The program was created in 1974. Along with New York; it has the highest overall maximum of any state in the country. Manager: Cletus Nnanabu FUNDING A fund composed of revenues generated by the state’s courts is used by the legislature to fund the compensation program and several other programs. The program receives an annual VOCA grant. ELIGIBILITY REQUIREMENTS Reporting period: 1 year from crime or within l year of time report could reasonably have been made Filing period: 2 years from report to police; 5 years with good cause Exceptions: Filing period for child victims does not start until 18th birthday. PROCEDURES Claims managers are authorized to make determinations on eligibility and benefits, and monitor treatment on ongoing basis. The bill payment section reviews bills and pays providers. Appeals: Request for reconsideration can be made within 90 days of a department decision. Claims managers review the request to determine if the original decision was correct and issue a further order. Appeals can be made with the Board of Industrial Insurance Appeals (an independent agency. Further appeals can be made to Superior Court. BENEFITS Maximum award: $150,000 for medical and mental health costs, which may be waived in special circumstances; $30,000 for nonmedical expenses; $40,000 for pension and death benefits, less other nonmedical expenses paid Compensable Costs (with limits) Medical expenses: fee schedules set limits on individual procedures and charges Mental health counseling: effective 11/1/99, 30 sessions for adults and 40 sessions for children; reports are required after 6 sessions and 15 sessions; report and pro authorization required for more than adult’s 40 sessions or child’s 30 sessions. Pro authorization required for inpatient hospitalization, concurrent treatment with more than 1 provider, electro convulsive therapy, neuropsychological evaluation, and day treatment. Lost wages/support: $15,000 for lost wages; $40,000 pension if the victim is permanently and totally disabled. Lost support of up to $40,000 if victim was employed, or $7,500 lump-sum death benefit if victim was not employed. Funerals: $5,477 Travel: to obtain treatment if not available with 10 miles of victim’s home Rehabilitation: vocational rehabilitation up to $5,000. Washington
0 comments