Compensation for Crime Victims in California

The Victim Compensation Program is an infallible resource for victims of violent crimes, their family, and close friends. Helping them cope with the emotional, physical, and financial aftermath of a crime, the program has helped thousands in California in 2006 alone. Victims may apply by filling out an application on the California Victim Compensation and Government Claims Board website.

Who is eligible to apply for the VCP?

A qualifying applicant must have been the victim of a crime involving the threat of personal injury, personal injury, or death. In some cases, all that needs to be shown is emotional injury—which can be more damaging and long-lasting than physical injury. Close family members of the victim who suffered—emotional, physical, or economic losses due to the crime—may also be eligible for compensation.

Eligibility:

1. When the crime occurred, the victim must have been a California resident
2. The crime occurred in California
3. The victim cooperated with the police and any court officials
4. The victim cooperated with the Victim Compensation Program staff in completing the application
5. The application was filed:
6. Within one year of the crime
7. One year after the direct victim turns 18 years of age
8. One year from when the crime was discovered

Not sure if you qualify? Call (800) 777-9229 to speak to a Victim Compensation Program representative.

In general, victims qualify if they are from at least one of the following categories:

• You were the physically injured or threatened victim—the event was the result of an act of crime or terrorism in the State of California
• You were a California resident or military personnel stationed in California who was the victim of a crime—regardless of where the crime occurred
• You are the legal dependent or eligible family member of the victim
• You are the spouse, child, parent, or sibling of the victim
• You are or were the fiancé of the victim at the time the crime was committed
• You were another family member of the victim who witnessed the crime
• You were a grandchild or grandparent of the victim at the time of the crime
• You were living with the victim at the time of the crime
• You were living with the victim previously for at least two years in a relationship such as a parent, sibling, grandparent, spouse, child, or grandchild (of the victim)
• You were a minor when you witnessed the crime (esp. in domestic violence)—or grew up in a home where domestic violence was the norm
• You assume the legal liability for the victim’s funeral, medical, or burial expenses
• You were the primary caretaker of the victim while they underwent treatment

Who is Not Eligible?

• The convicted perpetrator of the crime
• Anyone who knowingly and willingly participated in the crime
• Anyone who was involved in events leading up to the crime
• Anyone who refused to cooperate with law enforcement agencies while attempting to apprehend the criminal
• For persons convicted of a felony: they may not apply for compensation until that person in question has been discharged from probation, released from a correctional institution, and discharged from probation or parole.

What Crimes are Usually Covered by VCP?

• Assault with a deadly weapon
• Terrorism
• Battery
• Unlawful sexual intercourse (where an injury or threat of injury occurs)
• Child sexual assault
• Child abuse
• Child endangerment and/or abandonment
• Sexual battery
• Sexual assault
• Domestic violence
• Stalking
• Driving under the influence
• Vehicular manslaughter
• Hit and run
• Robbery
• Murder
• Other crimes that cause physical injury or involve a threat of physical injury

What Expenses are Eligible for Reimbursement?

The Victim Compensation Program typically reimburses expenses that were necessary due to the crime. These expenses were not already covered by insurance or health benefits. Those enrolled in the CAPS program may still apply for VCP.

Here is a list of the potentially eligible expenses:

1. Medical and dental expenses accumulated by the victim as a direct result of the accident
2. Counseling or other outpatient mental health treatment
3. Funeral expenses
4. Loss of wages for up to 5 years following the date of the crime
5. If the victim suffered permanent disability, they may be compensated for additional time of lost wages
6. The injured or deceased legal dependents may receive reimbursement for lost support
7. Parents or legal guardians of a minor victim may receive up to 30 days wage loss compensation. This only applies if the minor victim is hospitalized or dies as a direct result of the crime
8. Renovation of a home as required to outfit permanent disability resulting from the crime
9. If the crime occurred in the victim’s home, the victim may be reimbursed for the installation of home security, not to exceed $1,000
10. Under dire or exceptional circumstances, in-patient psychiatric hospitalization
11. Relocation expenses—not to exceed $2,000 per household
12. Crime scene cleanup if the victim dies as a result of the crime in their residence—not to exceed $1,000

What is not Eligible for Reimbursement under the VCP?

• Excluding medically necessary replacement of items such as assistive devices or eyeglasses, a victim may not be reimbursed for personal property
• Expenses dealing with the prosecution of the perpetrator
• Compensation for “pain and suffering”
• One may not submit expenses that were incurred three years prior—unless the victim is liable for the debt at the time the expense is submitted to the Victim Compensation Program
• The expense in question was incurred while the applicant was convicted of a felony while incarcerated, on felony probation, or parole

Are there Limits to Assistance?

There are limits to financial reimbursement of out-of-pocket bills or expenses incurred by the victim (or on behalf of the victim) or applicant that have already been reimbursed or compensated by other sources—this may include insurance.

For crimes occurring after January 1, 2001, reimbursements may total up to $70,000. Prior to this date, maximum reimbursement was $46,000.

The Board is authorized by California law to establish maximum rates and limitations for the reimbursement of medical bills and services—including mental health and counseling services. The current limits are notated below:

Medical & Dental:

Eligible medical expenses for reimbursement include:

1. Medicare rate in addition to 20% for services covered by Medicare
2. 75% of billed amount for services not covered by Medicare
3. Medicare DME rate for DME (durable medical equipment)
4. 100% for cosmetic surgery, hearing aids, prosthetics, and eyeglasses

Eligible dental expenses are reimbursed at 75% of the total amount billed to the victim or applicant. Preauthorized approval for treatment may be obtained by the dentist by visiting www.boc.ca.gov.

Mental Health:

The Board revised reimbursement rates for mental health services on March 1, 2006. Please review current and past rates at www.boca.ca.gov.

1. $130 per hour is reimbursed for individual services provided by a licensed psychiatrist
2. $110 per hour is reimbursed for individual services provided by a licensed clinical psychologist.
3. $90 per hour is reimbursed for individual services provided by a licensed clinical social worker, mental health nurse, marriage and family therapist (MFT), or clinical nurse specialist with a specialist in psychiatric mental health nursing.
4. For group therapy, 40% of the maximum individual session rate is reimbursed.
5. Family therapy is reimbursed as individual session rates listed above.

The following lists the rates for mental health session limits. For past limits or more detailed information on current limits, please visit www.boca.ca.gov.

1. In the beginning, an eligible applicant may receive up to 5 mental health counseling sessions per claim.
2. A therapist must submit a Treatment Plan (TP) in order to gain the approval of further sessions.
3. Further treatment sessions will be granted based upon the applicant’s initial session limitations—this may be an additional 15, 30, or40 mental health sessions.
4. Once the applicant has reached their limit of 15, 20, or 40 sessions, the therapist must determine whether the victim requires further treatment. If so, they must submit an Additional Treatment Plan (ATP) for review. If approved, additional sessions may be authorized.

I have Reimbursements from Other Sources. What do I Do?

The Victim Compensation Program may only reimburse those expenses not already covered by other sources or programs. These other sources include insurance, workman’s compensation, MediCal, or other benefits. According to California law, the Victim Compensation Program is the “last resort” for covering expenses after being victimized by a crime. If other reimbursement resources are available to the applicant, they must pursue those first before filing for aid with the VCP.

Other Reimbursement Sources:

1. Medical insurance (this also includes dental or vision insurance)
2. Public program benefits, including those obtained through MediCal, the Department of Rehabilitation, disability benefits, or unemployment insurance
3. Car insurance
4. Workman’s compensation
5. Court-ordered restitution
6. Recoveries from a civil lawsuit

Applicants must inform the Victim Compensation Program of all available sources of reimbursement for their particular situation. If monies are later covered by other sources, the applicant is required to pay back payments determined not eligible.

What Happens if Another Source Pays Later On?

If a third party covers any part of the victim or applicant’s total recovery expenditures, the state is entitled to recover the amount of assistance granted to the victim if that was previously covered by the Victim Compensation Program. This right is secured through a statutory lien against the recovery—Government Code Section 13963. The state of California may also recover any amount of assistance granted in the form of workman’s compensation—as stated in Government Code Section 4903(h). For more information on these rights, please review the Victim Compensation Program application or speak to a representative directly by calling (800) 777-9229.

How do I apply?

Luckily, there are many way to apply for compensation through the Victim Compensation Program:

1. You may contact your local Victim Assistance Center. For a list of locations, please visit http://vcgcb.ca.gov/vwlist
2. You may apply online at http://vcgcb.ca.gov/VCAppSF.htm
3. You may download an application from the website, print, fill it out, and mail it in.
4. Request an application via mail by calling (800) 777-9229. They can also assist you in other stages of the application process.

In some cases, victims and their families find themselves swamped with overdue bills and fees as a result of the serious injury and crime. In order to mitigate substantial hardship that may result from delaying compensation until complete and final consideration of the application, applicants may request an emergency award for reimbursement of any eligible expense—the Board will decide whether the award is necessary.

If granted, an emergency reimbursement is issued, which represents an advance pending the final award of compensation. The amount of this award depends upon the immediate needs of the victim or family. If the application is later found to be ineligible for the Victim Compensation Program, they must repay any awarded amount.

Are There Any Limitations to Filing a VCP Application?

Most limitations to filing an application with the Victim Compensation Fund deal with timing—one may file only within a certain time after the crime occurs.

An application should be filed (a) within one year of the date of the crime, (b) one year after the victim turns 18 years of age, or (c) one year from the date the applicant knew or in the exercise of ordinary diligence could have discovered that an injury or death has been sustained as a direct result of the crime. The Victim Compensation Program will recognize the latest of these possible dates for filing. Extensions may be granted under particular circumstances.

What is the Process of Application Review?

Once the application and related documentation are received by the Victim Compensation Program, the Board will determine whether the victim or applicant is eligible for their financial assistance. In addition to the application, the Board will need a copy of the crime report for reference.

Those assisting with the investigation and prosecution of the crime may be contacted, including police officers, doctors, hospital staff, psychiatrists, counselors, employers, friends, and family members. They will be used to verify crime details, losses, injuries, and expenses incurring as a result of the crime.

Once the application has been reviewed, a recommendation to approve or deny the claim is made to the Board. These recommendations are usually made within 90 days of receiving the application.

Can Applicants Appeal?

If a claim is recommended for denial, the applicant may appeal. This appeal must be filed within 45 days of the date the Board mailed the application denial notice. The denial may be considered immediately if new information is provided in a timely matter. However, in most cases, appeals are scheduled for a hearing before the Hearing Officer. At the hearing, the applicant or victim is given the opportunity to present information supporting the claim, and give further insight into the situation at hand.

If the victim or applicant still does not agree with the Board’s final decision, they may file a Petition for a Writ of Mandate in the Supreme Court.

Do Any California Laws Govern the Compensation Program?

The California law that allows crime victims to receive payments from the Restitution fund for losses not reimbursed as a result of a crime are governed by Government Code sections 13950-13969.7. The Victim Compensation Program’s primary funding source is the Restitution Fund. These monies are collected through fines and penalties imposed by judges upon persons convicted of crimes and traffic violations in the State of California.

If I still Need More Information, Where Do I Go?

For more information about the Victim Compensation Program in California, visit their website at http://vcgcb.ca.gov/vwlist or call toll-free at 800-777-9229. Email questions to info@vcgcb.ca.gov.