On December 18, 2015 President Obama signed into law the Reauthorization of the James Zadroga 9/11 Health and Compensation Act as part of the Congressional omnibus budget. The reauthorized act provides for the following changes:
- Fully funds World Trade Center Health Program until 2090
- Extends VCF filing deadline until 2020
- Prior filing deadline of October 3, 2016 is extended until December 18, 2020
- All other relevant deadlines still apply
- Increases the VCF’s total funding
- $2.775 billion becomes available immediately with an additional $4.6 billion in funding becoming available in October 2016.
- Orders VCF to issue full payment on existing loss determinations
- Separates claims into two categories: Group A and Group B
- VCF is processing full payments to Group A claimants – those with loss calculation letters dated on or before December 17, 2015.
- Puts minor limitations on future award amounts
- Limits total amount of non-economic loss that can be awarded, eliminates claims for future out-of-pocket medical expenses and caps annual income level at $250K per year
What you need to know about the new claim categories: Group A and Group B.
- Group A
- Defined as all claims that have been issued a loss determination letter (“LDL”) dated on or before December 17, 2015
- VCF is currently making full payments on Group A claims
- If you are in Group A and submitted an amendment, only the additional award based upon Amendment will fall into Group B
- If you are in Group A and submitted an appeal, the appeal will fall into Group A
- If you are in Group A and amended to add new condition, the VCF will process amendment and render an updated Eligibility decision. However, if you then seek additional compensation for the new condition, that portion of the amendment will be reviewed and processed under Group B.
- Group B
- Defined as all claims that have not been issued an LDL dated on or before December 17, 2015.
- Decision on claim will not be made until Special Master publishes updated regulations.
- Law requires Special Master to publish new rules by June 18, 2016.
- Funding is not available to pay Group B claims until all Group A payments have been made or by October 2016, whichever is earlier.
When will VCF issue full payments?
- Payments will be processed in groups based on the following general guidelines
- Claims that were already in the payment process when the new law was signed, your amendment is in Group A and the VCF expects all of these payments to be authorized by the Special Master by the end of January. The remaining 90% payment on these claims will then be made as a separate payment based on the groupings described below.
- Claims that have been designated by the Special Master as “Expedited” due to terminal illness or extreme financial hardship will be the first to receive their full payment.
- Claimants who have already received their 10% initial payment – The VCF will begin processing the remaining 90% payments on these claims working from the oldest to the most recent loss determinations.
- Claimants who have not yet received any payment on their claim are the ones who recently received their loss calculation letters, have not yet received their initial payment, and were not yet in the payment process when the new law was enacted. These claimants will receive one payment for the full amount of their loss, rather than an initial 10% payment and then a subsequent 90% payment. This will save significant time and resources that would otherwise be needed to issue two payments for these claims.
- Claimants who received a loss calculation letter that included a request for missing information that is required in order to make payment on the claim cannot be processed until the missing documents are submitted to the VCF. Once we receive and process the missing information, we will begin processing the full payment on these claims once the groupings of claimants listed above have been paid.
- Claims in the appeals process will not be paid until the appeal is completed and a post-appeal decision is issued. At that time, the payment will be processed based on the groupings described above.
- Claimants who received a supplemental payment from a 9/11-related lawsuit will not be paid until the VCF confirms the loss calculation has been properly adjusted to include the additional offset. These claimants will receive a revised loss calculation letter. Once the letter is issued, payment will be processed based on the groupings described above.
For more information please contact Pitta & Baione LLP at firstname.lastname@example.org or call 844-WTC-COMP.