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21 FACTS you need to know

BEFORE filing an application for
Crime Victim Compensation Benefits

1.BENEFITS ARE NOT AUTOMATIC. YOU MUST
FILE A CLAIM with the Crime Victim Compensation
program. The claim must be filed on a claim form approved by
the division. Claims forms can be obtained from law
enforcement, County Attorney's, victim/witness advocates,
hospitals, et cetera, or by calling the compensation program at
1-800-498-6455 or (406) 444-3653.

The claimant/victim is responsible for all medical expenses
relating to a crime until a decision on a claim is completed. A
decision can take up to 6 months or longer. Do not delay
medical attention or wait for a decision to be made. If you
make payments on medical expenses incurred, submit copies
of your canceled checks or receipts to the Crime Victim
Compensation program for possible reimbursement should
your claim be awarded.

2.Criminally injurious conduct must be reported to a law
enforcement officer within 72 hours after the crime occurred or
good cause must be shown to extend the time limit. In cases
involving the sexual abuse of a minor, the 72-hour time limit
begins when the child tells an adult.

3.A claim must be filed with the Crime Victim Compensation
program within 1 year after the day the criminally injurious
conduct was reported to law enforcement or an agency of the
state responsible for provision of child welfare services, or
within 1 year after the day the victim reaches 18 years of age.
Extensions may be granted for good cause shown.

4.Victims need to keep the Crime Victim Compensation program
informed of any changes in address and phone numbers.
Failure to do so could result in inactivation or denial of your
claim.

5.A victim must fully cooperate with all law enforcement agencies
and prosecuting attorneys in the apprehension and prosecution
of the offender. Failure to do so could result in a reduction or
denial of benefits.

6.A victim’s actions leading up to the injuries received are taken
into consideration when reviewing a claim. Compensation may
be denied or reduced if the victim’s actions contributed to the
injuries they received.

7.Compensation shall be reduced or denied to the extent the
benefits paid can be recovered from collateral sources (i.e., the
offender, United States government, Social Security,
Medicare, Medicaid, Worker’s Compensation, wage
continuation programs, Health/Accident/Life Insurance,
managed care programs, third party).

8.WE ARE NOT AN INSURANCE COMPANY. Only
those medical expenses directly relating to the crime can be
submitted for consideration. Pre-existing conditions are not
covered and medication taken prior to a crime cannot be
considered. A victim must receive prior approval from the
compensation program before changing to another
physician or therapist or if you are referred to another
physician. Without prior approval, cost of treatment may be
denied.

9.MEDICAID AND INDIAN HEALTH SERVICES ARE
PRIMARY TO CRIME VICTIMS COMPENSATION.
If Medicaid or Indian Health Services are available, the
claimant must notify medical providers so that these agencies
can be billed. Crime victims cannot pay if a victim is covered
by these agencies. If a victim has applied for Medicaid and
Medicaid backdates coverage to the date of the crime, all bills
must be submitted to Medicaid for payment. A victim must
notify us if they have applied for Medicaid and have
been approved or denied.

10.If other sources are available to pay for medical expenses, such
as Managed Care, Health/Accident/Life Insurance, Medicare,
Champus, Social Security, Worker’s Compensation, etc., they
are primary and all bills MUST be submitted to them prior to
crime victims for payment. Send explanation of benefit sheets
(or copies) as you receive them. FAILURE TO SUBMIT
MEDICAL EXPENSES DIRECTLY RELATING TO A
CRIME TO YOUR INSURANCE COMPANY WITHIN
THE TIME FRAMES SPECIFIED IN YOUR POLICY
COULD RESULT IN DENIAL OF THOSE EXPENSES
BY THE COMPENSATION PROGRAM.

11.Individual mental health therapy for primary victims is limited to
12 consecutive months or $2,000.00, whichever limit is
reached first. Extensions must be requested by the claimant. A
peer review by another licensed professional will determine if
an extension is to be granted. Allowable charges are $76.84
per hour of therapy.

a.A mental health therapist must be one of the following:
1.medical doctor;
2.licensed clinical psychologist;
3.licensed social worker;
4.licensed professional counselor; or
5.a mental health center for services of any of the
therapists listed above.
b.In-patient psychiatric care is not covered.
c.Chemical dependency counseling is not covered.

12.Secondary mental health benefits may be awarded to the
parent, spouse, child, brother or sister of a victim who is killed
as a direct result of the crime or to the parent, brother, or sister
of a minor victim who is a victim of a sexual crime.
Stepparents, grandparents, aunts, uncles, etc., are not
authorized to receive benefits under the Act. Benefits are
limited to $2,000.00. No extensions are allowed for
secondary mental health counseling.

13.Chiropractic services are covered up to 30 days/visits unless
victim is under the care of another physician.

14.Wage loss may be considered if physical injuries prevent a
claimant from returning to work for an extended period of time.
(Must lose over 40 consecutive hours to qualify and provide a
physician's statement as to earliest date victim may return to
work.) Work lost due to emotional or stress-related conditions
is not covered nor are lost wages to care for a victim or
children.

15.Maximum funeral/burial expenses payable by the program are
$3,500.00.

16.Payment will not be made for medical/mental health expenses
for treatment obtained more than 5 years after the last date of
treatment submitted to the program for consideration.

17.There is no good cause to extend the time limit if the claim is
filed more than 5 years after the latest date the claim could
have been filed in accordance with the law.

18.If a victim receives restitution from the offender or money
through a civil suit, you MUST notify the compensation
program. This will not affect your eligibility for benefits, but you
must advise us as soon as possible.

19.Victims who have medical expenses, property loss, loss of
wages, etc., as a result of a crime, MUST contact either the
city attorney, county attorney or justice of the peace to advise
them of their losses. Ask to fill out a Victim Loss Statement
and always request restitution from the offender.

20.If you contact an attorney prior to filing an application for
compensation benefits, be sure to complete SECTION I on
the claim form. If you contact an attorney after you have filed
an application for compensation benefits, you must notify the
compensation program immediately.

21.The maximum benefit allowed by law is $25,000.00. Not
every claim will reach this maximum. A victim is not entitled to
all $25,000.00 unless approved expenses reach that limit. Only
compensable expenses directly relating to the crime are
approved for payment. In cases involving death benefits, the
primary claim and all secondary claims may not exceed
$25,000.00 in the aggregate.

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