EFTA00038436.pdf

Type: pdf
Source set: data-set-8
Extracted text

2 _ , A4EW 
YORK 
 
 STATE Office of 
Victim Services 
Claim Application and 
Instructions 
How to Apply for Compensation 
Who can apply for compensation? 
Innocent victims of crime, certain relatives, dependents, 
legal guardians and eligible Good Samaritans can apply 
to the Office of Victim Services (OVS) for compensation 
of out-of-pocket expenses not covered by insurance or 
other resources. 
What kind of expenses can I get compensated 
for? 
OVS offers compensation related to personal injury, 
death and loss of essential personal property. 
The specific expenses OVS may cover include: 
• 
Medical, pharmacy and counseling expenses 
• 
Loss of Essential Personal Property (up to $500, 
including $100 for cash) 
• 
Burial or Funeral Expenses (up to $6,000) 
• 
Lost Wages or Lost Support (up to $30,000) 
(Parents or guardians of hospitalized minor children 
may be eligible for this benefit.) 
• 
Transportation (court/medical) 
• 
Occupational/Vocational Rehabilitation 
• 
Security Devices and DV Shelter Costs 
• 
Crime scene clean-up (up to $2,500) 
• 
Good Samaritan property losses (up to $5,000) 
• 
Moving expenses (up to $2,500) 
How do I ask for compensation? 
Send us your completed OVS application along with 
copies of: 
• 
Police reports 
• 
Medical bills 
• 
Correspondence with insurance companies 
or benefits plan saying if they will cover your loss 
• 
Insurance cards 
• 
Receipts for essential personal property 
• 
Death certificate and funeral contract 
• 
Victim's birth certificate 
• 
Proof of age (driver's license, birth certificate etc.) 
• 
Legal guardianship papers 
What if I don't have some of the papers OVS 
needs? 
Send your application in right away. You can send the 
other documents later. 
What if my property was lost, damaged or 
destroyed because of the crime? 
If you are under 18, 60 or over, disabled or were injured, 
you may apply for benefits to replace your essential 
personal property or cash that was not covered by any 
other resourc…
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