Section 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(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 Eff. 6/30/73, Register 46; am 12/20/75, Register 56; am 10/29/99, Register 152; am 9/30/2009, Register 191; am 4/17/2019, Register 230, April 2019A 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