Current through Register Vol. 54, No. 44, November 2, 2024
(a) A
claim may be filed by a person eligible under the act and §
411.3(a)
(relating to persons eligible for compensation).
(b) A claim shall be filed within the
prescribed time frame under section 702(b) of the act (18 P. S. §
11.702(b)).
(c) A claimant may request compensation by
completing and submitting OVS's official claim forms to OVS.
(d) A claim may be filed by mail, in person
or electronically. If filed by mail, a claim is deemed filed on the date it is
postmarked. If filed by electronic means or in person, it is deemed filed on
the date received by OVS.
(e) When
OVS receives a claim, a claim number is assigned and the data is entered into
OVS's records.
(f) In determining
whether the direct victim or intervenor complied with the act's requirement of
reporting the crime to proper authorities within the prescribed time period
after the occurrence of the crime, the following apply:
(1) Proper authorities may include a law
enforcement officer; district attorney or other applicable prosecutorial
authority; district justice; military police; campus police; United States
Postal Inspection Service; appropriate hospital security; probation and parole
officer; child protective services; adult protective services or, in the case
of a PFA order, the prothonotary or equivalent authority. If the crime occurs
in a foreign country, a proper authority includes the United States
consulate.
(2) OVS may consider a
delay past the prescribed time period to be justified when one of the following
circumstances exist:
(i) The direct victim,
intervenor or claimant is mentally or physically incapacitated.
(ii) The victim is a minor.
(iii) There is a fear of
retaliation.
(iv) The occurrence of
the crime is not readily apparent.
(v) Other circumstances when good cause is
shown by the claimant.
(g) In making the determinations discussed in
subsections (b) and (f) for claims where the occurrence of the crime is not
readily apparent, OVS may deem the prescribed time periods to begin to run on
the date and time that the person with the obligation to report the crime or
file the claim has knowledge that a crime occurred.
(h) Claimants do not have to wait until a PFA
becomes final to file a claim. In the process of verifying a claim, OVS will
confirm the disposition of a final PFA order.
(i) If a temporary PFA order is issued and
the claimant chooses not to pursue a final order, OVS will consider the PFA
order withdrawn and deny the claim unless OVS determines the withdrawal to be
justified. OVS may consider the withdrawal of a PFA justified when one of the
following circumstances exist:
(1) The direct
victim, intervenor or the claimant is mentally or physically
incapacitated.
(2) There is a fear
of retaliation.
(3) Other
circumstances when good cause is shown by the claimant.
(j) Subsections (h) and (i) only cover the
filing of an initial PFA. If there is a violation of a PFA involving an
otherwise eligible crime, the crime shall be reported within the prescribed
time frame set forth under section 707(a)(3) of the act (18 P. S. §
11.707(a)(3)) in a timely
manner to the proper authorities, which may include filing of a private
criminal complaint, to be considered for compensation payments.
(k) When requested by OVS, the claimant shall
submit copies of documents that are needed to process the particular type of
claim, which include the following:
(1)
Medical treatment expenses.
(i) Itemized bills in the name of the
claimant showing the name, address and telephone number of the provider, dates
of service, type of service performed and the amount charged for each
service.
(ii) Insurance benefit
statements indicating payments or rejection.
(iii) Canceled checks, verification from a
medical provider or receipts for any medical bills related to the injury that
were paid by the direct victim, intervenor or claimant.
(iv) Written justification if the direct
victim or intervenor is covered by an insurance plan or Medical Assistance, but
did not utilize the prescribed coverage, such as that the direct victim or
intervenor could not obtain the required care, could not maintain ongoing care
from a previous provider, travel considerations or other circumstances when
good cause is shown by the claimant.
(2)
Funeral expenses.
(i) Certified death certificate.
(ii) Itemized funeral bills in the name of
the claimant for which the claimant is responsible.
(iii) Canceled checks, receipts or
verification from a provider for funeral bills relating to the death that were
paid by claimant.
(iv) Statements
for benefits or payments received by the claimant as a result of the death of
the direct victim or intervenor, such as life insurance or Social Security
death benefits.
(3)
Loss of earnings.
(i)
Stolen money.
(A) Statements
for the month of the crime of payments such as Social Security, retirement,
pension, disability, court-ordered child support or court-ordered spousal
support.
(B) Federal tax returns as
filed, including all schedules if applicable, for the years requested or a
signed statement that the claimant is not required to file a tax
return.
(C) Documentation of the
homeowner's or renter's insurance coverage.
(ii)
Loss of wages.
(A) Pay stubs or other earnings records for
periods immediately prior to the loss. If not obtainable, withholding
statements and Federal tax returns as filed, including schedules, if
applicable, for the years requested, or a written statement that Federal tax
returns were not filed.
(B) Full
name and complete address of claimant's employer.
(C) Full name and complete address of a
physician or psychologist who will certify the existence, duration and cause of
the disability.
(4)
Loss of support.
(i) Certified death certificate.
(ii) Full name and complete address of
employer of the deceased.
(iii)
Federal tax returns as filed, including schedules, if applicable, for the years
requested, or a written statement that Federal tax returns were not filed. If
unavailable, pay stubs, withholding statements or other earnings records for
periods immediately prior to the injury.
(iv) Statements for benefits received as a
result of the death of the direct victim or intervenor, such as life insurance,
Social Security, veterans' benefits or survivor benefits.
(v) Documents that demonstrate financial
dependency, including birth certificates, support orders or Federal tax returns
as filed.
(vi) Guardianship papers,
when applicable.
(5)
Counseling expenses.
(i)
Itemized bills in the name of the claimant showing the name, address and
telephone number of the provider, dates of service and the amount
charged.
(ii) Insurance benefit
statements indicating payments or rejection.
(iii) Canceled checks, verification from a
provider or receipts for any counseling bills related to the injury that were
paid by the direct victim, intervenor or claimant.
(iv) Written justification if the direct
victim or intervenor is covered by an insurance plan or Medical Assistance, but
did not utilize the prescribed coverage, such as that the direct victim or
intervenor could not obtain the required care, could not maintain ongoing care
from a previous provider, travel considerations or other circumstances where
good cause is shown by the claimant.
(v) The following information establishing
the claimant's relationship to the direct victim, the claimant witnessing the
crime or the claimant's discovery of the homicide victim:
(A)
Witness. If the witness
is not listed in the police report obtained by OVS, a written statement
provided by someone who could substantiate that the witness was at the scene,
preferably written by someone named in the police report.
(B)
Relative of direct
victim. A copy of a birth certificate, if applicable, or other
identifiable information acknowledging the relationship to the direct
victim.
(C)
Individual
engaged to the direct victim. An engagement announcement or a copy of
the application for a marriage license. If either is unavailable, a written
statement from the engaged individual plus a written statement from a family
member acknowledging the intent of the union.
(D)
Shared household. A copy
of a document, such as a bill or lease or mortgage agreement that indicates the
same address for the direct victim and the victim or claimant filing for
counseling expenses.
(E)
Individual who discovers homicide body. A police
report.
(F)
Individual
responsible for the direct victim's welfare. Foster parent
documentation, guardianship papers or other documentation showing that the
claimant filing for counseling is an individual responsible for the direct
victim's welfare.
(6)
Crime-scene cleanup
expenses.
(i) Itemized bills and
receipts in the name of the claimant related to the crime scene cleanup for
which the claimant is responsible.
(ii) Cancelled checks, receipts or
verification from a provider for bills related to the crime scene
cleanup.
(iii) Documentation of
homeowner's or renter's insurance coverage.
(7)
Relocation expenses.
(i) Itemized bills and receipts related to
the relocation for which the claimant is responsible.
(ii) Cancelled checks, receipts or
verification from a provider for bills related to the relocation.
(iii) A verification letter from a human
service agency, law enforcement or medical provider explaining the immediate
need for relocation.
(8)
Miscellaneous expenses.
(i)
Itemized bills and receipts in the name of the claimant for which the claimant
is responsible related to the miscellaneous expense.
(ii) Cancelled checks, receipts or
verification from a provider for bills related to the injury.
(l) The claimant shall
provide OVS with information pertaining to payments received or to be received
by another source as a result of the injury, including restitution payments,
workers compensation, insurance benefits or awards or settlements in a civil
action.
(m) If a minor or
incapacitated person has more than one guardian, OVS will determine the
appropriate party for filing a claim on behalf of the minor or incapacitated
person.
(n) If the direct victim or
intervenor dies while a nonhomicide claim relating to that direct victim or
intervenor is being processed, OVS may substitute the executor or administrator
of the direct victim or intervenor and complete the processing of the claim. A
claim may not be filed by the estate of a direct victim or
intervenor.
(o) The claimant may
request a supplemental award by submitting additional out-of-pocket expenses or
losses at any time after the initial claim, provided that the claimant has not
received the maximum award payable by law. OVS will verify out-of-pocket
expenses and losses submitted for a supplemental award to determine that they
directly relate to the original crime.
