bona fide contract for services.
(d) No compensation under 940 CMR 14.06(11)
will be paid for the replacement or repair, of property damaged as a result of
the crime or follow up investigation.
(e) The maximum compensation amount under 940
CMR 14.06(11) shall not exceed $1,500.
(12) Replacement of Clothing and Bedding. A victim shall be eligible for compensation for the reasonable replacement costs of clothing and bedding seized as evidence or rendered unusable as the result of a criminal investigation that is the direct result of a crime provided that:
(a) The
claimant can demonstrate by way of police reports, law enforcement
correspondence, or other case related documentation, at the discretion of the
division that
1. the clothing/bedding was in
their possession at the time of the crime;
2. the items were seized by law enforcement
officials or rendered unusable as a result of the criminal
investigation.
(b) In
order to receive payment, the victim must submit receipts, cancelled checks,
bills or other proof of payment or liability for replacement of the items
seized or rendered unusable.
(c)
The maximum compensable amount under 940 CMR 14.06(12) shall not exceed
$250.
(13) Security Measures. A victim, or a family member residing with the victim at the time a crime is committed, shall be eligible for compensation for the costs associated with the implementation of security measures.
(a) In order to be eligible for
compensation under 940 CMR 14.06(13), the victim, or family member residing
with the victim at the time of the crime, must demonstrate that, as a result of
a crime or, in conjunction with the circumstances surrounding a crime, the
implementation of security measures would reasonably address their safety
concerns. In determining eligibility under 940 CMR 14.06(13)(a), the Division
shall consider factors including but not limited to the location of the crime,
the relationship of the offender to the victim, and access of the offender to
the claimant or the residence
(b)
Security measures may include but are not limited to, external and internal
doors and locks, exterior windows and locks, security systems, and
reprogramming security codes.
(c)
In order to receive payment the claimant must submit receipts, cancelled
checks, bills for products and services provided, or other proof of payment or
liability for products or services. Determination of allowable expenses may be
based on a bona fide contract for services.
(d) The maximum compensable amount under 940
CMR 14.06(13) shall not exceed $500.
(14) Catastrophic Injury Loss. Expenses incurred for treatment and services related to an injury that creates a permanent impairment for the victim, as defined pursuant to M.G.L. c. 258C, including medically necessary expenses, crime related expenses, medical, hospital, mental health counseling, or any other service or treatment that would otherwise qualify pursuant to M.G.L. c. 258C as determined by the Program Director up to the maximum amount defined in M.G.L. c. 258C.
(a) Compensation for "Catastrophic Injury" is
limited to those expenses incurred and allowable pursuant to 940 CMR
14.06.
(b) Compensation for
catastrophic injury expenses is limited to services, supplies and equipment
that are medically necessary as a direct result of the crime. Compensation
shall not be awarded for unrelated conditions or services or for preexisting
conditions except to the extent they were exacerbated by the crime.
(c) Upon request of the Division, the
treating medical provider must submit verification of the catastrophic injury
and resulting permanent disability of the claimant on a form prescribed by the
Division.
(d) The claimant must
demonstrate an out-of-pocket loss or legal liability for payment of compensable
catastrophic injury expenses that are not reimbursed or reimbursable by any
other source. In order to make this demonstration, the claimant must:
1. submit all bills to insurance
providers;
2. exhaust all other
sources of public reimbursement including Medicaid, Medicare, workers
compensation, social security, veterans benefits, and care funded by the Health
Safety Net Trust Fund under M.G.L. c.118G;
3. comply with all reasonable requests by the
Division to secure information and verifications necessary to investigate the
claim.
4. provide current billing
and balance information, including information about amounts covered by
insurance, public benefits or other sources, and current information about any
amounts paid and by whom;
5.
certify whether the services rendered are reimbursable by Medicaid;
6. in the case of hospitals, assist the
claimant in applying for health insurance or care funded by the Health Safety
Net Fund under M.G.L. c.118G.
(e) All medical providers must be licensed by
the Massachusetts Board of registration in Medicine or an equivalent state
licensing authority or must be certified by the recognized national
certification body for that profession.
(f) The Division may authorize an award for
outstanding medical expenses payable directly to the medical provider, but only
if the provider has fully cooperated with the Division in the investigation of
the claim. Otherwise, awards shall be made payable solely to the
claimant.
(g) If an acute or
non-acute hospital provides compensable medical services, any award made
payable jointly to the claimant and the hospital shall be based on payment
rates established by the contract between the hospital and the Executive Office
of Health and Human Services in accordance with M.G.L. c. 118E, § 12 and
c. 118G, § 11 at the time the claim is filed. Amounts awarded for all
other medical services shall be based on reasonable fees charged. If the
provider employs a sliding scale fee structure for any category of patient or
service, the award shall not exceed the amount the claimant would be charged if
he qualified under the provider's sliding scale fee structure.
(h) Any medical provider that receives
payment from the Commonwealth for medical services, supplies, or equipment
pursuant to an award under M.G.L. c. 258C shall, as a condition of the receipt
of such payment, accept such payment as discharging in full any and all
obligations of the claimant to pay, reimburse, or compensate the provider for
medical services, supplies, or equipment, that have been reimbursed under
M.G.L. c. 258C.
(i) In making
determinations regarding claims for catastrophic injury, the Program Director
may obtain an advisory opinion of a peer review panel consisting of volunteer
experts in the medical, rehabilitative, communities or those who specialize in
working with people with disabilities.
(15) Maximum Award. The maximum award for compensation to a claimant is defined by M.G.L. c.258C.
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