120-RICR-00-00-2
120-RICR-00-00-2. Rules and Regulations Pertaining to the Crime Victim Compensation Program (version Technical Revision, 10/29/2013 to 03/21/2018)
2.1 Introduction
A. These Rules and Regulations
pertaining to the Crime Victim Compensation Program are promulgated
pursuant to Rhode Island General Laws (R.I. Gen. Laws) § 12-25-18(b)
and are established for the purpose of effectuating the provisions
and overall purpose of the Criminal Injuries Compensation Act of
1972, the Criminal Injuries Act of 1996, and the 1999 amendments to
the Criminal Injuries Compensation Act of 1996.
B. In accordance with the
provisions of R.I. Gen. Laws § 42-35-3(c), in the development of the
regulations, consideration was given to:
1. alternative
approaches to the regulations;
2. duplication
or overlap with other state regulations; and
3. any
significant economic impact on small business as defined in R.I. Gen.
Laws Chapter 42-35.
4. Based
on the available information, no known alternative approach,
duplication or overlap was identified. The health, safety, and
welfare of the public override any economic impact which may be
incurred from these proposed regulations.
2.2
Purpose
The General Treasurer of
Rhode Island promulgates these regulations related to financial
compensation for victims of violent crime pursuant to the authority
under R.I. Gen. Laws § 12-25-18(b).
2.3
Scope
These regulations apply to
applications for financial compensation filed under R.I. Gen. Laws §§
12-25-1 et seq.
2.4
Definitions
A. “Administrator” means
the program administrator of the 1996 Act, and the 1999 amendments to
the Criminal Injuries Compensation Act of 1996, who issues notices of
award or denial pursuant to R.I. Gen. Laws § 12-25-18. The
Administrator is charged with the duty of and granted the power to
effectuate the provisions and overall purpose of the Criminal
Injuries Compensation Act of 1972, the Criminal Injuries Act of 1996,
and the 1999 amendments to the Criminal Injuries Compensation Act of
1996 in an efficient and equitable manner.
B. “Application” means
an application for compensation under R.I. Gen. Laws §§ 12-25-1 et.
seq. on an application form provided by the office as in effect from
time to time.
C. “Applicant” means a
person who files an application for compensation under R.I. Gen. Laws
§§ 12-25-1 et. seq. An application may be filed by a person
eligible for compensation as defined in § 2.6 of this Part, or by a
parent or legal guardian of any such person.
D. “Child” means any
unmarried person who is under eighteen (18) years of age and includes
a stepchild or an adopted child.
E. “Court” means Superior
Court.
F. “Crime” means an act
committed by a person which, if committed by a mentally competent,
criminally responsible adult who has no legal exemption or defense,
would constitute a crime; provided, however, that such act involves
the application of force or violence or the threat of force or
violence by the offender upon the victim, resulting in physical or
psychological injury to the victim.
1. The word crime shall
include any of the offenses specified in R.I. Gen. Laws § 12-25-20
inclusive, any violation of any provision of R.I. Gen. Laws §§
31-27-1 through 31-27-2.2, inclusive, and any violation of R.I. Gen.
Laws § 31-27-2.6, and any conduct that would constitute a violation
of R.I. Gen. Laws § 15-15-3.
2. The
word crime shall apply to an act committed against any person within
the physical confines of Rhode Island or within the maritime
jurisdiction of the state of Rhode Island, including land subject to
federal jurisdiction.
3. The
word crime shall also apply to an act which occurs against a resident
of Rhode Island in a state which does not have a crime victim
compensation program of any kind. If a Rhode Island resident is
injured or killed outside of the state of Rhode Island, the victim
first must apply for compensation in the state, possession, territory
or district of the United States in which the offense occurred. In
the event that a Rhode Island resident is denied compensation in the
state, possession, territory or district of the United States in
which the offense occurred, he/she may apply for compensation with
the office in accordance with the provisions of the 1999 amendments
to the Criminal Injuries Compensation Act of 1996.
4. The
word crime shall also apply to an act of terrorism as defined in 18
U.S.C. § 2331 that occurs outside the State of Rhode Island to any
victim who had his or her residence in this state at the time the
offense occurred who is injured or killed by an act of terrorism
occurring either outside of the United States, as defined in 18
U.S.C. § 2331, or within the United States as referred to in 42
U.S.C. § 10603b.
5. The
word crime does not include death by suicide.
G. “Dependent” means a
person wholly or partially dependent upon the income of the victim at
the time of his or her death or would have been so dependent but for
the incapacity due to the injury from which the death resulted and
shall include a child of the victim born after the death of the
victim. The paternity of a child born after the death of the victim
must have been established by a court of competent jurisdiction and
the child’s birth registered pursuant to R.I. Gen. Laws § 23-3-10
or R.I. Gen. Laws § 23-3-15.
H. “Minor” means a person
under the age of eighteen (18) years old.
I. “Offender” means an
adult or juvenile who commits the crime for which the Applicant seeks
compensation.
J. “Office” means the
Crime Victim Compensation Program within the Office of the General
Treasurer for the State of Rhode Island, as established pursuant to
R.I. Gen. Laws §§ 12-25-1 et. seq.
K. “Pecuniary loss” means:
1. Actual,
out-of-pocket medical expenses (including psychiatric care), hospital
expenses, loss of past earnings, and loss of future earnings because
of a disability incurred as a result of personal injury to the victim
for which the victim is not compensated by any other source. In the
case of a claim for loss of future earnings by a victim, the
Applicant must demonstrate that he/she is disabled from performing
any gainful employment.
2. Funeral
and burial expenses in the case of death for which the victim’s
estate is not compensated by any other source.
3. Loss
of support to the dependents of the victim for which the dependents
are not compensated by any other source.
4. Loss
of earnings of a parent/guardian of a minor or incompetent victim as
set forth in § 2.8(A)(10) of this Part for which the parent/guardian
is not compensated by any other source.
L. “Personal injury” means
actual physical bodily harm, or mental or nervous shock, and a
pregnancy resulting from a sexual attack.
M. “Relative” means a
spouse, parent, grandparent, stepfather, stepmother, child,
grandchild, brother, sister, half-brother, half-sister, and a
spouse’s parents.
N. “Resident” means any
person who has his or her residence within the state of Rhode Island.
O. “State” means the
District of Columbia, the fifty (50) states, the Commonwealth of
Puerto Rico, and the United States’ territories and possessions.
P. “Treasurer” means the
General Treasurer of the State of Rhode Island or his or her
designee.
Q. “Victim” means a victim
is either:
1. a
person who is an involuntary participant in a criminal act or totally
unaware that he or she is a potential participant in a crime, who
suffers personal physical or psychological injury or death by any act
of a person or persons as a result of:
a. any of the offenses
specified in R.I. Gen. Laws § 12-25-20;
b. which act occurs within the
physical confines of the state of Rhode Island; or
c. which act occurs within the
maritime jurisdiction of the state of Rhode Island; or
2. a
resident of the state of Rhode Island who is a victim of an act of
terrorism as defined in 18 U.S.C. § 2331, occurring outside the
United States or within the United States as referred to in 42 U.S.C.
§ 10603b.
R. “Violent felonious
criminal conduct” means criminally injurious conduct, which, if
proven beyond a reasonable doubt, would constitute a felony under the
laws of the state of Rhode Island, any other state, or the United
States, and includes those crimes specified in R.I. Gen. Laws §
12-25-20 as follows:
1. Assault
with intent to commit murder, robbery, or rape;
2. Assault
with a dangerous weapon;
3. Assault
and battery;
4. Mayhem;
5. Indecent
assault and battery on a child under thirteen (13) years of age;
6. Arson
or statutory burning;
7. Kidnapping;
8. Robbery
or larceny from that person;
9. Murder;
10. Manslaughter;
11. First
or second degree sexual assault;
12. Child
molestation, 1st or 2nd degree;
13. Driving
under the influence of alcohol or drugs;
14. Refusal
by a driver to submit to a chemical test for alcohol or drugs in
immediate aftermath of a collision;
15. Driving
so as to endanger, resulting in death, pursuant to R.I. Gen. Laws §
31-27-1;
16. Driving
so as to endanger, resulting in personal injury, pursuant to R.I.
Gen. Laws § 31-27-1;
17. Failure
to stop by a driver in circumstances which result in the death of any
person, pursuant to R.I. Gen. Laws § 31-26-1; and
18. Any
other crime excluding motor vehicle offenses other than those
enumerated in this section, which results in personal injury of
death.
S. “1972 Act” means the
Criminal Injuries Compensation Act of 1972, established pursuant to
R.I. Gen. Laws §§ 12-25-1 through 12-25-15.
T. “1996 Act” means the
Criminal Injuries Compensation Act of 1996, and the 1999 amendments
to the Criminal Injuries Compensation Act of 1996, established
pursuant to R.I. Gen. Laws §§ 12-25-16 through 12-25-31.
2.5
Transition Rules
A. New cases filed on or after
the effective date of the 1996 Act, August 21, 1996, or on or after
the effective date of the 1999 amendments to the Criminal Injuries
Compensation Act of 1996, September 1, 1999, shall do so through the
Criminal Injuries Act of 1996, as amended, established pursuant to
R.I. Gen. Laws §§ 12-25-16 through 12-25-31.
B. All claimants with cases
filed pursuant to the 1972 Act awaiting decisions from the court
shall have the option of transferring their cases to the 1996 Act at
any time prior to receiving a decision on their case from the court
under the 1972 Act. Any request for transfer to the 1996 Act shall be
final and irrevocable. No victim shall be permitted to have claims
pending under both the 1972 and 1996 Acts for the same incident.
C. Claims shall be paid in the
chronological order in which decisions are made under either the 1972
or 1996 Acts or the 1999 amendments to the Criminal Injuries
Compensation Act of 1996. Claims filed under the 1972 Act shall be
paid according to the date the judgment is ordered by the court and
claims filed under the 1996 Act or the 1999 amendments to the
Criminal Injuries Compensation Act of 1996, shall be paid according
to the date a final decision is reached on the claim. In either case,
whether the claim for compensation was filed under the 1972 Act, the
1996 Act or the 1999 amendments to the Criminal Injuries Compensation
Act of 1996, each claim shall be paid in chronological order
according to the date of the original judgment or the date of the
original decision, notwithstanding any request for reconsideration or
appeal. The office shall stay payment on any original judgment or
original decision pending the outcome of a request for
reconsideration or appeal.
D. Those claimants who filed
claims prior to August 21, 1996, and voluntarily transfer their
claims to the 1996 Act shall abide by all the provisions of the 1996
Act, with the following exceptions:
1. They
shall be eligible for attorney fees as provided for in the 1972 Act,
pursuant to R.I. Gen. Laws § 12-25-8. The basis for determining
attorneys’ fees shall be the amount which would be awarded to the
victim under the 1996 Act. The amount of compensation for attorney
fees shall not exceed fifteen percent (15%) of the total amount
awarded to the claimant, or two thousand dollars ($2,000), whichever
is less.
2. The
requirement that the action for compensation be commenced within one
(1) year after the date of personal injury or death is extended to
three (3) years, and shall be considered satisfied as long as the
requirement was met in the original filing for compensation under the
1972 Act.
3. The
requirement that no compensation be awarded for an injury or death
resulting from a crime which was not reported to the appropriate law
enforcement authority within three (3) days of its occurrence is
extended to ten (10) days of its occurrence.
E. Those claimants with claims
currently pending under the 1972 or 1996 Acts or whose claims arose
under the 1972 or 1996 Acts but have not yet filed, may voluntarily
transfer or file their claims in the first instance under the program
established pursuant to the 1999 amendments to the Criminal Injuries
Compensation Act of 1996. Those claimants as referenced herein shall
abide by and be subject to all the provisions of the program
established pursuant to the 1999 amendments to the Criminal Injuries
Compensation Act of 1996. Any claimant transferring his/her claim
under the 1972 Act shall be required to dismiss his/her action
pending in the Superior Court and file an application for
compensation under R.I. Gen. Laws §§ 12-25-1 et. seq. on an
application form provided by the office as in effect from time to
time.
F. The Administrator shall
have the discretion to pay claims out of chronological order when:
1. the
Applicant, victim, party or entity entitled to compensation from the
fund has agreed to receive a reduced payment in return for expedited
payment; or where the Administrator finds that the Applicant has
demonstrated compelling circumstances to warrant expedited payment of
an award or a portion thereof. The Administrator shall set forth, in
writing, the reasons for expediting payment in these situations.
2.6
Persons Eligible for Compensation
A. Persons Eligible: The
following persons are eligible for compensation:
1. victims
as defined in § 2.4(Q) of this Part;
2. dependents
and relatives of a victim who dies as a direct result of violent
crime as provided in R.I. Gen. Laws § 12-25-19(b)(3);
3. parent,
spouse, minor sibling, or minor child of a victim who dies as a
direct result of a violent crime as provided in R.I. Gen. Laws §
12-25-21(2)(c);
4. legal
guardians of the victim;
5. child
advocate as provided in R.I. Gen. Laws § 42-73-9.1; and
6. legal
representatives of the victim’s estate in the case of the victim’s
death.
B. Persons Ineligible: The
following persons are ineligible for compensation:
1. Applicant
attempting to derive rights from a person who was not an eligible
victim pursuant to R.I. Gen. Laws §§ 12-25-1 et. seq.;
2. persons
injured while serving time in any federal, state, county or city
jail, prison, correctional facility or criminal institution;
3. persons
injured during the performance of their duty whose occupations
inherently entail high risk hazards. Such occupations include, but
are not limited to, police officers, correctional officers, security
guards, and firefighters.
2.7
Eligibility Requirements
A. A person eligible for
compensation must satisfy each of the following conditions:
1. Timely
Filing of Application: An application for compensation pursuant to
the 1996 Act must be filed within one (1) year after the date of the
personal injury or death of the victim if the personal injury or
death occurred prior to September 1, 1999. An application for
compensation pursuant to the 1999 amendments to the Criminal Injuries
Compensation Act of 1996 must be filed within three (3) years after
the date of the personal injury or death of the victim if the
personal injury or death occurred on or after September 1, 1999. The
filing period shall commence on the date the crime was committed,
except in the following circumstances;
a. If the victim was a minor
when the crime was committed and the crime did not result in the
death of the minor, that is, the victim suffered personal injury, the
filing period shall not commence until the victim reaches the age of
eighteen. For applications based on the personal injury of a minor
victim, the application must be filed within one year after the date
on which the minor victim reaches the age of eighteen if the personal
injury occurred between August 21, 1996 and August 31, 1999. If the
personal injury to the minor victim occurred on or after September 1,
1999, then the application must be filed within three years after the
date on which the minor victim reaches the age of eighteen. For
applications based on the death of a minor victim, the application
must be filed within one year after the date of death of the minor,
if the death occurred between August 21, 1996 and August 31, 1999, or
within three years after the date of death of the minor if the death
occurred or on or after September 1, 1999;
b. If the Applicant did not
discover the act which constitutes a crime until more than one year
after the crime was committed, the filing period shall not commence
until the Applicant discovered or, in exercise of reasonable
diligence, should have discovered, the act which constitutes a crime,
provided, however, that in such cases, the crime for which the
Applicant seeks compensation must have resulted in the issuance of a
criminal complaint, indictment or criminal information, or other
judicial determination of probable cause that an act constituting a
crime occurred;
c. office may allow an
application for compensation to be filed with the office after the
expiration of the statute of limitations if the victim was of unsound
mind or for good cause shown. Delay resulting from the lack of
knowledge of the filing requirements of R.I. Gen. Laws §§ 12-25-1,
et seq. shall not constitute good cause.
d. If more than one of the
exceptions described in § 2.7(A)(1) of this Part applies, the
application may be filed within the longest time period permitted by
§ 2.7(A)(1) of this Part.
2. Reporting
of Crime to Law Enforcement: An Applicant must demonstrate that the
crime for which he/she seeks compensation was reported to police or
other appropriate law enforcement authorities, or to an agency or
entity obligated by law to report complaints of criminal misconduct
to law enforcement authorities.
a. Appropriate law enforcement
authorities to whom a crime may be reported include: federal, state
or local police; school, college or university police.
b. Crimes involving minor
victims may be reported to the Department of Children, Youth and
Families pursuant to the reporting requirements of R.I. Gen. Laws §§
40-11-3 and 40-11-3.1. All other crimes must be reported to law
enforcement authorities specified in §§ 2.7(A)(2)(a) or (c) of this
Part.
c. The reporting of a crime to
a court through a citizen application for a restraining order under
R.I. Gen. Laws § 15-15-3 accompanied by an affidavit in support of
the application for protection, or through a citizen application for
a criminal complaint, shall constitute a report to law enforcement
authorities.
d. Reports to private security
personnel, rape crisis centers, rescue personnel, or the Crime Victim
Compensation Program do not constitute reports to law enforcement
authorities.
e. Crimes involving victims of
sexual assault may be reported to a Sexual Assault Nurse Examiner or
other medical professional for compensation related to the costs of
forensic sexual assault exams pursuant to § 2.7(A)(2) of this Part
and R.I. Gen. Laws § 12-25-22(a).
3. Timeliness
of Report to Law Enforcement Authorities: An Applicant must
demonstrate that the crime was reported within ten (10) days of its
occurrence except where the Administrator finds good cause for delay.
a. A crime is reported within
ten days of its occurrence if it is reported within ten days of when
the crime was discovered, or reasonably should have been discovered.
b. Good cause for delay shall
include, but not be limited to, delay caused by physical or
psychological incapacity which prevented the making of a report; or
by reasonable fear of retaliation by the offender or others.
c. Delay resulting from a
belief that law enforcement authorities will not investigate the
crime, or delay resulting from lack of knowledge that an award under
R.I. Gen. Laws § 12-25-1 et. seq. is contingent upon reporting the
crime to law enforcement authorities, does not constitute good cause
for delay.
d. A finding of good cause for
delay does not excuse the reporting requirement which must be
satisfied as a condition of receiving compensation.
4. Cooperation
with Law Enforcement: A victim must cooperate with the reasonable
requests of law enforcement agencies and personnel in the
investigation and prosecution of the crime.
a. Victim’s obligations:
Cooperation with law enforcement agencies and personnel includes
reporting the crime to law enforcement authorities; assisting in
identifying the suspect; and complying with all reasonable requests
of law enforcement agencies and personnel for information and
assistance. Cooperation with law enforcement shall also include
applying for the issuance of a criminal complaint in circumstances in
which police did not witness the incident and have no right of
arrest, provided that in such circumstance, police records clearly
demonstrate that the victim was advised of his right to apply for the
issuance of a criminal complaint.
2.8
Compensable Expenses
A. The following expenses are
compensable in accordance with the following requirements:
1. General
Requirements.
a. No compensation shall be
awarded in excess of twenty-five thousand dollars ($25,000) plus any
attorney fees awarded pursuant to a successful request for
reconsideration to the Treasurer or Treasurer’s designee or
pursuant to a successful appeal to the Superior Court. If two or more
Applicants are eligible for compensation arising out of a crime
committed against one victim for the same crime, their applications
shall be joined under one application for compensation and each
Applicant shall be entitled to receive compensation to the extent of
out-of-pocket loss and in proportion to the out-of-pocket loss of
every other Applicant, but in no event shall the total compensation
exceed the maximum allowable under the statute.
b. In determining the amount
of the award, the Administrator, pursuant to the authority under R.I.
Gen. Laws § 12-25-18(b) to promulgate all rules and regulations to
effectuate the provisions and overall purpose of the 1972 and 1996
Acts and the 1999 amendments to the Criminal Injuries Compensation
Act of 1996, shall take into consideration the rates and amounts
payable for injuries and death under other statues of this state and
of the United States, and the amount of revenue in the violent crimes
indemnity account and the number and nature of claims pending against
it.
c. Fund of Last Resort: The
Criminal Injuries Compensation Act is a fund of last resort. An
Applicant must demonstrate that his/her compensable losses or legal
liability exceed reimbursements or eligibility for reimbursement or
compensation from any other collateral resource including, but not
limited to, all resources and sources of payment or reimbursement
listed in § 2.11(B)(5) of this Part and R.I. Gen. Laws §
12-25-23(b). Awards for compensation shall be reduced by all amounts
reimbursed, reimbursable or otherwise compensable by any other
source. No third party which has provided any compensation to an
Applicant shall have any claims against the office or the Program or
to the funds awarded to the Applicant pursuant to R.I. Gen. Laws §
12-25-24.
d. Elderly Victims: The
Administrator will make every effort to accelerate decisions on
awards for compensation and payments on applications filed by victims
over the age of sixty (60).
e. Order of Payments:
Applications shall be paid in the chronological order in which
decisions are made.
f. Reopening: An application
for compensation may be reopened or the Administrator may issue a
supplemental award for additional medical expenses, including
psychiatric care and mental health counseling expenses, and lost
earnings, provided that the Applicant provides proper documentation
that the additional expenses have been actually and reasonably
incurred as a direct result of the personal injury. The Administrator
shall issue a supplemental award as long as the total award does not
exceed the maximum award allowable under this statute.
g. The Administrator may issue
an award for expenses related to psychiatric care and mental health
counseling for a parent, spouse, sibling or child of a victim who
dies as a direct result of a violent crime, provided that the parent,
spouse, sibling or child provides proper documentation that the
psychiatric care and mental health counseling have been actually and
reasonably incurred as a direct result of the death of the victim.
h. Property losses are not
compensable expenses.
i. No interest shall be
included in or added to an award for compensation.
2. 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 and reasonably incurred 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. The cost of repair or replacement of
eyeglasses damaged or destroyed as the direct result of a crime shall
have a maximum award amount of $200.00. Compensation shall not be
awarded on the basis of an estimate of services to be rendered.
However, where the medical provider requires pre-authorization for
payments for medical treatment, the Administrator may authorize
payment for those medical services upon a showing by the medical
provider that:
(1) the
medical services to be rendered are related to the crime for which an
application for compensation was filed with the office; and
(2) the
medical services are reasonable and necessary to correct the injury
to the victim; and
(3) the
fees and costs associated with the proposed medical services are
reasonable and in conjunction with R.I. Gen. Laws § 12-25-19(h). In
addition, compensation shall not be awarded for photocopying of
medical records or for the writing of medical reports.
b. The Applicant must
demonstrate an actual out-of-pocket loss or legal liability for
payment of compensable medical expenses, including the cost of
eyeglasses as stated in § 2.8(A)(2)(a) of this Part, which are not
reimbursed or reimbursable by any other source. In order to make this
demonstration, the Applicant must:
(1) if
the victim is covered by a private insurance provider, submit all
bills for payment to the insurance provider;
(2) exhaust
all other sources of public reimbursement including, but not limited
to, Medicaid, Medicare, workers’ compensation, social security,
veterans benefits, community free service, charity care, free care or
uncompensated care;
(3) comply
with all reasonable requests by the office to secure information and
verifications necessary to investigate the application.
c. Upon request by the office,
medical providers, including those rendering services for the
replacement of eyeglasses as stated in § 2.8(A)(2)(a) of this Part,
shall cooperate with the office in the investigation of applications
for compensation and are required to:
(1) verify
that the services rendered are medically necessary and reasonably
incurred as a direct result of the crime. Where medical services or
therapy extend beyond six months or 30 sessions (whichever is
greater), the office may, as a condition of further payment, require
current verification that the services are medically necessary and
reasonably incurred 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 or any
other public or private insurance source, including, but not limited
to, community free service, charity care, free care or uncompensated
care;
(4) in
the case of hospitals, assist the Applicant in applying for community
free service, charity care, free care or uncompensated care.
d. All medical providers,
including those rendering services for the replacement of eyeglasses
as stated in § 2.8(A)(2)(a) of this Part, must be licensed by the
Rhode Island Board of Medical Licensure and Discipline or an
equivalent state licensing authority, or must be certified by the
recognized national certification body for that profession.
e. The Administrator may
authorize an award for outstanding medical expenses payable directly
to the medical provider, but only if the provider has fully
cooperated with the office in the investigation of the claim.
Otherwise, awards shall be made payable solely to the Applicant.
f. Where compensable medical
services have been rendered, any award made payable to the medical
provider or jointly to the Applicant and the medical provider shall
be based on the current final adjustment to charge ratio approved by
the Department of Labor and Training pursuant to R.I. Gen. Laws §§
28-33-1 et seq. and applied by the Rhode Island Workers’
Compensation Unit in establishing payout ratios for inpatient
charges, emergency room charges, and ambulatory surgery charges.
Amounts for all other medical services shall be based on the current
Rhode Island Workers’ Compensation Medical Fee Schedule. If the
provider employs a sliding scale fee structure for any category of
patient service, the award shall not exceed the amount the Applicant
would be charged if he/she qualified under the provider’s sliding
scale fee structure.
g. Any medical provider that
receives payment from the Office of the General Treasurer for medical
services, supplies or equipment pursuant to an award under R.I. Gen.
Laws §§ 12-25-1 et. seq. shall, as a condition of the receipt of
such payment, accept such payment as discharging in full any and all
obligations of the victim or Applicant to pay, reimburse or
compensate the provider for medical services, supplies or equipment,
that have been reimbursed under this section. By accepting payment as
referenced herein, said medical provider shall be prohibited from
assessing any additional charges against the victim or Applicant.
h. In making determinations
regarding applications for medical expenses, the Administrator may
obtain an advisory opinion of a review panel consisting of members of
the medical community.
3. Mental
Health Counseling
a. A victim shall be eligible
for compensation for reasonable and necessary mental health
counseling and psychiatric care expenses that have been actually and
reasonably incurred as a direct result of the crime. A parent,
spouse, sibling or child of a victim who dies as a direct result of a
violent crime shall be eligible for compensation for reasonable and
necessary mental health counseling and psychiatric care expenses that
have been actually and reasonably incurred as a direct result of the
death of the victim. Compensation shall not be awarded for treatment
of unrelated conditions, or for preexisting conditions to the extent
they were exacerbated by the crime. Compensation shall not be awarded
on the basis of an estimate of services to be rendered. However,
where the mental health provider requires pre-authorization for
payments for mental health counseling or psychiatric care, the
Administrator may authorize payment for such mental health counseling
or psychiatric care upon a showing by the mental health provider
that:
(1) the
mental health counseling or psychiatric care to be rendered is
related to the crime for which an application for compensation was
filed with the office;
(2) the
mental health counseling or psychiatric care is reasonable and
necessary to correct the injury to the victim; and
(3) the
fees and costs associated with the proposed mental health counseling
or psychiatric care are reasonable and in conjunction with R.I. Gen.
Laws § 12-25-19(h).
(AA) The following maximum
rates and limitations for the payment of mental health treatment
sessions:
(i) $130
per hour is reimbursed for individual services provided by a licensed
psychiatrist;
(ii) $110
per hour is reimbursed for individual services provided by a licensed
clinical psychologist;
(iii) $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 specialty in
psychiatric mental health nursing;
(iv) For
group therapy, 40% of the maximum individual session rate is
reimbursed;
(v) Family
therapy is reimbursed as individual session rates listed above.
b. Upon request of the
Administrator, the treating mental health provider must submit a
mental health treatment plan on a form prescribed by the office. If
mental health treatment extends beyond six months or 30 sessions
(whichever is greater), the Administrator may require, as a condition
of further payment, the submission of a current, updated mental
health treatment plan by the mental health provider.
c. All mental health providers
must be registered or certified with, or licensed by, or under the
direct supervision of a person who is registered or certified with,
or licensed by either the Rhode Island Board of Medical Licensure and
Discipline, the Rhode Island Board of Registration of Social Workers,
the Rhode Island Board of Psychology, or the Rhode Island Department
of Health as a Mental Health Counselor or a Therapist in Marriage or
Family Practice, or by an equivalent state licensing authority.
d. In making determinations
regarding applications for mental health counseling or psychiatric
care, the Administrator may obtain an advisory opinion of a peer
review panel consisting of volunteer members of the mental health
provider community.
e. The office shall compensate
mental health counseling or psychiatric care expenses in accordance
with the following maximum rates and limitations as follows:
(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 specialty 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.
f. Compensation for mental
health counseling may be denied for expenses incurred in the
following instances:
(1) Missed
or canceled appointments;
(2) non-therapeutic
testimonial court appearances by a mental health provider;
(3) non-therapeutic
investigatory consultations;
(4) photocopying
and report writing; or
(5) tele-therapy
or dial-for-therapy services unconnected to any face-to-face
consultation of diagnosis.
g. The Administrator may
authorize payment directly to a mental health provider, but only if
the provider has fully cooperated with the office in the
investigation of the claim. Any mental health provider that receives
payment from the Office of the General Treasurer pursuant to an award
under R.I. Gen. Laws §§ 12-25-1 et. seq. shall, as a condition of
the receipt of such payment, accept such payment as discharging in
full any and all obligations of the victim or Applicant to pay,
reimburse or compensate the provider for services that have been
reimbursed under this section. By accepting payment as referenced
herein, said mental health provider shall be prohibited from
assessing any additional charges against the victim or Applicant.
4. Loss
of Earnings: If, at the time of the crime, the victim was employed,
he may be eligible for compensation for loss of earnings.
a. In order to be eligible for
loss of earnings, the victim must demonstrate that, as a direct
result of injuries caused by the crime, he/she is medically disabled
from working and, further, the exact number of weeks for which he/she
will be disabled from working. Upon request by the office, 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 an exact date
when the victim is able to resume working. The disability letter must
be on the letterhead of the treating physician or mental health
provider, or on a disability form prescribed by the Crime Victim
Compensation Program, and signed by the treating physician or mental
health provider.
b. An award for loss of
earnings 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, or if the
victim had received a bona fide offer of employment at the time of
the crime, the office 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 loss of earnings. Any award for loss of
earnings based on seasonal, nonsalaried, or intermittent work, or on
a bona fide offer of employment shall be based on an average net
anticipated salary for the period of employment. If the victim was
self-employed, the office may look to the victim’s earnings history
based on the victim’s financial statements or tax returns for the
three (3) years prior to the time of the crime. Any award for loss of
earnings for self-employed victims shall be based on an average net
salary for the aforementioned period of self-employment.
c. If, at the time of the
crime, the victim was not employed, the Administrator shall not make
an award for loss of earnings.
d. Upon request by the office,
the Applicant must provide:
(1) verification
from his/her employer (or, if self-employed, from his/her own income
tax records) that he/she was employed at the time of the crime; and
of the dates he/she was absent from work, his/her net weekly earnings
at the time of the crime, and any sick and/or vacation benefits used
in his/her absence;
(2) proof
of employment and earnings history for one year preceding the crime.
e. An award for loss of
earnings shall be based on the loss of reported income. Unreported
income may not form the basis of an award for loss of earnings.
f. An award for loss of
earnings 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, but not limited to,
workers’ compensation benefits, social security benefits,
disability benefits, and sick and vacation benefits.
g. Failure to provide proof of
earnings, or failure to provide proof of medical disability, may
result in denial of a claim for loss of earnings.
5. Eligibility
for Compensation for Loss of Support: Dependents of homicide victims
shall be eligible for loss of the victim’s financial support in
accordance with the following requirements:
a. In order to be eligible for
loss of financial support, an eligible Applicant must demonstrate
that, at the time of the crime, he/she was wholly or partially
dependent upon the financial support of the victim at the time of his
or her death.
(1) An
eligible Applicant shall be presumed wholly financially dependent on
the victim if he/she demonstrates that:
(AA) he/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; for purposes of a
minor child, the value of the care provided by a stay-at-home parent
with whom the child resided, shall constitute financial support; or
(BB) at the time of the crime,
the eligible Applicant was living with the victim and the victim’s
income constituted his/her primary source of financial support.
(2) An
eligible Applicant may establish that he/she was partially dependent
on the victim if he/she demonstrates that:
(AA) he/she is a minor child
of the victim who, at the time of the crime, was not living with the
victim but was receiving financial support directly from the victim;
or
(BB) at the time of the crime,
the eligible Applicant was living with the victim and dependent on
financial support received directly from the victim as shown by the
joint loan agreements, joint bank accounts or other documents
evidencing financial dependence.
6. Calculation
of Award for Loss of Support: Once the dependency of the eligible
Applicant has been established, an award for loss of support shall be
calculated based on the number of weeks for which the Applicant would
have remained financially dependent on the victim.
a. If the Applicant was wholly
dependent on the victim for financial support an award for loss of
support shall be based on the rate of $250.00 per week.
b. If the Applicant was
partially dependent on the victim for financial support, an award for
loss of support shall be based on the rate of $125.00 per week.
c. The Applicant must
demonstrate the number of weeks for which he/she would have remained
financially dependent on the victim. In making this determination,
the following limitations shall apply:
(1) if
the Applicant is a minor, the period of dependency shall continue
until the Applicant reaches the age of 18 years old, or in the case
of a full-time student, the period of dependency shall continue until
the Applicant reaches the age of 23 years old.
(2) the
period of dependency shall not exceed the life expectancy of either
the victim or the Applicant, whichever is sooner.
d. If two or more Applicants
seek compensation for loss of financial support from the same victim,
the award shall be apportioned based on each Applicant’s loss of
financial support from the victim, notwithstanding, in the case of
two or more minor children seeking compensation for loss of support
from the victim-parent, then the award shall be divided equally
between the minor children.
e. As a condition of making an
award to a minor dependent of a crime victim, the Administrator may
require that such funds be placed in a trust account for the benefit
of the minor dependent. The Administrator may also require that the
Applicant or individual entrusted with the care and custody of the
minor dependent execute and deliver to the office a trust agreement
certifying that said individual will hold the funds separate and
apart from his/her own monies, that said individual will, throughout
the period of the minor dependent’s minority, hold and safeguard
said funds for the benefit of the minor dependent, expend said funds
for the health and welfare of the minor dependent, and that upon the
minor dependent’s attainment of majority, transfer title to all
remaining funds and investments made on his/her behalf to said minor
dependent. If, at the time of the award, a permanent guardian has not
been appointed for the minor dependent, the office may defer issuance
of all or part of the award until such time as a permanent guardian
or trustee has been appointed, or until the dependent reaches the age
of 18, whichever is sooner.
7. Funeral
and Burial Expenses: An award for funeral and burial expenses shall
be based on reasonable and necessary expenses actually incurred by
the Applicant as a result of the death of the victim, less burial and
life insurance benefits and less contributions and donations received
from friends, other relatives or other sources.
a. Taking into consideration
the amount of revenue in the violent crimes indemnity account and the
number and nature of claims pending against it, the maximum award for
funeral and burial expenses shall be limited to five thousand dollars
($5,000.00).
b. Funeral and burial expenses
shall be limited to those expenses incurred at the funeral home,
including reasonable and necessary cemetery charges, and including
reasonable and necessary expenses for a headstone for the victim and
such other reasonable and necessary charges as determined by the
Administrator.
c. If the Applicant is
eligible for payment of funeral and burial expenses through the
Department of Human Services pursuant to R.I. Gen. Laws § 40-6-3.10,
this benefit must be deducted from the funeral and burial expenses
actually incurred by the Applicant.
d. The office may award
emergency compensation under the 1999 amendments to the Criminal
Injuries Compensation Act of 1996 for the burial expenses of a victim
who dies as a direct result of a violent crime. An award for
emergency compensation shall be awarded at the sole discretion of the
Administrator. An award for emergency compensation shall not exceed
the sum of five thousand dollars ($5,000.00). Any award for emergency
compensation shall be deducted from the final award. In the event the
victim is later found to be ineligible for compensation under the
provisions of R.I. Gen. Laws §§ 12-25-1 et. seq., then the victim’s
estate or the Applicant, or both, shall repay the amount of the
emergency award to the fund.
e. The office shall work with
law enforcement authorities to obtain relevant facts and
circumstances surrounding the events that led to the death of the
victim before making an emergency burial award, including, but not
limited to, reviewing police reports and records and the criminal
record, if any, of the victim. If the Administrator determines that
the victim is not eligible, then no emergency burial award will be
made.
f. The office will act as
expeditiously and thoroughly as possible to ensure that prompt
payment of an emergency burial award is made.
8. Pain
and Suffering: This § 2.8(A)(8) of this Part shall not apply to any
claims for compensation filed pursuant to the 1999 amendments to the
Criminal Injuries Compensation Act of 1996. Accordingly, any claims
involving crimes resulting in personal injury or death which occurred
on or after September 1, 1999 would not be eligible for an award for
pain and suffering. Further, any claims arising under or made
pursuant to the 1972 or 1996 Acts which are voluntarily transferred
by the Applicant into the program established pursuant to the 1999
amendments to the Criminal Injuries Compensation Act of 1996 would
not be eligible for an award for pain and suffering. The Applicant
and/or the victim, by transferring said claim, would waive all rights
to a claim of pain and suffering. As to claims filed pursuant to the
1972 Act or the 1996 Act, only a victim, the legal guardian of a
victim, or the child advocate filing an application for compensation
on behalf of a minor victim are eligible for an award for pain and
suffering. Relatives, dependents, and legal representatives of the
victim’s estate are not eligible for an award for pain and
suffering.
a. In determining the amount
of the pain and suffering award, the Administrator shall take into
consideration the rates and amounts payable for injuries and death
under other statues of this state and of the United States, and the
amount of revenue in the violent crimes indemnity account and the
number and nature of claims pending against it. The amount of the
award for pain and suffering shall be based on the amount deemed
necessary and appropriate, taking into account the particular
circumstances involved in the crime and the financial resources
available in the violent crimes indemnity fund.
b. An award for pain and
suffering shall be based on a rate of $250.00 per week for each week
of total disability and a rate of $125.00 per week for each week of
partial disability. For the purpose of determining an award for pain
and suffering, the number of weeks the victim is totally or partially
disabled shall mean that period of time during which the victim was
either:
(1) hospitalized
as an inpatient at an acute care hospital, non-acute rehabilitation
hospital, nursing home facility, or psychiatric hospital; or
(2) treated
on an ongoing basis by a physician or mental health provider for
injuries incurred as a direct result of the crime; or
(3) unable
to resume employment due to the injuries incurred as a direct result
of the crime.
c. The victim must submit a
disability letter from a treating physician or mental health provider
specifically describing the victim’s disability, the exact number
of weeks the victim received treatment from the physician or mental
health provider, and the exact number of weeks the victim was totally
disabled and/or partially disabled.
9. Attorney
Fees: For any cases currently pending under the 1972 Act, upon a
judgment in favor of the plaintiff, the amount of compensation
awarded to a plaintiff’s attorney shall not exceed fifteen percent
(15%) of the total amount awarded to the plaintiff, or two thousand
dollars ($2,000.00), whichever is less, provided, however, that in
unusual circumstances, the court may award a larger attorney’s fee
if it finds that a departure from the limits set forth herein is
warranted, stating specific reasons upon which the finding and award
is based. For cases filed pursuant to the 1996 Act or the 1999
amendments to the Criminal Injuries Compensation Act of 1996,
attorney fees shall only be awarded upon a successful request for
reconsideration of the Administrator’s decision to the Treasurer or
the Treasurer’s designee or upon a successful appeal of the
Treasurer or the Treasurer’s designee’s decision to the Superior
Court. Any attorney who charges, demands, receives or collects for
services rendered in connection with any proceeding under the 1996
Act or the 1999 amendments to the Criminal Injuries Compensation Act
of 1996, any amount in excess of that allowed under this section, if
any compensation is paid, shall be subject to disciplinary action and
other appropriate action to be taken by the Supreme Court of the
state of Rhode Island.
a. In order to be eligible for
an attorney fee award, the following conditions must apply:
(1) the
attorney must fully cooperate with the office in the investigation of
the application, including fully and promptly responding to all
requests for information and verification; and
(2) the
attorney must submit an affidavit which sets forth the hours worked,
the services rendered, and the amount of fee proposed to be charged
for representing the Applicant during the proceedings.
b. In determining the amount
of an attorney fee award, the Treasurer or the Treasurer’s designee
shall make a determination, based on the attorney affidavit and a
review of the file, of a reasonable amount of time in preparation, in
settlement negotiations, and in hearing attendance, the total amount
awarded to the Applicant for injuries incurred, and the amount of
revenue in the violent fines indemnity account, together with the
number and nature of the claims pending against it.
c. In no event shall an
attorney fee award exceed 15% of the total award for compensation, or
fifteen hundred dollars ($1,500.00), whichever is less, provided,
however, that in unusual circumstances, the Treasurer or court may
award a larger attorney’s fee if it finds that a departure from the
limits set forth in this subsection is warranted, stating specific
reasons upon which the finding and award is based.
d. Attorney fees shall not be
awarded in those cases brought by The Office of the Child Advocate.
10. Loss
of earnings for parent/guardian of minor or incompetent crime victim:
In order for the parent/guardian of a minor or incompetent crime
victim to be eligible for loss of earnings, the parent/guardian must
demonstrate that he/she was absent from work as a direct result of
circumstances attributed to the crime due to required medical
treatment for the victim, required mental health treatment for the
victim, required court appearances for the victim or required
meetings for the victim with law enforcement in the preparation and
prosecution of the criminal case. Proof will be required of the
following:
a. documentation of the
reason(s) the parent/guardian was absent from work due to caregiver
responsibilities which are a direct result of the crime, as set forth
above; documentation of each absence shall be required as to the
date, time, place and purpose which resulted in the parent/guardian’s
absence from work.
b. documentation by the
employer of the parent/guardian as to the absence from work.
c. calculation of loss of
earnings shall be as follows:
(1) An
award for loss of earnings shall be based on the parent/guardian’s
actual earnings.
(2) If
the parent/guardian was performing salaried employment the award
shall be based on the parent/guardian’s salary at the time of the
absence from work.
(3) If
the parent/guardian was performing seasonal, nonsalaried or
intermittent work at the time of the crime, the office may look to
the parent/guardian’s earnings history and the value of the
parent/guardian’s contractual work obligations in order to
determine the parent/guardian’s loss of earnings. Any award for
loss of earnings based on seasonal, nonsalaried, or intermittent work
shall be based on any average net anticipated earnings for the period
of employment. If the parent/guardian was self-employed, the office
may look to the parent/guardian’s earnings history based on the
parent/guardian’s financial statements or tax returns for the three
(3) years prior to the absence from work. Any award for loss of
earnings for self-employed parent/guardian shall be based on an
average net salary for the aforementioned period of self-employment.
(4) Upon
request by the office, the parent/guardian must provide verification
from his/her employer (or if self-employed, from his/her own income
tax records) that he/she was gainfully employed at the time of the
required absence; and of the dates he/she was required to be absent
from work, his/her net weekly earnings at the time of the required
absence from work, and any sick, vacation or personal time benefits
available during his/her absence. An award for loss of earnings shall
be based on the loss of reported income. Unreported income may not
form the basis of an award for loss of earnings. An award for loss of
earnings 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, but not limited to,
workers’ compensation benefits, social security benefits,
disability benefits, and sick, vacation or personal time benefits.
11. Crime
scene clean-up reimbursement: Crime scene clean-up refers to the
professional bio-hazard clean-up, disinfecting, and removal or
attempted removal of items contaminated by blood or other bodily
fluids, dirt stains or other debris caused by the crime for which
victim or Applicant is seeking compensation. This may include the
removal or attempted removal of stains, odors and broken glass to the
premises and/or property where the crime occurred.
a. An award for crime scene
clean-up shall not exceed the sum of $2,000. Any award for
crime-scene clean-up shall be deducted from the final award. The
costs must be an actual loss incurred.
b. An award for crime scene
clean-up shall be limited to expenses for cleaning and disinfecting,
and shall exclude any repair costs or costs for replacement of
property which is destroyed or damaged. For example, the cost of
painting, replacing doors, windows, or carpet shall not be
reimbursed.
c. The Administrator may deny
an award for crime scene clean-up for lack of verification showing
the need for the clean-up and detailing the expenses. Crime scene
clean-up expenses may be verified by the applicable law enforcement
report or by other detailed descriptions of the clean-up expenses.
d. An award for crime scene
clean-up shall be limited to expenses which are the responsibility of
the victim or Applicant.
12. Emergency
relocation expenses: The Administrator may issue an award for
expenses resulting from the temporary or permanent relocation of a
victim, or the temporary or permanent relocation of a relative,
domestic partner or dependent of a homicide victim provided that such
relative, domestic partner or dependent was living in the same
household where the homicide occurred. Compensation awarded for
emergency relocation expenses shall not exceed the sum of $2,500. Any
award for emergency relocation expenses shall be deducted from the
final award.
a. In order to qualify for
compensation of relocation expenses, the following conditions must be
met:
(1) The
crime must have occurred in the victim’s primary place of residence
or the Applicant must demonstrate that, as a result of the crime, he
or she reasonably fears for his or her continued safety in his or her
primary place of residence.
(2) An
Applicant must have an immediate need to relocate, a reasonable fear
to continue to live within the arrangements as established prior to
the crime, or, alternatively, immediately following the crime, the
Applicant must be unable to afford the documented housing costs.
b. If the crime did not occur
in the victim's primary residence, the Administrator may require that
the Applicant provide documentation demonstrating that, as a result
of the crime, he or she possesses a reasonable fear of living in his
or her primary residence. The victim’s need for relocation may be
certified by a domestic violence agency, rape crisis center, treating
mental health provider or any other certified victim's advocate
agency.
c. All relocation expenses
must be incurred by the victim, relative, domestic partner or
dependent of a homicide victim as a direct result of the crime. The
expenses must be reasonable and necessary.
d. Types of expenses:
(1) Temporary
housing expenses: Temporary housing expenses are limited to $100 per
night, for not more than 10 nights.
(2) Start-up
expenses: Start-up expenses may include deposits for gas, oil and/or
electric utility connection. Start-up costs are not to exceed $300.
(3) Moving
expenses: Moving expenses may include rental trucks, moving
companies, and storage fees not to exceed three months. Total moving
expenses are not to exceed $1,000.
(4) Housing-related
expenses: Housing related expenses may include, but are not limited
to, mortgage, rent, or other housing costs. The Administrator will
have discretion to determine what is considered “reasonable rent”
based on the area of relocation.
(5) One-way
transportation expenses: One-way transportation expenses to relocate
to another permanent location, state, or jurisdiction.
Transportation costs may include: plane; train; auto rental; or bus
fare. One-way transportation costs are not to exceed $500 per
person. CVCP shall not be liable for any ancillary costs incurred
including but not limited to accidents or stolen vehicles.
(6) In
no event shall the sum of the compensation awarded to an Applicant
for relocation expenses exceed the aggregate amount of $2,500. Prior
to any reimbursement, substantiating documents must be presented to
CVCP.
2.9 Limitations
on Compensation
A. Violent Felonious Criminal
Conduct: If the victim has pled nolo contendere or been convicted of
violent felonious criminal conduct, committed within the past five
(5) years or subsequent to his or her injury, the Administrator may
reduce or deny an award to the Applicant or Applicants.
B. If the victim has pled nolo
contendere or been convicted of a crime listed in § 2.9(A) of this
Part above, the Administrator may reduce or deny an award to the
Applicant or Applicants. In determining whether to reduce or deny an
award, the Administrator may consider the following factors:
1. The
remoteness in time between the prior conviction and the application
for benefits;
2. The
nature and seriousness of the crime which led to the conviction;
3. The
extent and gravity of the injury to the claimant’s victim(s) in the
crime which led to the conviction;
4. The
victim’s disdain for the law as represented by the extent of the
victim’s prior criminal record; and
5. The
victim’s remorse and rehabilitation since the conviction, such as,
the efforts made by the victim to provide restitution for the crime
committed which led to the conviction or efforts made by the victim
to reimburse the office for payments made to any person or entity in
connection with the convictions.
C. Any individual who is
incarcerated at any criminal institutional facility at the time of
his or her injury shall not be eligible to receive an award of
compensation.
D. Contribution: To the extent
the victim’s acts or conduct provoked or contributed to the
victim’s injuries, the Administrator shall reduce or deny the award
to the Applicant or Applicants.
1. Definition
of contributory conduct: Contributory conduct is intentional conduct,
willingly and knowingly engaged in by the victim that is both a
direct cause, and a proximate cause, of the victim’s injuries.
2. Circumstances
that, in general, do not warrant the denial or reduction of an award
based on contributory conduct include:
a. acts of self-defense or
defense of others;
b. acts attributable to
reasonable efforts by the victim to aid a crime victim, to prevent a
crime from occurring in his/her presence, or to apprehend a person
who has committed a crime in his/her presence.
3. Circumstances
that may warrant a reduction or denial of an award based on
contributory conduct include:
a. crimes in which the victim
deliberately provoked the offender by means of fighting words, racial
or other bias-motivated taunting, or by threats coupled with overt
actions indicating the victim’s intent to carry out the threat;
b. crimes in which the victim
initiated or significantly escalated a physical altercation with the
offender;
c. crimes in which the victim
could have anticipated the conflict and retreated, but decided not to
retreat;
d. crimes constituting acts of
retaliation or retribution for a crime or crimes previously committed
by the victim;
e. crimes in which the victim
acted as an accomplice to the offender;
f. crimes committed during the
course of an illegal act in which the victim was a knowing and
willing participant;
g. crimes in which the
victim’s felony criminal record, coupled with the circumstances of
the crime, lead to the reasonable inference that the crime for which
the Applicant seeks compensation was directly caused or provoked by
the victim’s criminal history.
4. If
the Administrator finds that a victim knowingly and willingly engaged
in intentional conduct that was a direct cause of his/her injuries,
the Administrator shall determine the proximate cause of the victim’s
injuries and may deny, reduce or allow the award as follows:
a. if it was reasonably
foreseeable that the victim’s contributory actions would result in
injuries of the type and nature he/she sustained, the application
shall be denied (e.g. an implicit or explicit agreement to fight, in
which a physical altercation ensued resulting in mutual injuries).
b. if it was reasonably
foreseeable that the victim’s contributory conduct would result in
injuries to the victim, but it was not reasonably foreseeable that
his/her actions would result in injuries of the type and nature
sustained by the victim, the award may be reduced by 50% percent
(e.g. victim was stabbed or shot in response to punching the
offender).
c. if the victim’s injuries
were not reasonably foreseeable, the award shall not be reduced or
denied even though the victim’s actions were an actual and direct
cause of his injuries (e.g. victim was stabbed or shot in response to
verbal provocation of the offender).
E. Unjust Enrichment:
1. An
Applicant shall not be eligible for compensation if such compensation
would directly or indirectly unjustly benefit the offender.
2. In
no event shall an Applicant be denied compensation solely because of
the Applicant’s or the victim’s familial relationship with the
offender or because of the sharing of a residency by the victim or
Applicant and the offender.
2.10
Appeals
A. Request for
Reconsideration:
1. Within
fifteen (15) days of the date of receipt of the notice of an award or
denial, the Applicant may submit a request for reconsideration of the
Administrator’s decision. The request for reconsideration must be
in writing, accompanied by any further documentation supporting the
application and the request for reconsideration.
2. In
addition, the Administrator, in his or her own discretion, may
reconsider a decision awarding or denying compensation where there
has been no request for reconsideration. The Administrator shall then
issue an amended notice of award or denial.
3. Within
thirty (30) days of the receipt of the request for reconsideration
and the supporting documentation, the Treasurer or the Treasurer’s
designee shall reconsider any award or denial and, based on the
additional supporting documentation submitted by the Applicant, shall
either affirm the award or denial, or issue an amended award or
denial or remand the matter to the Administrator for further review.
The Applicant shall be notified of the decision upon reconsideration
by certified mail, return receipt requested, and by first class mail.
The decision of reconsideration shall be accompanied by information
informing the Applicant of the right to judicial review of the
decision upon reconsideration.
4. Any
request for reconsideration that involves a medical expense, mental
health counseling or psychiatric care expense, or funeral and burial
expense not previously submitted with the original application shall
be treated as a reopening of the application for compensation. The
Administrator shall investigate the request for reopening and issue a
supplemental award, if appropriate.
5. If
no request for reconsideration is filed within the time period
specified in R.I. Gen. Laws § 12-25-18(f), the decision of the
Administrator shall be final.
B. Appeals:
1. Within
thirty (30) days of the Treasurer’s or Treasurer’s designee’s
decision upon reconsideration, the Applicant may petition the
Superior Court for judicial review pursuant to the Administrative
Procedures Act, R.I. Gen. Laws § 42-35-15 and pursuant to R.I. Gen.
Laws § 12-25-18(h).
2.11
Obligations of the Applicant
A. Applicant’s Obligations:
An Applicant shall have the following obligations with respect to an
application for compensation:
1. The
application must be made on an application form provided by the
office;
2. The
application must be signed by the Applicant under the pains and
penalties of perjury;
3. The
application must be accompanied by copies of bills and other
supporting documentation necessary to verify the application; and
4. The
application must contain a release of information necessary to
investigate the application.
B. Continuing Obligations: An
Applicant shall have a continuing obligation to:
1. provide
the office with current information relating to the application;
2. cooperate
with the office in the investigation of the application including
responding promptly to all requests for further information and
verifications, and responding promptly to all requests to exhaust
other sources of reimbursement;
3. notify
the office of any change in address;
4. provide
information to the office about any civil action anticipated or filed
in connection with the crime;
5. exhaust
all other sources of payment or reimbursement for compensable
expenses, and promptly notify the office of any order for payment or
eligibility for payment received or to be received by the victim or
by any of his or her dependents and relatives from any other source,
including, but not limited to:
a. life insurance, health
insurance, disability insurance or any other private or public
insurance program for personal injury or death, including lost wages;
b. workers’ compensation,
social security benefits, veterans benefits, retirement benefits or
other private or public benefit program from the United States, the
state of Rhode Island or any state or any of its subdivisions;
c. Medicaid, Medicare,
community free service, charity care, free care or uncompensated
care, or any other form of public assistance to the aged and disabled
or any successor;
d. restitution in the criminal
action received from the offender or from any person on behalf of the
offender;
e. proceeds from a civil suit;
or
f. institutional gifts,
charitable gifts, contributions, or donations.
6. In
the event that an award has been issued and payment has been made by
the office, the Applicant and/or victim shall promptly reimburse the
violent crimes indemnity fund, to the extent of compensation actually
paid, for payments received from any other source that exceed the
total compensable injuries suffered by the victim as determined by
the Administrator.
7. In
the event that an award has been issued but payment has not been made
by the office, the office shall be entitled to withhold payment to
the Applicant and/or victim when said Applicant and/or victim has
received payments from or settled any matter with any other source as
mentioned herein that exceeds the total compensable injuries suffered
by the victim as determined by the Administrator.
C. Burden of Proof: The
Applicant has the burden of demonstrating his/her eligibility for
compensation, and his/her compensable expenses, by a preponderance of
the evidence. The Applicant must provide written documentation to
establish the facts supporting his/her application for compensation.
Such documentation shall include, where appropriate, all expenses,
lost wage verifications, W-2 forms, tax returns, death and birth
certificates, and the incident report from the appropriate law
enforcement authorities.
D. Failure to Comply: An
Applicant’s failure to comply with any obligation set forth in §
2.11 of this Part may result in denial of the application for
compensation.
E. Fraudulent Application: Any
person who submits a false or fraudulent application; intentionally
makes or causes to be made any false statement or representation of a
material fact in relation to any application pending before the
office; or intentionally conceals or fails to disclose information
affecting the amount or the initial or continued right to any such
award shall be punished by a fine or not more than one thousand
dollars ($1,000) or imprisonment for not more than six (6) months, or
both.
2.12
Recovery from Offender
A. Whenever any person is
convicted of an offense and compensation is awarded for a personal
injury or death resulting from the act constituting the offense, the
state of Rhode Island shall institute an action against that person
for the recovery of the whole or any specified part of the
compensation in the Superior Court of the state of Rhode Island in
any county, or in the state or federal court of any other state or
district in which that person resides or is found.
B. The Administrator shall
pursue such recovery whenever possible in order to provide additional
funds for the violent crimes indemnity account. If such action is
impractical or impossible, the Administrator shall make a finding in
writing stating the reasons why such action is not instituted.
C. When a court orders a
defendant to make financial restitution to the victim of a crime to
whom compensation has been awarded pursuant to R.I. Gen. Laws §§
12-25-1 et seq., the state of Rhode Island may enforce the civil
judgment entered by the trial court against the defendant on behalf
of the victim pursuant to R.I. Gen. Laws § 12-28-5.1.
D. An action instituted by the
state of Rhode Island against any person for the recovery of the
whole or any specified part of the compensation awarded as mentioned
herein must be commenced within ten (10) years from the date
compensation is awarded by the office.
E. Notwithstanding the
provisions of § 2.9 of this Part, in the event that an offender
files an application for compensation with the office, the
Administrator shall have the authority to reduce any amount of
compensation awarded to the offender by any sum awarded to the victim
of the offender.
2.13
Confidentiality of Records
All medical records, mental
health counseling records, psychiatric records, employment
information, personal financial information and investigative records
received, obtained or maintained by the office in connection with any
application for compensation shall be maintained as confidential
investigative material, and shall not be released or disclosed to any
person or entity whatsoever, except as authorized by the Applicant or
as otherwise provided by law. The application and the notice of award
or denial shall be deemed public records, unless otherwise provided
by law.