2 AAC 80.010 - Applications for compensation
(a) All
applications for compensation shall be made on the form authorized by the board
or by using the on-line application on the board's official website. In order
for the board to consider the claim, the claimant must supply in full the
information required by the board, including the claimant's social security
number. Additional sheets may be used, as necessary, to complete descriptions
of the injury, incident, or expenses. For minors, the mentally incompetent, or
persons unable to make applications for compensation themselves, claims may be
filed by a parent, guardian, or other individual authorized to administer the
injured person's estate.
(b) If
medical or mental health expenses are claimed, the applicant shall provide an
itemized statement from the professial provider for all medical or mental
health expenses incurred as the date of application .The applicant may satisfy
this requirement by identifying the provider and the dates of service so that
the baord may request the itemized statement from the professional provider
.The board may require the applicant submit mental health tratement notes or
progress notes in order to determine whether the treatment is necessary as the
result of the violent crime. Notes are confidental. On the basics of their
material aid to the determination of the board,the board may order additional
medical reports by an impartial medical expert concerning the previous medical
history of the claimant, the injuries sustained by the claimant, or the death
of the claimant, as well as any examinations of the claimant.
(1) For losss of income evidance of income
loss as well as the statement of disability of work excuse from the treating
medical or mental health provider;
(2) For funeral or burial expenses ,an
itemized statement for all funeral or burial expenses incurred
(3) For relocation expenses, a completed
relocation plan with estimates of expenses to be incurred or recepits for
expenses already incurred;
(4) For
Security measures, a detailed estimate of expenses to be incurred or receipts
for expenses already incurred;
(5)
For loss of support for a dependent of a homicide victim proof of prior
maintainance and verification of the victim's income;
(6) For any other type of expense,sufficiant
documentation substaining the expense incurred or that is to be
incurred
(c) Repealed
4/17/2019.
(d) Repealed
4/17/2019.
(e) In order to perform
its duties and responsibilities under AS 18.67, the board may request and
collect claimants' social security numbers for the purpose of identity
verification and payment of claims.
(f) An applicant shall provide the following
information for each category of assitance claimed
Notes
A person may obtain an application form by writing to the Violent Crimes Compensation Board at P.O. Box 111200, Juneau, AK, 99811-1200, by calling the board at (800) 764-3040, or by visiting the board's web site at http://doa.alaska.gov/vccb/pdf/application.pdf.
Authority:AS 18.67.030
AS 18.67.060
AS 45.48.470
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